Plantar Fasciitis: Understanding the Pain and Finding Relief

“Immerse yourself in the complex world of plantar fasciitis, where each step reveals a unique story of pain and resilience. Discover the secrets of this common condition and explore the avenues of relief, because understanding plantar fasciitis is opening the door to foot well-being and freedom of movement. »

Introduction to Plantar Fasciitis

Plantar fasciitis, a common ailment that often disrupts the daily lives of numerous individuals, remains, at times, poorly comprehended despite its widespread occurrence. In unraveling the intricacies of this painful condition, we embark on a journey to delve into its core, exploring the origins, manifestations, and potential avenues for relief. This exploration places a particular emphasis on the critical significance of early diagnosis and the implementation of appropriate therapeutic approaches. Join us on this enlightening journey as we demystify plantar fasciitis and uncover valuable insights on the path to enduring relief.

At the heart of plantar fasciitis lies an inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes, creating the arch of the foot. This inflammation often leads to persistent pain, primarily experienced near the heel. Despite its prevalence, the understanding of plantar fasciitis can be elusive, with varying factors contributing to its development.

The origins of plantar fasciitis are multifaceted. It frequently arises due to repeated stress on the plantar fascia, leading to micro-tears and inflammation. Factors such as excessive physical activity, improper footwear, obesity, and prolonged standing contribute to the strain on the plantar fascia. Additionally, individuals with certain biomechanical issues, like flat feet or high arches, may be more prone to developing plantar fasciitis.

The manifestations of plantar fasciitis are characterized by sharp, stabbing pain, often at its most intense during the initial steps after periods of rest, such as getting out of bed in the morning. As individuals move and the foot loosens up, the pain may subside, only to return after prolonged periods of standing or physical activity. This recurrent pain can significantly impact daily activities, leading to a decreased quality of life for those affected.

Early diagnosis is paramount in effectively managing plantar fasciitis. Healthcare professionals, often starting with a comprehensive examination of medical history and physical assessments, can diagnose the condition. Imaging studies, such as X-rays or ultrasound, may be employed to confirm the diagnosis and rule out other potential causes of foot pain.

Anatomy and Physiology

The plantar fascia, also known as the plantar aponeurosis, is a fibrous structure located under the skin on the sole of the foot. It is a dense band of connective tissue that extends from the heel bone (calcaneus) to the base of the toes. The plantar fascia plays an important role in the stability of the foot and in the transmission of forces during walking and running.

Plantar Fascia Anatomy

1. Origin: The plantar fascia originates from the calcaneus, more precisely from the calcaneal tuberosity, which is the protruding part at the back of the heel.
2. Path: It extends forward, crossing the sole of the foot, and then divides into several bundles which attach to the heads of the metatarsals, thus contributing to the formation of the transverse arch of the arch of the foot.
3. Characteristics: The plantar fascia is composed of dense and resistant connective tissue. It looks like a thick, fibrous band that supports the structures of the foot and absorbs shock while walking.

Functions of the Plantar Fascia

1. Longitudinal Arch Support: The plantar fascia plays an essential role in maintaining the medial arch of the foot. It helps prevent this arch from collapsing when bearing body weight.
2. Shock Absorption: As a component of connective tissue, the plantar fascia acts as a shock absorber by absorbing shock forces that occur when the foot contacts the ground.

Plantar Fascia Physiology

1. Elasticity: The plantar fascia has a certain elasticity which allows it to stretch slightly when the foot is loaded and then return to its original shape. This contributes to the flexibility of the foot.
2. Muscle Activation: The plantar fascia works in synergy with the muscles of the foot to ensure efficient walking and running. Proper coordination between the plantar fascia and the intrinsic muscles of the foot is crucial for stability and movement.

