Plantar Fasciitis and Heel Pain Treatment - Vancouver, BC

When a patient comes to see Dr. Joseph Stern with heel pain, the most common cause is plantar fasciitis. One in ten people will get plantar fasciitis during their lifetime, and the condition usually strikes in middle age. The pain that plantar fasciitis causes typically is noticed with the first step out of bed which interferes with the enjoyment of daily activities, and reduces the quality of life.

Dr. Stern has diagnosed, treated, and educated patients about plantar fasciitis in Vancouver for over 30 years. The following is a brief overview of plantar fasciitis, its symptoms, prevention, and common ways this condition is treated.

What Is the Plantar Fascia?

The plantar fascia is a band of soft tissue connecting the heel with the front of the foot. It provides flexibility and stability to the arch. It is a few millimeters (a fraction of an inch) thick but is sometimes thicker in people with plantar fasciitis.

The plantar fascia is curved so that it can store energy during walking. This makes walking more efficient, but it forces the plantar fascia to bear a substantial fraction of the body weight during each step. The plantar fascia is vulnerable to stresses that come from rolling the foot inward, the collapse of the foot’s arch, or any high-impact activity that puts pressure on the foot’s sole.

What Is Plantar Fasciitis?

Plantar fasciitis is tearing or inflammation of the plantar fascia.  In extreme cases, the plantar fascia can rupture, which causes pain and swelling.

Stress and overwork can cause many tiny tears to form on the plantar fascia. The damage triggers inflammation as part of the body’s healing response. Chronic strain on the plantar fascia prevents healing and worsens the inflammation.

What Causes Plantar Fasciitis?

There are many potential causes and risk factors for plantar fasciitis. People who do not walk a lot may develop tightness in the plantar fascia from lack of exercise. On the other extreme, overuse of the plantar fascia can cause plantar fasciitis, so runners are more likely to develop the condition.

Fallen arches or a lack of arch support can lead to plantar fasciitis because the flat foot position forces the plantar fascia to stretch further than it should. A high arch also places more stress on the plantar fascia.

Tightness in other structures in the foot, such as the Achilles tendon, can put additional strain on the plantar fascia.

Conditions that place additional stress on the plantar fascia are risk factors for plantar fasciitis. Overweight or pregnant persons are at risk. Wearing shoes that do not adequately support the arch, such as worn-out shoes, increases the chance of developing plantar fasciitis.

Symptoms of Plantar Fasciitis

The main symptom of plantar fasciitis is heel pain. This can be a dull ache throughout the day to intense pain with the first step each morning. Plantar fasciitis can sometimes cause swelling at the bottom of the heel. Symptoms can be severe enough to interfere with walking. If plantar fasciitis interferes with posture, it might lead to pain in the calf or leg muscles, even though it is not directly a symptom of plantar fasciitis.

Heel Pain in Plantar Fasciitis

People with plantar fasciitis usually describe stabbing pain in the heel. Ligaments and muscles can become tight during sleep, so plantar fasciitis is often worse just after waking up and gets better once the plantar fascia has had a chance to stretch. Exercise does not typically cause plantar fasciitis, but the condition can become aggravated after exercises when the plantar fascia and foot muscles are tired.

Swelling in Plantar Fasciitis

Swelling can occur in the bottom of the feet. The soft tissues on the feet can become red, irritated, and inflamed.

Diagnosing Plantar Fasciitis

Plantar fasciitis can be confused with certain neurological conditions such as sciatica, pinched nerves, or entrapped nerves. Swelling of the feet could indicate a problem with the circulatory system. Heel pain could also be a symptom of a stress fracture or other bones in the foot.

Treatment for Plantar Fasciitis

Plantar fasciitis has several treatment options, ranging from conservative measures to surgery. The symptoms of plantar fasciitis will sometimes go away by themselves. However, if plantar fasciitis affects gait or posture, these changes could lead to further problems with walking and pain in other parts of the body. So seeking treatment early on can lead to a faster recovery. A variety of treatment options are available and Dr. Stern will work with you to devise a custom plan to help you get back on your feet.  

