When is it time to see a doctor for plantar fasciitis?

Have you ever stepped out of bed to find a tightness in the arch of your foot or sharp pain at your heel? At first, symptoms might be subtle, and after a few steps it resolves itself on its own. But then, throughout the course of the week or month, the tightness increases and becomes painful, and you find yourself struggling to walk.

Plantar fasciitis is the inflammation of the dense, thickened tissue at the plantar area of the foot that connects the heel bone to the toes and creates the arch. This connective tissue is meant to support the foot but can become inflamed or torn and cause pain. The pain resides in the arch and the heel, occurring after periods of rest or immobility. 

Common symptoms and causes of plantar fasciitis

Plantar fasciitis is often noticed through “post-static pain,” or pain occurring after a period of rest, usually after overexertion (increased running or walking, usually in poor shoes) or even due to a more sedentary lifestyle.

If you’re struggling with symptoms related to plantar fasciitis, you may have experienced one or more of the following triggers:

• increased activity without appropriate preparation
• not stretching or warming up before an activity
• wearing poorly supportive shoes or going barefoot for long periods of time on a hard surface
• weight gain, resulting in added pressure to the fascia

Who commonly experiences plantar fasciitis?

The people most commonly affected by plantar fasciitis are about 40-60 years old and are still trying to remain active but might be less flexible. You could be diagnosed earlier or later in life, however. Certain foot types, such as extremely flat feet or extremely high-arched feet, may be more prone to plantar fasciitis, but there’s no genetic predisposition that we currently know of.

How to resolve plantar fasciitis pain

A lot of the pain from plantar fasciitis is individualized and depends on the person’s activity that led up to the diagnosis. The first goal in treating plantar fasciitis is to reduce the inflammation with non-steroidal anti-inflammatory drugs (NSAIDs, such as aspirin, ibuprofen and naproxen) and to control the pain, usually with the RICE (rest, ice, compression and elevation) method.

The second goal is to figure out what may be a trigger and how to control it (for example, excess running may require rest). A podiatrist can examine your foot type and help recommend appropriate shoes or how to avoid the triggers to your pain. Stretching a tight calf muscle and fascia can also help reduce tension.

The important steps are controlling pain, increasing flexibility and being aware of lifestyle changes that trigger plantar fasciitis so that you can prevent It from recurring in the future.

When to seek medical attention for plantar fasciitis

If you’ve tried the initial RICE treatments and/or your pain isn’t responding to some of the plantar fasciitis treatments mentioned above, there may be other causes for heel pain that should be investigated. Seek medical attention as soon as possible so that you can get help developing a treatment plan and better understanding the causes of your pain.

Other types of treatment for plantar fasciitis

Physical therapy

If pain continues after home therapy, or if you’re having a hard time consistently keeping up with home therapy, it’s recommended to seek professional assistance from a physical therapist. Additionally, there may be some exercises and stretches only available through formal physical therapy that can help resolve the pain. 

Steroid injections

Steroid injections are usually reserved for people whose pain doesn't respond to stretching, RICE, etc. or if they can’t use those methods. It could also be considered for people with pain that’s become severe but who have to be on their feet more, where rest may not be a practical option.

Foot surgery

Surgery can be considered if plantar fasciitis becomes more of a chronic issue, where the inflammatory tissue becomes more scarred or you can’t seem to recover from the condition with more conservative measures.

Why is plantar fasciitis so common?

Along with an increase in obesity, which can put more pressure on the fascia, one theory is that there’s a heightened awareness of the need to exercise, leading to more people incorporating running or walking into their daily schedule. They may not be wearing proper shoes that have enough support for the arch, or may not be educated on proper stretching techniques, making them more prone to plantar fasciitis.