Causes of Plantar Fasciitis

Plantar fasciitis is usually caused by excessive strain on the plantar fascia, the ligament that connects the heel to the toes. This repeated tension can lead to microtrauma, causing inflammation and pain in the heel. Specific causes of plantar fasciitis include:

1. Overload and Repetitive Activities: Plantar fasciitis is frequently associated with activities that place increased stress on the plantar fascia, such as running, prolonged walking, or activities that frequently place stress on the feet.
2. Foot Problems: People with flat feet, high arches, or other foot problems may be more prone to plantar fasciitis.
3. Changes in Physical Activity: Sudden changes in the level of physical activity, such as a sudden increase in exercise intensity or duration, may increase the risk of developing plantar fasciitis.
4. Wearing Inappropriate Shoes: Shoes that do not provide adequate arch support, sufficient cushioning, or that are worn out can contribute to the development of plantar fasciitis.
5. Obesity: Excess weight can put increased pressure on the plantar fascia, increasing the risk of developing inflammation.
6. Age: Plantar fasciitis is more common in middle-aged people, although it can affect people of any age.
7. Arthritis: Certain forms of arthritis, such as rheumatoid arthritis, can increase the risk of plantar fasciitis.
8. Anatomical Factors: The way bones, muscles and ligaments interact in the foot can also contribute to the development of plantar fasciitis.

Symptoms of Plantar Fasciitis

Symptoms of plantar fasciitis usually manifest as pain in the heel, especially when taking the first steps in the morning or after a prolonged period of rest. Typical symptoms include:

1. Heel Pain: The pain is usually located in the heel, near the base of the arch of the foot. It can be described as a stinging, pulling or burning sensation.
2. Pain upon waking up: The pain is often more intense during the first steps after waking up. During the night, the plantar fascia contracts, and the initial stretch when standing up can trigger a sharp pain.
3. Pain after Rest: Pain can also occur after prolonged periods of rest or immobility, such as after a long period of sitting at a desk or after watching television.
4. Pain During Activity: Pain may intensify during walking, running, or other activities that use the arch of the foot.
5. Redness or Swelling: In some cases, there may be slight redness or swelling in the heel area.
6. Sensitivity to Touch: The heel area may be sensitive to touch, especially near the attachment of the plantar fascia at the calcaneus (heel bone).
7. Pain Along the Arch: Pain can sometimes extend along the arch toward the front of the foot.

Aging and heel fat pad atrophy are 2 degenerative risk factors for plantar fasciitis

Pathophysiology of plantar fasciitis

Plantar fasciitis is a common medical condition that involves the inflammation of the plantar fascia, a thick band of connective tissue that connects the heel to the toes, supporting the arch of the foot. The pathophysiology of plantar fasciitis can be influenced by several factors, and while the exact cause may vary from person to person, here are some general things that are often associated with this condition:

1. Repetitive Strain Injuries: Plantar fasciitis is often linked to repetitive strain injuries, such as overuse of the foot. Activities such as running, prolonged walking, or prolonged standing can place excessive pressure on the plantar fascia, leading to micro-injuries and inflammation.
2. Excessive Tension: Excessive tension on the plantar fascia can be due to factors such as flat feet, cavus feet, excessive pronation (inward rolling of the foot) or supination (outward rolling of the foot) . These conditions can cause abnormal stretching of the plantar fascia, contributing to its irritation and inflammation.
3. Biomechanics Problems: Abnormalities in the biomechanics of the foot, ankle or knee can also play a role in the development of plantar fasciitis. These abnormalities can lead to changes in the way weight is distributed across the foot, putting more pressure on the plantar fascia.
4. Anatomical Factors: Pathophysiology can be influenced by anatomical factors, such as foot length, heel morphology, or the way the bones and joints of the foot interact with each other.
5. Age and Physical Activity: Plantar fasciitis is more common in middle-aged to older people, as well as those who are physically active. Age can influence the flexibility of the plantar fascia, and physical activity can increase the risk of strain injuries.
6. Obesity: Being overweight or obese can increase the load borne by the plantar fascia, which can contribute to the development of plantar fasciitis.

The pathophysiology of plantar fasciitis involves a cascade of inflammatory reactions, with release of chemical mediators and recruitment of immune cells to the affected area. This leads to symptoms such as heel pain, which is often worse in the morning or after a period of inactivity.

