What is plantar faciitis (or more precisely plantar faciopathy)?

It is one of the most common lower limb connective tissue disorder conditions affecting mainly the foot, affecting 10 - 15% of the population. It is caused by inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot and connects the heel bone to the toes. Left untreated it can last more than 6 months.

There are several factors that can contribute to the development of plantar fasciitis, including:

1. Overuse: Plantar fasciitis is often seen in athletes, runners (it accounts for 10% of running injuries), and people who spend long hours on their feet, such as healthcare workers or factory workers. Overuse and repetitive stress can lead to micro-tears in the plantar fascia, causing inflammation and pain.

2. Foot mechanics: People with flat feet, high arches, or abnormal gait patterns may be more prone to developing plantar fasciitis. These foot mechanics can alter the way weight is distributed across the foot, putting extra stress on the plantar fascia.

3. Obesity: Excess body weight puts additional stress on the feet, including the plantar fascia. This can increase the risk of developing plantar fasciitis.

4. Tight muscles: Tight calf muscles or Achilles tendons can pull on the heel bone and put stress on the plantar fascia. This can lead to inflammation and pain.

5. Improper footwear: Wearing shoes that do not provide adequate support or cushioning can put extra stress on the plantar fascia. High heels and shoes with a thin sole or no arch support can increase the risk of developing plantar fasciitis.

6. Aging: As we age, our muscles and tendons become less flexible and more prone to injury. This can increase the risk of developing plantar fasciitis.

What are the symptoms?

The most common symptom of plantar fasciitis is pain in the heel and bottom of the foot. The pain is typically worse in the morning or after prolonged periods of sitting or standing. Other symptoms may include:

1. Stabbing or sharp pain in the bottom of the foot near the heel

2. Pain that worsens with activity or prolonged periods of standing or walking

3. Stiffness and limited mobility in the foot and ankle

4. Swelling and redness in the affected area

5. Pain that improves with rest or when off the feet

6. Pain that worsens over time if left untreated

What are your treatment options?

There are several treatment options available for plantar fasciitis, and the best approach will depend on the severity of your symptoms and your individual needs. Some common treatment options include:

1. Rest: Resting the affected foot can help reduce inflammation and promote healing. This may involve avoiding activities that exacerbate symptoms or using crutches to keep weight off the foot.

2. Ice: Applying ice to the affected area can help reduce pain and inflammation. Ice can be applied for 15-20 minutes at a time, several times per day.

3. Stretching: Stretching exercises can help improve flexibility and relieve tension in the foot and calf muscles. Some common stretches include calf stretches and plantar fascia stretches.

4. Footwear: Wearing shoes that provide adequate support and cushioning can help reduce stress on the plantar fascia. Shoes with a low heel and good arch support are often recommended.

5. Orthotics: Custom-made shoe inserts or orthotics can help provide additional support and cushioning to the foot.

6. Physiotherapy: A physio can help develop a customised exercise and stretching program to help relieve pain and improve function.

7. Medications: Over-the-counter pain medications such as ibuprofen or acetaminophen may be recommended to help manage pain and inflammation.

8. Injection therapy: Corticosteroid injections may be used to help reduce inflammation and relieve pain.

9. Surgery: In rare cases, surgery may be recommended if other treatment options have failed. Surgical options may include plantar fascia release or heel spur removal.

However, in my experience in my clinic, using Shockwave therapy has shown to be really effective. My patients report significant improvements in pain and function following treatment. The procedure is typically performed without the need for anaesthesia or sedation. Most patients are able to resume their normal activities shortly after treatment.