PLANTAR FASCIITIS: AN UNCOMFORTABLE HEEL PAIN
What causes Plantar Fasciitis?
Foot and heel pain can cause some of the most disabling pain - it can make even going to get a cup of tea unpleasant and sore! It often causes you to move in a different way, which can exacerbate the this pain, as well as spread it to other muscles and joints in the body. Most foot and heel pain comes from an obvious source - a traumatic injury from dropping something on your foot, twisting it on uneven ground or even treading on something sharp. However there are lots of less obvious causes of foot and heel pain that can range from inside the complicated bones, joints,ligaments to the tendons of the foot.
This article specifically addresses plantar fasciitis and when to see your NHS or Private GP. It is caused by damage to the band of fibrous tissue along the sole (plantar surface) of the foot. Generally, this can be easy to solve, however there is a risk of increasing the damage done already by engaging in strenuous activity involving the plantar fascia. The plantar fascia runs from the heel to the start of the toes and supports the arch of the foot, it can therefore be damaged by stress and overuse, such as standing on hard surfaces for long periods (weeks not hours) and running and walking with poorly supportive footwear. Being obese or overweight can complicate the issue, as this puts an increased amount of stress on the joints, ligaments and tendons in the foot . Strenuous activities that involve the plantar fascia can cause micro tears, which may result in degenerative changes, inflammation and pain. The pain can be in any area under the foot but it is most commonly localised underneath the heel. The pain characteristically starts after periods of standing and walking after a long rest. This could be triggered by getting out of bed in the morning or after sitting at a desk for several hours but the pain will typically go away after a short period of walking.
This injury can be especially difficult to manage if you are very active because it can only heal with a period of zero activity. So if you’re a dedicated tennis player, footballer or if your exceptionally superhuman and want to participate in an Ultra marathon, then this injury can cause you to break your routine. If you do continue to pursue such activities, it could ultimately result in the plantar fascia rupturing - causing a much greater level of damage to the foot.
Heel Pain Treatment
Therefore, if you have heel pain it is important to have it examined by a doctor, such as our private GPs, as they will be able to identify what is causing the pain through feeling and moving the joints in your foot and leg. Importantly they will “dorsiflex” your foot, bringing your toes up and back towards your leg. This will stretch the plantar fascia and cause it to hurt if it is damaged. Your doctor will also perform other tests and movements to check that the pain is coming from the plantar fascia. They may request some additional tests including x-rays and ultrasounds, but if there are clear signs and symptoms of plantar fasciitis, this should be unnecessary.
If your doctor diagnoses it as plantar fasciitis, then they may recommend a course of physiotherapy or some simple stretches to do at home. They may also recommend painkillers, although it is important that you take these as instructed by your doctor, as unsupervised long term use of some anti-inflammatories can damage your stomach lining. The majority of people with plantar fasciitis respond well to this approach, but if after several months there is no significant change, then other therapies including injections and surgery can be considered in consultation with an expert.
How to Avoid Foot Pain:
There is also some general, simple, advice that can be valuable when suffering with foot or heel pain.
- Try not to overuse your foot and heel - you can continue to walk but avoid long periods of standing, deliberately going for walks, running and other kinds of sports.
- Wear supportive and well fitting footwear- this can help to stabilise and support your foot, which in turn supports and stabilises the painful and inflamed joints and ligaments inside the foot.
So if you are have any foot pain or heel-related injury and want to check in with a private doctor, then book in for an appointment at one of our 6 central London Clinics for a 15 minute appointment for only £69 to make sure that you are not suffering needlessly!
Ruth Laurence King