Complications of plantar fasciitis

Foot pain in the morning

• The joints and tissues in your foot tighten during sleep because there is no active movement for several hours, so foot pain in the morning is common with plantar fasciitis.
• It is therefore recommended to perform several stretching exercises and foot baths before going to bed.
• Additionally, stretching right after waking up is essential for a pain-free morning.
• If you experience foot pain in the morning, find out which stretching exercises work best for you.
• There are also orthopedic devices that can help.

Unilateral foot pain

• A common indicator of plantar fasciitis is pain in a specific area of ​​the foot.
• Another sign is whether the unilateral foot pain decreases with exercise or not.
• While plantar fasciitis patients experience relief after stretching, tendon fractures or tears are not affected by stretching movements.
• Unilateral foot pain may also indicate that there is more pressure on one side of the foot than the other.

Severe foot pain after exercise

• Another symptom of plantar fasciitis is pain that occurs after a workout.
  • Using the wrong running shoes, changing your workout too quickly, and suddenly increasing the intensity of your exercise can lead to shooting pain in the bottom of your foot.
  • The calf muscles also play a role.
  • If they are too weak to support you during exercise, you will feel pain.
  • It’s important to make appropriate adjustments to relieve pain: put inserts in your shoes, wear appropriate shoes, or use orthopedic devices.

Formation of bone spurs

Too much pronation has the effect of stretching the plantar fascia, supporting ligaments and intrinsic muscles of the foot. This results in micro-tears near the calcaneus attachments. In the event of excessive pronation due to flat foot and/or increased body weight, greater than normal compressive forces are exerted at the heel. As a result, the flat foot will have a reduced ability to absorb ground impact during locomotion. The plantar fascia and fat pad in the heel are necessary to absorb a greater amount of stress. The soleus muscle compensates by increasing its activity, which increases pressure on the plantar fascia and Achilles tendon.

A bone spur (exostosis) may form on the medial anterior calcaneus. This can be caused by traction on the plantar fascia or compressive forces. There are various hypotheses to explain the formation of bone spurs. One of them states that over time, repetitive micro-tears of the periosteum can lead to micro-hemorrhages, increased fibroblast activity and new bone formation.

Patients with pes cavus are also prone to this condition. They have a more rigid foot type that has difficulty absorbing the impact of the heel on the ground, increasing the pressure on the plantar fascia.

It is also possible that the fibers attaching to the metatarsal may also be inflamed leading to metatarsalgia.

The pain is worse after waking up for the first 3 steps.

A strained Achilles tendon is strongly linked to plantar fasciitis

It should be noted that Achilles tendon and plantar fasciitis are two separate conditions, although they can sometimes be related or co-exist in some people. The Achilles tendon is the tendon located at the back of the ankle, connecting the calf muscles to the heel bone. Plantar fasciitis, on the other hand, is an inflammation of the plantar fascia, the band of tissue that connects the heel bone to the toes, located under the arch of the foot.

A tight Achilles tendon can put extra pressure on the arch of the foot, which can eventually contribute to the development of plantar fasciitis. However, it is important to note that many factors can contribute to plantar fasciitis, and it can develop regardless of Achilles tendon strain.

Unbalanced Leg Length and Plantar Fasciitis

A leg length imbalance can contribute to the development of plantar fasciitis, although it is not always the only cause. Plantar fasciitis is usually associated with overuse, excessive tension on the plantar fascia, problems with flat feet or high arches, and sudden changes in physical activity.

If a person has one leg shorter than the other, this can lead to uneven weight distribution on the feet when walking or running. This can cause changes in the way forces are absorbed by the feet, leading to increased pressure on the plantar fascia. This excessive and repeated pressure can lead to inflammation of the fascia and plantar fasciitis.

It is important to note that leg length imbalance can be congenital (present at birth) or acquired (developed over time due to factors such as injury or poor posture).

Most plantar fasciitis is caused by excessive overload on the arch or arch of the foot. A flat or hyperpronated foot will have a negative impact on the arch of the foot. Indeed, if this situation is not corrected, a lime deposit will form the attachment of the plantar fascia to the calcaneus. Thus, the body by reaction will form additional protection which is in the form of limestone. In short, blood stagnation will be responsible for an increase in nervous sensitivity. 

