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Severe Foot Pain: Is It Plantar Fasciitis?

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Barbara K. Hecht, PhD

Plantar fasciitis is a relatively common cause of severe foot pain. It may affect anyone but especially strikes runners and other physically active people. The pain results from inflammation of the plantar fascia, a thick band of tissue that stretches from the heel to the front of the foot and supports the arch of the foot.

The plantar fascia becomes less resilient with age and may be damaged by frequent or intense physical activity. Vigorous participation in sports such as running, tennis, and aerobics (dance, step, etc.) that puts particular stress on the foot is the most common cause of damage to the plantar fascia. It may sometimes plague tourists who are doing a lot of sightseeing on foot in shoes without adequate support.

Plantar fasciitis can also result from a bony spur projecting from the underside of the heel that makes walking painful. Spurs under the sole (plantar area) typically cause localized tenderness and pain that is made worse by stepping down on the heel.

People with plantar fasciitis describe a sharp, stabbing pain in the heel that is most pronounced first thing in the morning after arising from bed. The pain may decrease as the day goes on. But with prolonged standing or walking, the pain can become dull and aching. Sometimes the pain is described as a burning sensation along the sole of the foot, and standing on tiptoes can be painful.

If your doctor suspects that you have plantar fasciitis, he or she will ask you questions about your foot pain and may order X-rays of your foot to rule out other causes of the pain.

The pain of plantar fasciitis may be reduced by medications such as acetaminophen or ibuprofen. The frequent application of ice packs to the foot can reduce pain and inflammation. Corticosteroid drugs may also be given to decrease the inflammation.

The use of an arch support, a donut-shaped cushion or another orthotic insert in the shoe can help distribute pressure on the foot. Specially fitted splints may also be worn at night. Exercises that strengthen the leg muscles and stretch the plantar fascia are also recommended for both symptom relief and prevention of further injury. In rare cases, surgical incision of the tightened, inflamed fascia may be indicated.

You can take steps to decrease your chances of developing plantar fasciitis. If you are physically active, always wear well-fitting shoes and avoid sudden drastic increases in exercise intensity. Stretching exercises can help maintain the stability of the plantar fascia and reduce the chances of injury. Maintaining a normal body weight is another way to avoid undue stress and damage to the plantar fascia.


Last Editorial Review: 8/19/2009




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