What is plantar fasciitis?

The plantar fascia is a piece of strong and thick tissue that runs along the bottom of the foot. It connects the heel bone to the toes, creating the foot's arch.

Plantar fasciitis is inflammation of the plantar fascia, either through overstretching, overuse or a medical condition.

It can be caused by:

• Playing sports that put stress on the heel bone, like running, dance and aerobics.
• Flat-footed or high arches.
• Being middle-aged or older.
• Being overweight.
• Pregnancy.
• Spending a lot of time on your feet.
• Wearing shoes with poor arch support or stiff soles.

Plantar fasciitis is often associated with a heel spur which is a spike of bone poking out from the heel bone, but many people have heel spurs without any pain.

Symptoms

The main symptom of plantar fasciitis is pain under the heel, which can be dull or sharp. The foot sole may ache or burn and your heel may be slightly swollen.

The pain is often worse:

• in the morning, as you take your first steps
• after prolonged standing or sitting
• after intense activity.

Diagnosis

To check whether you have plantar fasciitis, your doctor will probably ask you some questions, for example, about your symptoms, the type of work you do and your lifestyle.

Also, it's likely they'll perform a physical exam to check the arches of your feet and to see whether there is any redness, swelling, tenderness, stiffness or tightness.

An X-ray or ultrasound scan is sometimes needed to rule out other possible causes of heel pain.

Treatment

Initially, your doctor may recommend one or more of the following treatments:

• Under the direction of your medical professional and in conjunction with your advised treatment plan, these bracesare recommended.
• pain-relief medicine, such as ibuprofen paracetamol
• Physiotherapy with specific stretching exercises
• resting your foot as much as possible
• shoes with good support and cushioning
• night splints to wear while sleeping
• heel pads and arch supports in your shoes (orthotics)
• an ice pack applied to your foot for 10 - 20 minutes up to four times daily.

If these measures don't work, your doctor may give you steroid injections in your heel. Very occasionally, people have surgery to try to fix it.