By Gilda Morales, ANP, DC
Plantar fasciitis is a common and painful condition of the sole and heel of the foot that is worse in the morning or after sitting for long periods of time. In a lucky few, this condition will resolve itself within a year, but it is not unusual for the pain to continue chronically or with intermittent episodes.
There are certain risk factors that predispose people to this condition. People who are overweight, female, between the ages of 40 to 60, and have a history of being runners, joggers, or have jobs that require them to be on their feet for long periods of time, are more prone to get plantar fasciitis.
Biomechanically, the problem usually stems from tightness in the Achilles tendon, calf and hamstring and can produce limited range of motion in flexion of the ankle. Heel spurs are sometimes present, but are not necessary to make the diagnosis.
There are several ways that people can prevent developing plantar fasciitis, from maintaining a normal body weight to avoid prolonged standing on bare feet, sandals or slippers. Runners should replace their shoes every 250 to 500 miles and avoid overtraining.
Treatment is usually conservative and geared toward nonsurgical methods. Patients should avoid wearing sandals or walking barefoot. Stretching of the plantar fascia is extremely effective when combined with the wearing of a night splint that keeps the foot stretched. There are other simple exercises that help strengthen the calf muscles and help with the pain, including using the toes to pick up a towel on the floor.
If the pain is severe, over the counter medications that can help with pain and inflammation are Naproxen 500 mg twice daily or Ibuprofen, 600 to 800 mg twice daily as needed for pain. Ice and massage can also provide relief, but surgery should be avoided at all costs. Cortisone injections have shown to provide some relief, but are painful with possible adverse effects from steroid use.