Wearing Inappropriate Shoes and Plantar Fasciitis

Wearing inappropriate shoes may be a contributing factor in the development of plantar fasciitis. Ill-fitting shoes that don’t provide good support or put excessive pressure on certain parts of the foot can increase stress on the plantar fascia and contribute to inflammation. Here are some aspects of shoes that may influence the risk of plantar fasciitis:

1. Lack of arch support: Shoes that do not provide adequate support to the arch of the foot can lead to overstretching of the plantar fascia.
2. Lack of cushioning: A lack of cushioning in shoes can increase the impact on the heel, thereby worsening the strain on the plantar fascia.
3. Poor fit: Shoes that are too tight or too loose can cause problems. Tight shoes can compress the feet, while shoes that are too loose may not provide adequate support.
4. Heel too high: Excessively high heels can change the distribution of weight on the feet, potentially increasing pressure on the plantar fascia.
5. Worn or inappropriate insoles: Worn or inappropriate insoles may not provide adequate support, which can contribute to foot problems.

It is essential to wear shoes that suit your foot type, gait and daily activities. If you have already developed plantar fasciitis, choosing appropriate footwear may also be part of the treatment plan recommended by a healthcare professional, such as a podiatrist.

Pregnant women and plantar fasciitis

Plantar fasciitis can affect pregnant women, and this can be attributed to several pregnancy-related factors. During pregnancy, the body experiences hormonal, weight and posture changes that can influence the development of plantar fasciitis. Here are some points to consider:

1. Weight gain: During pregnancy, there is a natural weight gain which can put additional pressure on the feet and plantar fascia.
2. Hormonal changes: Hormones produced during pregnancy, particularly relaxin, can affect ligaments and connective tissues, making them more flexible. This can contribute to increased tension on the plantar fascia.
3. Gait Changes: Some changes in gait and posture may occur due to weight gain and hormonal changes, which can also influence the load placed on the plantar fascia.
4. Edema: Many pregnant women experience swelling in their feet and ankles due to fluid retention. This can also contribute to discomfort in the plantar fascia.

Differential diagnoses of plantar fasciitis

There appears to be a typo in your question, but I’m going to assume you mean the differential diagnosis of plantar fasciitis. Plantar fasciitis is a painful inflammation of the plantar fascia, the thick connective tissue that connects the heel to the toes. Differential diagnosis involves distinguishing plantar fasciitis from other conditions with similar symptoms. Here are some of the conditions a healthcare professional might consider:

1. Heel spur: A heel spur is a bony growth in the heel. Although it can be associated with plantar fasciitis, not all cases of plantar fasciitis necessarily have a heel spur.
2. Tarsal tunnel syndrome: This is compression of the posterior tibial nerve in the ankle, which can cause pain in the ball of the foot.
3. Arthritis: Certain forms of arthritis, such as rheumatoid arthritis or osteoarthritis, can cause pain in the feet, including in the plantar fasciitis area.
4. Achilles tendonitis: Inflammation of the Achilles tendon can cause pain in the heel and sole of the foot.
5. Necrotizing fasciitis: Although very rare, necrotizing fasciitis is a serious bacterial infection that can cause pain in the heel and foot area.
6. Medial tibial stress syndrome: Overuse of the muscles of the foot and shin bone can lead to this syndrome, characterized by pain along the inner edge of the shin bone.
7. Retrocalcaneal bursitis: Inflammation of the bursa located at the back of the heel can also cause pain in the heel area.

It is important to consult a healthcare professional, such as a podiatrist, orthopedist or doctor, to obtain an accurate diagnosis. The professional may use physical examinations, x-rays, ultrasounds or other tests to establish the differential diagnosis and recommend the appropriate treatment.

Factors predisposing to plantar fasciitis

• Poor biomechanics
  • Excessive pronation of the subtalar joint
  • Excessive supination of the subtalar joint
  • Excessive external rotation of the hip joint during walking
• Short, tight gastrocnemius and soleus muscles that predispose the foot to pronation
• Inappropriate shoes, worn, too soft, too stiff or that do not provide adequate arch support;
• Weight gain, including pregnancy, which puts strain on the plantar aponeurosis.

