Plantar fasciitis (PLAN-tur fas-e-I-tis) involves pain and inflammation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot and connects your heel bone to your toes. Plantar fasciitis is one of the most common causes of heel pain.

Plantar fasciitis commonly causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position.

Plantar fasciitis is particularly common in runners. In addition, people who are overweight, women who are pregnant and those who wear shoes with inadequate support are at risk of plantar fasciitis.

Symptoms

In most cases, the pain associated with plantar fasciitis:

1) Develops gradually

2) Affects just one foot, although it can occur in both feet at the same time

3) Is triggered by, and is worst with, the first few steps after awakening, although it can also be triggered by long periods of standing or getting up from a seated position

4) Feels like a stab in the heel of your foot

Causes

Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. If tension on that bowstring becomes too great, it can create small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed.

Western Medicine Treatment

About 90 percent of the people who have plantar fasciitis recover with conservative treatments in just a few months.

Medications

Medications to ease symptoms of plantar fasciitis may include:

1) Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve), may ease pain and inflammation, although they will not treat the underlying problem.
2) Corticosteroids. This type of medication may be delivered through a process called iontophoresis, in which a corticosteroid solution is applied to the skin over the painful area and the medication is absorbed with the aid of a nonpainful electric current. Another delivery method is injection. Multiple injections are not recommended because they can weaken your plantar fascia and possibly cause it to rupture, as well as shrink the fat pad covering your heel bone.

Ultrasound guidance is sometimes used for more accurate placement of the corticosteroid injection.

3) Therapies. Stretching and strengthening exercises or use of specialized devices may provide symptom relief. These include:

A) Physical therapy. A physical therapist can instruct you in a series of exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles, which stabilize your ankle and heel. A therapist may also teach you to apply athletic taping to support the bottom of your foot.

B) Night splints. Your physical therapist or doctor may recommend wearing a splint that stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight and facilitates stretching.

C) Orthotics. Your doctor may prescribe off-the-shelf or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly.

Surgical or other procedures

When more-conservative measures aren't working, your doctor might recommend:

1) Extracorporeal shock wave therapy. In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It is usually used for chronic plantar fasciitis that has not responded to more-conservative treatments. This procedure may cause bruises, swelling, pain, numbness or tingling, and has not been shown to be consistently effective.

2) Surgery. Few people need surgery to detach the plantar fascia from the heel bone. It is generally an option only when the pain is severe and all else fails. Side effects include a weakening of the arch in your foot.

Adopted from mayoclinic.com