Relentless foot pain?


The plantar fascia is a band-like ligament that stretches from the toes to the heel. It is quite a robust ligament and bears lots of stress. However, it helps maintain the shape and tension in the foot arch and thus plays an important role in gait stability.

However, it may become weak in certain people due to metabolic issues, disease, sedentary lifestyle, excessive stress, and more. Its weakness is both due to internal and external factors. Internal factors are things like metabolic disorders, obesity, or aging, causing a slowdown in metabolism. External factors could be like walking or standing too much.

If this fascia becomes inflamed or starts regenerating, it causes severe pain in the heel, especially when walking or standing. The pain may be dull or even sharp and stabbing. It is quite a debilitating condition as it tends to be chronic.

A person may feel harsh pain when walking on hard surfaces in this condition. Fortunately, the condition is not life-threatening but is debilitating and tends to be chronic. In addition, the plantar fascia is slow to heal because fascia, ligaments, and tendons have a relatively poor blood supply.

The condition is not very common, but neither rare. Studies show that about 1% of the population is affected by it. However, its prevalence may be higher in older adults and females.

What causes plantar fasciitis?

It results from too much pressure on the fascia, its weakness, degeneration, inflammation, overstretching, and tears. This may occur for many reasons like some anatomical issues (e.g., flat feet), choosing the wrong kind of shoes, obesity, metabolic disorders, and hormonal problems.

Additionally, sportspeople are also at greater risk due to microtrauma or stress. Thus, it is more common in athletes, jumpers, those who exercise on a hard surface, those involved in high-impact activities, and exercise without an adequate warmup and stretching.

Signs and symptoms of plantar fasciitis

Plantar fasciitis is relatively easy to diagnose due to its typical signs and symptoms. It would almost cause pain of the heel and nearby in all the cases. However, pain intensity may vary significantly. In some, it may be dull pain that occurs after prolonged standing. In others, it may be stabbing pain appearing immediately on standing on feet.

Since, in the condition, fascia is weak, damaged, and inflamed, the pain becomes worse on physical exertion. Thus, it would worsen after a walk, running, or standing.

It may also cause pain in the foot arch.

Here it is vital to note that in the condition, pain is worse after prolonged rest. Thus, it isn’t good in the morning. Walking gets a bit better during the day due to improved local blood flow. However, it is not entirely gone. Prolonged walking and stress may make it worse. Thus, only short walks may help relieve the pain.

Further, it is essential to know that it is a highly chronic ailment and pain continues for months and even a few years. Additionally, most people may experience a tight Achilles tendon.

Plantar fasciitis rarely causes pain in the toe. However, it may cause calf tightness, and pain may radiate to the ankles. Changes in the posture caused by the condition may even increase the risk of back pain.

How is the condition diagnosed?

It is generally easy to diagnose based on medical history. Moreover, a person would have a pain in the heel for several months. Additionally, there would be a pain in the plantar fascia on physical examination, and trained doctors know how to elicit it.

Additionally, there are signs like pain worse in the morning and decreases a bit during the day, but there is no complete relief. Generally, doctors may carry out some additional tests to exclude other conditions like tendinitis or other issues.

Doctors may also carry out imaging tests like x-ray, bone scans, ultrasound, and MRI. These tests may not provide much information about the condition, but they help with differential diagnosis.

To conclude, plantar fasciitis is not a rare condition. It causes pain in the heel that worsens in the morning and gets better during the day. There are many ways to treat the condition from pain killers, physical therapy, physiotherapy, and devices like  Extracorporeal Shock Wave Therapy (ESWT). Most of these treatments aim to reduce pain and promote local tissue regeneration.

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