Osteopathic approach for the treatment of plantar fasciitis

The osteopathic approach offers a holistic and comprehensive perspective for the treatment of plantar fasciitis, going beyond simple symptom management to address the root causes of this painful condition. Osteopaths adopt specific manual techniques aimed at restoring musculoskeletal balance and promoting the body’s natural healing. Here is how osteopathy can be applied in the treatment of plantar fasciitis:

1. Comprehensive assessment: An osteopath begins with a thorough assessment of the patient, examining not only the painful heel area, but also the body as a whole. This assessment helps identify imbalances, movement restrictions, and muscle tension that may be contributing to plantar fasciitis.
2. Restoring mobility: Osteopaths use gentle manual techniques to restore mobility to the joints of the foot, ankle and leg. This may include joint manipulations, stretching, and myofascial release techniques aimed at reducing muscle tension.
3. Correction of postural imbalances: Osteopaths address postural imbalances that can contribute to plantar fasciitis. This may involve spinal adjustments to improve the patient’s overall posture and reduce strain on the foot.
4. Kinetic chain work: Osteopathy considers the kinetic chain, looking at how movements in one part of the body can affect other areas. By working on the kinetic chain, osteopaths can identify and treat compensations that can worsen plantar fasciitis.
5. Myofascial release techniques: Osteopaths use myofascial release techniques to relax tight connective tissues, including the plantar fascia. This promotes blood circulation, reduces inflammation and helps with healing.
6. Lifestyle Advice: In addition to manual interventions, osteopaths provide lifestyle advice, including home stretching exercises, ergonomic adjustments, and shoe recommendations to support healing and prevent recurrences.

The individualized osteopathic approach aims to treat each patient uniquely, taking into account their anatomical characteristics, lifestyle and specific contributing factors to their plantar fasciitis. By integrating these different dimensions, osteopathy offers a complete and personalized approach for the relief of plantar fasciitis. It is essential that people suffering from this condition consult a qualified osteopath to benefit from an accurate assessment and care tailored to their needs.

Therapeutic approach to plantar fasciitis

• Plantar orthosis which will aim to support the arch of the foot
• Caution with corticosteroid injection, Injections may leak into the fat pad causing degeneration of the fat pad and rupture of the plantar fascia
• The night splint keeps the foot dorsiflexed during the night and stretches the gastrocnemius and soleus
• Deep transverse friction

Frottement longitudinal caudal

• Widening by compression and deep longitudinal friction, The triceps surae is an integral part of the kinetic chain of tightness in plantar fasciitis.

Longitudinal friction of the posterior compartment

Stretching

Calf stretch

The wall hand calf stretch is an effective exercise for stretching the calf muscles, especially the gastrocnemius muscle. Here’s how to perform this stretch:

Equipment needed: A wall or any vertical surface.

Instructions :

1. Stand facing a wall, about an arm’s length away.
2. Place your hands on the wall at shoulder height.
3. Take a step forward with one leg and let the other leg back, keeping both feet flat on the floor.
4. Slightly bend the knee of the front leg while keeping the back leg straight.
5. The foot of the back leg should be firmly anchored to the ground, with the heel touching the ground.
6. Tilt your pelvis and trunk forward while keeping your hands on the wall.
7. You should feel a stretch in the calf of the back leg.
8. Hold the position for 15 to 30 seconds, breathing deeply.
9. Slowly return to the starting position.

Advice :

• Make sure the back foot is facing directly toward the wall to effectively target the gastrocnemius muscle.
• Do not force the stretch beyond your comfort threshold, and avoid bouncing.
• Repeat the stretch on the other side, reversing the position of the legs.

This calf stretch is beneficial for improving muscle flexibility and can be helpful for people suffering from tension in this area. If you have any pre-existing health conditions, consult a healthcare professional before beginning stretching exercises.

Roll a ball under your foot

Rolling a ball under your foot is a self-massage technique that can help release tension in the arch and associated muscles. Here’s how to perform this exercise:

Equipment needed: A tennis ball, golf ball or foam ball.

