Plantar Fasciitis: It's One Big Pain in the Foot

by Sheryl Kraft

If you've been walking around in flip-flops all summer, it's possible that you are yelling this out loud when you step down and feel an excruciating burning, stabbing or aching pain across the bottom on your foot.

Plantar fasciitis (pronounced fa-shee-EYE-tis) is one of the most common orthopedic complaints relating to the foot. You might feel OK when you go to bed, but after the fascia ligament tightens during the night while you sleep, that first step that places pressure on the ligament can be oh-so-painful. The pain generally decreases once your foot limbers up, but it can return after long periods of standing or physical activity.

The plantar fascia is a dense band of tissue that runs along the bottom of your foot, connecting the heel to the toes. It cushions the foot and helps to support the arch --when it's working right. Though it's hard for experts to predict just who will get this condition, it's m`ore likely to occur if you're a person who runs and/or does a lot of things on your feet.

What do flip-flops have to do with plantar fasciitis, and what else can cause your feet to ache?

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-- Shoes with thin soles or poor arch support. These shoes can't protect your feet properly. Yes, they may feel comfy -- but you might be paying a price later on.

-- High heels. These might cause your Achilles tendon, which is attached to your heel, to shorten and contract, leading to strain on the tissue around your heel.

-- Foot mechanics. Having flat feet or a high arch can put greater stress on the plantar fascia. Additionally, an incorrect gait -- especially pronation, where the foot turns outward -- can put added stress on the heel bone and tissue.

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-- Age. As you approach middle age, you lose fat in your foot; less cushioning can put you more at risk for developing the painful condition.

-- Pregnancy. Changes during pregnancy, like extra weight and hormonal changes, cause ligaments and other tissue to relax.

-- Arthritis. Certain types of arthritis cause inflammation in the tendons, particularly among the elderly.

-- Diabetes. Although doctors are not sure of the reason, people with the condition are more prone to develop plantar fasciitis.

-- Being overweight. Our heel absorbs much of our body's pressure when we walk; extra weight equals more pressure, contributing to damage and plantar fasciitis.

-- Occupation. Being on your feet all day adds to the load your feet are enduring.

-- Overuse. Long-distance runners are more likely to develop this condition. But you need not be a super-athlete: jogging, walking, aerobics or even stair-climbing can stress the heel bone and surrounding tissue.

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What to Do?

The good news: Nonsurgical treatment usually improves the pain.

The bad news? You need to practice patience. Treatment can last anywhere from several months to a couple of years before the pain improves.

Things Your Doctor Might Suggest You Try:

-- Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation

-- Heel and foot stretching exercises
-- Night splints that stretch the foot while you sleep
-- Wearing shoes with cushioning and adequate support
-- Ice for the first 24 hours
-- Nonimpact activity
--Over-the-counter arch supports
--Custom orthotics