Rest

Rest can improve plantar fasciitis symptoms. Cutting back on running or sports that stress the feet gives the plantar fascia time to recover. In acute cases, immobilization with a walking boot or cast may be warranted.

Pain Management

To reduce inflammation and pain, non-steroidal anti-inflammatory medications such as ibuprofen and naproxen may be prescribed. Cortisone and other corticosteroids can also treat severe plantar fasciitis. While injections might help in the short term, they are not guaranteed to provide long-term relief, especially if there is an underlying mechanical issue.

Other standard therapies for pain, such as heat, ice, and foot exercises, are often effective against plantar fasciitis.

Custom Foot Orthotics

Orthotic devices such as shoe inserts provide arch support and correct abnormalities in the gait and foot structure that might contribute to plantar fasciitis. Night splints can give a gentle stretch to prevent the arches from tightening up during sleep to minimize heel pain for the first steps in the morning.

Physiotherapy

Stretches and exercises that target foot muscles, tendons, and ligaments can improve arch support and relieve tension on the plantar fascia. A tight Achilles heel and tight calf muscles can contribute to plantar fasciitis. Targeted exercise stretches your calf muscles to remove one source of tension on the plantar fascia.  Dr. Stern may also refer you to a physiotherapist for additional treatment modalities. 

Injections  

Cortisone, ultrasound-guided dextrose, and platelet-rich plasma injections are all possible treatment options. Cortisone and ultrasound-guided dextrose can help reduce the painful symptoms. Platelet-rich plasma, which promotes healing for many medical conditions, relieves plantar fasciitis pain in some patients. The white blood cells and platelets in PRP encourage healing and pain relief.

Extracorporeal Shock Wave Therapy

Extracorporeal Shock Wave Therapy uses intense sound waves to treat plantar fasciitis. The vibration triggers blood flow to the plantar fascia and promotes the healing process.

Surgery

Most people with plantar fasciitis do not need surgery. For persistent plantar fasciitis that does not respond to other treatments, a surgical procedure can cut the plantar fascia away from the heel, releasing the tension on the ligament. However, this is the last resort.

Plantar fasciitis surgery carries the risk of complications, including recurring heel pain, nerve damage, and neuromas. However, most people who undergo surgery experience a reduction in plantar fasciitis pain.

Prognosis For Plantar Fasciitis

Plantar Fasciitis symptoms can resolve independently, but treatment can shorten the recovery period and reduce symptoms. Preventing further damage and preventing other ligaments, tendons, and muscles from sustaining an injury is vital for recovering from plantar fasciitis.

Preventing Plantar Fasciitis

Stretching exercises that increase the flexibility of the plantar fascia and strengthen muscles that support the arch can be beneficial. Regular exercise keeps tendons and ligaments limber.

If you play sports, be sure to have proper arch support and ankle support. Take a moderate approach to exercise or sports to prevent overusing the plantar fascia.

Avoid work activities or hobbies that require you to stand for long periods during the day to avoid tiring out the muscles of your feet and putting stress on your feet. When you are physically active, take breaks to allow your feet to rest.

Recognizing Symptoms of Plantar Fasciitis

One of the key ways of avoiding long-term damage from plantar fasciitis is to rest and treat the signs of inflammation as soon as possible. Every step a person takes while suffering from plantar fasciitis risks making the symptoms worse, particularly if the person is not treating the condition.

People often suffer reduced quality of life and chronic pain with undiagnosed injuries because they have not had the chance to see the appropriate specialist and uncover the root cause of their problem.

Podiatrists have an important role in raising community awareness regarding plantar fasciitis and other conditions affecting millions. Medical professionals can have a significant impact if they can reach more people in their communities.

Dr. Stern Will Help You Get Back on Your Feet

Dr. Joseph Stern is a foot and ankle specialist with over 30 years of experience and offers a broad range of advanced orthopedic and non-surgical treatment options for heel pain.

Working out of their Vancouver office, our doctor and his team offer the highest level of care so you can overcome heel pain and return to your daily activities.

Schedule an appointment today if you’re ready to better understand your treatment options and say goodbye to heel pain.