Instructions :

1. Sit in a chair or stand, making sure you have good stability.
2. Place the ball under the sole of your foot.
3. Apply light pressure to the ball with your body weight.
4. Roll the ball under your foot in circular motions.
5. Focus on areas that feel points of tension or discomfort, adjusting pressure to your tolerance.
6. Continue rolling for 1 to 2 minutes on each foot.

Advice :

• Control the pressure on the ball to avoid excessive pain.
• You can adjust the intensity by varying the pressure exerted and using a harder or softer ball depending on your comfort.
• If you experience sharp pain, stop exercising and consult a healthcare professional.

This exercise can help release tension in the arch muscles and stimulate blood circulation. It may be particularly beneficial for people suffering from plantar fasciitis or foot pain.

• Sit on a chair
• Roll a ball under the arch of the foot
• Roll in a forward and backward motion for 2 minutes

Stretching the plantar fascia using a towel

Materials needed: A rolled or folded towel.

Instructions :

1. Sit on the floor with your legs extended in front of you.
2. Roll up the towel and place it under the ball of your foot, just in front of the heel.
3. Hold both ends of the towel with your hands, keeping your knees straight.
4. Flex your toes slightly toward you while gently pulling on the towel to create slight tension on the plantar fascia.
5. Hold this position for 15 to 30 seconds, breathing deeply and focusing on stretching the bottom of the foot.
6. Gently release the tension and repeat the stretch several times.

Advice :

• Make sure you maintain a comfortable position and don’t force the stretch beyond your tolerance level.
• If you experience sharp pain or excessive discomfort, release the tension immediately.
• Repeat the stretch on both sides, even if you only feel tension in one foot.
• You can do this stretch several times a day, including in the morning before getting up and in the evening before going to bed.

This stretch can help soften the plantar fascia and relieve symptoms of tension or pain in the heel area. However, if you have existing foot problems or health concerns, consult a healthcare professional before undertaking stretching exercises.

Pick up the towel

Purpose of the exercise: Strengthen the muscles of the feet, especially the muscles of the arch of the foot.

Instructions :

1. Sit in a chair with your feet flat on the floor.
2. Place a folded towel in front of you, hand distance apart.
3. Use your toes to grab the towel and begin to pick it up, pulling it towards you.
4. Once you have pulled the towel towards you as far as possible using your toes, hold this position for a few seconds.
5. Release the towel slowly, pushing it back with your toes to return to the starting position.
6. Repeat the movement for approximately 10 to 15 repetitions.

Advice :

• Make sure to keep your heels on the floor during the exercise.
• Control the movement and avoid doing it quickly.
• If you find the exercise too difficult at first, you can start with a small towel and gradually increase the size as your muscles strengthen.

This exercise can help strengthen the intrinsic muscles of the foot, which can be beneficial for stability and the prevention of certain foot problems.

Calf and Plantar Fascia Stretch on Steps

1. Find a staircase or raised surface.
2. Stand facing the stairs with both feet on the bottom step.
3. Make sure toes, arch and heel are aligned with the edge of the step.
4. Bend your knees slightly and let your heels hang gently off the edge of the step.
5. Hold for 15 to 30 seconds, focusing on the stretch felt in the calves and plantar fascia.
6. To accentuate the stretch, you can gently lean your weight forward while maintaining a stable position.

Advice :

• Be careful not to overstretch and respect your comfort threshold.
• Repeat the stretch several times, varying the angle of your feet slightly to target different parts of the calves and plantar fascia.
• Perform this stretch regularly, especially before and after activities that put stress on your feet.

This exercise can help loosen the calf muscles and stretch the plantar fascia, providing potential relief for those suffering from plantar fasciitis.

Collect the marbles

“Picking up the marbles with your foot” is a fun and beneficial exercise to strengthen the foot muscles and improve coordination. Here’s how to do it:

1. Place several small marbles on the ground in front of you.
2. Stand with your feet together.
3. Use one foot to pick up one marble at a time by gripping it between your toes.
4. Lift the ball off the ground and hold it in place for a few seconds.
5. Release the marble and repeat the process with each marble present.
6. Once you have picked up all the marbles with one foot, repeat the exercise with the other foot.

