Understanding plantar fasciopathy

Plantar fasciopathy, commonly known as plantar fasciitis, is a prevalent condition characterised by pain in the heel and bottom of the foot. This ailment occurs due to inflammation, degeneration, or micro-tears in the plantar fascia - a thick band of connective tissue that runs along the sole, connecting the heel bone to the toes. Here to tell us more about the condition is esteemed consultant orthopaedic surgeon, Mr Georgios Kiziridis. 

Causes and risk factors

Plantar fasciopathy often arises from repetitive strain on the plantar fascia, which can be caused by various factors. Overuse from activities such as running, prolonged standing, or walking on hard surfaces is a primary cause. Additionally, structural foot problems like flat feet or high arches can increase tension on the fascia. Age is another risk factor, as the plantar fascia loses elasticity over time. Obesity and sudden weight gain also contribute by placing extra stress on the feet.

Symptoms and diagnosis

The hallmark symptom of plantar fasciopathy is sharp, stabbing pain in the heel, especially noticeable with the first steps in the morning or after periods of inactivity. This pain typically decreases with movement but can return after prolonged standing or physical activity.

Diagnosis is primarily clinical, based on patient history and physical examination. Doctors may perform a thorough assessment, including checking for tenderness along the plantar fascia. In some cases, imaging studies such as X-rays or MRIs are used to rule out other conditions like fractures or nerve entrapments.

Treatment options

Effective treatment for plantar fasciopathy often involves a combination of approaches. Initial treatments focus on relieving pain and reducing inflammation. Rest, ice application, and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly recommended.

Stretching exercises targeting the Achilles tendon and plantar fascia can help improve flexibility and alleviate symptoms. Physical therapy may also be beneficial. For more severe or persistent cases, treatments such as orthotic devices, night splints, or corticosteroid injections might be considered. Extracorporeal shockwave therapy (ESWT) and, in rare cases, surgical intervention are options for those who do not respond to conservative treatments.

Prevention and long-term management

Preventing plantar fasciopathy involves maintaining proper foot health and biomechanics. Wearing supportive footwear, especially during activities that put strain on the feet, is crucial.

Regular stretching exercises, particularly for the calves and plantar fascia, can help maintain flexibility and reduce the risk of recurrence. Managing body weight through a healthy diet and regular exercise is also essential in reducing stress on the plantar fascia. With appropriate care and preventive measures, individuals can effectively manage and reduce the impact of plantar fasciopathy on their daily lives.