As any of you who have or have had plantar fasciitis know, it is truly a pain in the a$$ heel. Compared to all the health problems that people have, I suppose it ranks nearer the bottom, but since I'm having some trouble with it, I thought I'd do some research and make a diary with my findings. I used the trusty Internet and looked at the information at seven websites. A couple of the websites mentioned that two million Americans per year have this problem, so I figured there might be some other souls who are in the same boat as I am. I plan to give a summary of the information I found, a list of all the links I used, and finally a little personal information about my own problem and what I've done.
What is it and what are the symptoms?
The plantar fascia is the thick band of tissue that connects the toes to the heel bone, following along the arch of the foot. Almost all the websites concluded that when the fascia becomes inflamed, it causes the pain. (One website said this view was outdated, as there were no inflammatory cells within the fascia, and that the cause was now thought to be degeneration of the collagen fibers close to the attachment to the heel bone.) The pain develops gradually, and is usually in one foot, but can be in both as well.
The most common symptom is pain at the bottom of the heel. The heel pain is worse right when you get up in the morning, as you take your first steps. The pain usually lessens as you walk around because walking stretches the fascia, but the pain can often be more acute after sitting or standing for a prolonged period.
What are some risk factors?
One website said it was most common in males, and one said it was most common in females, so perhaps it affects both equally. The sites generally agreed that risk factors included being overweight, having arch problems (both flat feet and high arches), having tight Achilles tendons or calf muscles, using shoes with poor arch supports or shoes that don't fit well, or walking, standing, or running, especially downhill or on uneven surfaces for long periods of time, especially on hard surfaces. Several websites explained that people used to think it was caused by heel spurs, but research has shown that is not the case.
What are some treatments?
The good news is that there are a lot of non-surgical treatments that you can try. The bad news is that it can take from several months to two years to get rid of symptoms, although most people improve in nine or ten months. Here is a list of some home treatments:
• Ice
Apply ice (wrapped in cloth) on your heel to reduce pain and swelling. (Suggestions vary from twice a day for 10 to 15 minutes to 3 or 4 times a day for 15 to 20 minutes.) An alternate ice therapy is to try an "ice massage" -- rolling your foot over a can of frozen juice or a frozen bottle of water.
• Stretching Exercises
There are several different recommended exercises that stretch the calf muscles, the plantar fascia and achilles tendon. Here are some foot stretches from the Mayo Clinic, and a calf stretch and a towel stretch from WebMD. Another suggestion is to do some stretches before you get out of bed to lessen the initial heel pain.
• Rest
Rest your feet and try not to walk or run on hard surfaces.
• Shoes
Don't go barefoot. Make sure you are wearing shoes with a good arch support, or use foot orthotics.
• NSAIDs
Take Nonsteroidal anti-inflammatory over-the-counter drugs like acetaminophen or ibuprofen for pain and inflammation, but they won't treat the underlying problem. Don't use for more than a month without checking with your doctor.
• Night splints
Since most people sleep with their feet pointed down, the pain is greater in the morning because the plantar fascia isn't stretched. There are a lot of types of night splints, but they all fit on your foot, keeping the toes pointed up and the foot and ankle at a 90-degree angle. It gives a stretch to the Achilles tendon and the plantar fascia while you are sleeping.
If these methods don't work, cortisone injections, physical therapy, strapping the foot, or even surgery can be tried.
What websites was the information taken from?
• Wikipedia
• US National Library of Medicine, National Institutes of Health--Pub Med Health
• WebMD
• Mayo Clinic
• Sports Injury Clinic on the Net
• American Academy of Orthopaedic Surgeons
• American College of Foot and Ankle Surgeons Foot Health Facts
Some personal thoughts
So, you might wonder, how are my heels? Well, I have pretty much accepted that this is a chronic condition for me. I don't remember when this last bout started, but it's been ongoing for a while. My problem is that it gets better and then worse. When it's worse, I tend to use ice and do stretches. When it gets better I tend to forget, so of course it gets worse again. An endless cycle. I do remember that I had the problem two years ago while I was getting cancer treatments, and one internal radiation treatment required a hospital stay and not getting out of bed for three days. That proved to be a "cure" at the time, but I'd rather not do it that way. I also remember being symptom free and running across a big street in order to make the light, and reinjuring it. So I'd say take care of it as well as you can, and be careful running on concrete.