Additional Tips:

• Start slowly and gradually increase the difficulty by adding more marbles.
• Focus on precise movement of your toes to maximize the benefits.
• Perform this exercise on a flat surface for added stability.

This exercise stimulates the intrinsic muscles of the foot, promotes toe mobility and strengthens foot-eye coordination. It can be particularly helpful in improving proprioception and foot strength, benefiting overall foot and ankle health.

X-ray signs of plantar fasciitis

It is important to note that plantar fasciitis is usually diagnosed based on clinical symptoms and physical examination by a healthcare professional. However, in some cases, x-rays may be used to evaluate for the presence of radiographic signs associated with plantar fasciitis. These radiographic signs may include bone spurs, also called heel spurs.

A heel spur is a thorn-shaped bony growth that forms on the calcaneus (heel bone). It is important to note that the presence of a heel spur alone does not necessarily confirm the diagnosis of plantar fasciitis, as many people with a heel spur do not experience any pain. Additionally, many people with plantar fasciitis do not have a heel spur.

Plantar fasciitis is often diagnosed based on the patient’s symptoms, such as heel pain, especially when taking the first steps in the morning, as well as the physical exam which may reveal pain on palpation of the bottom of the foot .

In summary, although x-rays may show heel spurs, the diagnosis of plantar fasciitis relies primarily on the evaluation of clinical symptoms and signs by a healthcare professional.

Quizzes

References

1. Ling Y, Wang S. Effects of platelet-rich plasma in the treatment of plantarfasciitis: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018 Sep;97(37):e12110. [PMC free article] [PubMed]
2. Becker BA, Childress MA. Common Foot Problems: Over-the-Counter Treatments and Home Care. Am Fam Physician. 2018 Sep 01;98(5):298-303. [PubMed]
3. Lee YK, Lee M. Treatment of infected Achilles tendinitis and overlying soft tissue defect using an anterolateral thigh free flap in an elderly patient: A case report. Medicine (Baltimore). 2018 Aug;97(35):e11995. [PMC free article] [PubMed]
4. Finkenstaedt T, Siriwanarangsun P, Statum S, Biswas R, Anderson KE, Bae WC, Chung CB. The Calcaneal Crescent in Patients With and Without Plantar Fasciitis: An Ankle MRI Study. AJR Am J Roentgenol. 2018 Nov;211(5):1075-1082. [PubMed]
5. Arnold MJ, Moody AL. Common Running Injuries: Evaluation and Management. Am Fam Physician. 2018 Apr 15;97(8):510-516. [PubMed]
6. Cotchett M, Lennecke A, Medica VG, Whittaker GA, Bonanno DR. The association between pain catastrophising and kinesiophobia with pain and function in people with plantar heel pain. Foot (Edinb). 2017 Aug;32:8-14. [PubMed]
7. Tschopp M, Brunner F. [Diseases and overuse injuries of the lower extremities in long distance runners]. Z Rheumatol. 2017 Jun;76(5):443-450. [PubMed]
8. Lai TW, Ma HL, Lee MS, Chen PM, Ku MC. Ultrasonography and clinical outcome comparison of extracorporeal shock wave therapy and corticosteroid injections for chronic plantar fasciitis: A randomized controlled trial. J Musculoskelet Neuronal Interact. 2018 Mar 01;18(1):47-54. [PMC free article] [PubMed]
9. Kim M, Choi YS, You MW, Kim JS, Young KW. Sonoelastography in the Evaluation of Plantar Fasciitis Treatment: 3-Month Follow-Up After Collagen Injection. Ultrasound Q. 2016 Dec;32(4):327-332. [PubMed]
10. McClinton S, Heiderscheit B, McPoil TG, Flynn TW. Physical therapist decision-making in managing plantar heel pain: cases from a pragmatic randomized clinical trial. Physiother Theory Pract. 2020 May;36(5):638-662. [PubMed]