What causes plantar fasciitis?

Written by Guan Yu Hua
Orthopedic Surgery
Updated on September 25, 2024
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Plantar fasciitis is mostly caused by prolonged standing, such as wearing high heels or leather shoes for extended periods. The fascia remains tense under these conditions, leading to tenderness in the sole's fascia upon examination. Pain tends to intensify while walking or bearing weight and alleviates when resting as the fascia relaxes. It is best to diagnose and treat this condition early. Applying heat, reducing the movement of the affected limb, and avoiding tension in the fascia are advisable. Consuming medications that invigorate blood circulation and relieve pain can also help, generally improving symptoms within 7 to 10 days. Recovery might be slow in some cases due to fascial damage. Furthermore, repeated pulling or tension from standing and working can lead to recurrent episodes. Rest is recommended for such individuals, and wearing softer sports shoes during activities can be beneficial. Resting and taking blood-invigorating medications usually lead to gradual recovery. For severe cases ineffective with conservative treatment, surgical cutting of the fascia may be performed to relieve pain. (Please use medication under the guidance of a professional physician.)

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Written by Guan Yu Hua
Orthopedic Surgery
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What should I do if plantar fasciitis is very painful?

Plantar fasciitis is mainly characterized by worsened symptoms after activity, with pain at the bottom of the foot, which tends to ease during rest. Typically, the most intense pain occurs when stepping down for the first time in the morning or when the affected foot bears weight painfully, possibly due to tension in the plantar fascia. This condition frequently arises in individuals who wear leather shoes or high heels for extended periods, stand for long durations, or walk on cobblestone pathways in flat shoes. Pain occurs when the plantar fascia is tense and gradually worsens, but rapidly alleviates when the fascia relaxes upon resting. Local heat application is recommended as it promotes dilation of the surrounding vessels, effectively stimulating blood circulation and thereby easing the symptoms. Additionally, it is suggested to reduce the amount of time standing and the frequency of activities, and to rest as much as possible in bed. Recovery is typically slow, generally improving gradually over about 3-4 weeks. For significant pain, medications that promote blood circulation and alleviate pain may be taken. If necessary, encapsulation therapy can be performed. In cases where repeated treatment is ineffective, fasciotomy might be considered, which can impact the function of the foot to various extents, yet the benefits outweigh the downsides and might be the last treatment option chosen. Many patients find that rest, along with medications that promote blood circulation and alleviate pain, physiotherapy, heat application, electric baking, massage, and others, help in alleviating the symptoms.

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Written by Wang Cheng Lin
Orthopedics
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How is plantar fasciitis treated?

The treatment of plantar fasciitis currently is divided into two methods in clinical practice. The first method is conservative treatment, which includes rest, avoiding strenuous exertion and excessive weight-bearing walking. It can be managed with physical therapy, massage, acupuncture, physiotherapy, and local block injections. If conservative treatments do not improve the condition or even if the pain progressively worsens over more than half a year, severely affecting daily life, surgical treatment may be necessary. The objectives of surgical treatment are firstly to release the plantar fascia and secondly to remove bone, as a significant portion of patients with plantar fasciitis also have heel spurs; therefore, the surgical procedure involves the removal of these bone spurs to alleviate the pain.

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Written by Wang Cheng Lin
Orthopedics
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Which department should I register for plantar fasciitis?

To register for plantar fasciitis at a hospital, you need to visit two departments. The first is the orthopedics department, where the primary goal is to determine the cause of your plantar fasciitis. Firstly, it is necessary to check for the presence of heel spurs by taking an X-ray of the foot. Secondly, an MRI of the foot may be required to ascertain whether there is significant congestion and edema in your plantar fascia. As for treatment, you can seek help from the pain management department. The pain management department can provide local physical therapy and local blockade treatment to alleviate your pain. If this pain does not improve or worsens after more than six months of conservative treatment, severely affecting your daily life, you might need to return to the orthopedics department for surgical treatment. The surgery involves loosening the plantar fascia to help relieve the pain.

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Written by Wang Cheng Lin
Orthopedics
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How to cure plantar fasciitis?

In clinical practice, there are currently two methods for treating plantar fasciitis. The first method is the most commonly seen conservative treatment, such as using rest, wearing orthotic shoes, and utilizing acupuncture, massage, electrotherapy, magnetotherapy, and local infiltration therapy to alleviate the symptoms of foot pain caused by the plantar fascia while walking. However, if conservative treatment does not yield results after six months or if the pain intensifies and severely affects weight-bearing walking, then it may become necessary to proceed with the second method of treatment, which is surgical intervention. The goals of surgical treatment include, firstly, loosening the plantar fascia and, secondly, removing bone spurs, as a significant number of patients with plantar fasciitis also develop bone spurs. Therefore, along with loosening the fascia, it is necessary to excise the bone spurs to relieve the symptoms of foot pain.

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Written by Wang Cheng Lin
Orthopedics
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Plantar Fasciitis Physical Therapy Methods

The most common clinical treatments for plantar fasciitis are, firstly, injection therapy, secondly, acupuncture, and thirdly, small needle knife therapy. Among these, injection therapy has the most noticeable effects, but it also has a significant problem. Since the injections contain steroids, excessive use of injection therapy can not only fail to alleviate symptoms but may actually damage the plantar fascia, leading to a worsening of plantar fasciitis symptoms. Therefore, it is crucial to limit the frequency of injection treatments to no more than once or twice a month. If the symptoms of plantar fasciitis do not improve significantly with physical therapy and the pain progressively worsens, then surgical treatment may be necessary. The goals of surgery are firstly to release the plantar fascia and secondly to remove bone spurs, thereby completely alleviating the symptoms of plantar fasciitis pain.