Plantar Fasciitis
Treatment
Dr Chiam Tut Fu
MBBS (Singapore)
MSS (Sports Medicine) (USA)
MMed (OM) (Singapore)
GDOM (Singapore)
DWD (Singapore)
What is Plantar Fasciitis?
Plantar fasciitis is a medical condition where the thick band of tissue on the bottom of your foot, called the plantar fascia, becomes inflamed. This tissue connects your heel to your toes and supports the arch of your foot. This condition typically causes sharp, stabbing heel pain, especially with the first steps in the morning or after periods of inactivity. The pain usually improves with movement but can return after prolonged standing or walking. Plantar fasciitis can affect one or both feet and is a leading cause of heel pain in adults.
Symptoms of Plantar Fasciitis
These symptoms can affect everyday living and quality of life, from minor to severe. Recognising these signs can aid in early diagnosis and treatment.
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Activity-related Pain
People with plantar fasciitis frequently experience pain during or after physical activity. While the pain may lessen during the activity, it typically intensifies after stopping, particularly after running, jumping, or standing for long periods.
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Limited Mobility
Plantar fasciitis can hinder foot and ankle mobility due to pain and stiffness, impacting daily activities. Mobility limitations can range from minor to severe.
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Stiffness and Tenderness
Foot stiffness and tenderness are particularly noticeable in the morning, making the first few steps after waking up difficult. Discomfort often eases as the foot warms up with activity. Tenderness is often felt along the bottom of the foot, especially near the heel, and may be accompanied by swelling or redness.
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Heel Spurs
While not a direct symptom of plantar fasciitis, heel spurs are often associated with the condition. Heel spurs are bony growths that develop on the heel bone due to chronic inflammation of the plantar fascia. They can contribute to the pain and discomfort experienced by people with plantar fasciitis, ranging from minor irritation to significant pain.
What Are The Causes and Risk Factors of Plantar Fasciitis?
Plantar fasciitis occurs due to inflammation of the plantar fascia, the thick band of tissue that runs along the bottom of the foot. Factors contributing to this condition include:
- Age: Plantar fasciitis is most common in people between the ages of 40 and 60, due to the natural loss of elasticity and stability in the plantar fascia with age.
- Obesity: Excess body weight places additional stress on the plantar fascia, leading to its inflammation and increasing the risk of plantar fasciitis.
- Physical Activity: Repetitive stress or overuse, often from activities such as running, walking, or standing for long periods, can cause tiny tears in the plantar fascia, leading to inflammation and pain.
- Foot Structure: Certain foot structures, such as flat feet, high arches, or an abnormal walking pattern, can place excessive stress on the plantar fascia, increasing the risk of plantar fasciitis.
- Occupational Factors: Jobs requiring prolonged standing or walking, especially on hard surfaces, can contribute to the development of plantar fasciitis due to constant pressure on the feet.
- Inadequate Footwear Support: Shoes with poor arch support or cushioning may result in the plantar fascia not receiving enough support, increasing strain and the risk of inflammation.
Types of Plantar Fasciitis
Plantar fasciitis can be categorised into two main types based on the duration and progression of symptoms:
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Acute Plantar Fasciitis
Acute plantar fasciitis develops suddenly and is usually linked to a specific incident of overuse or injury. The symptoms of acute plantar fasciitis include severe inflammation and sudden, severe pain.
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Chronic Plantar Fasciitis
Chronic plantar fasciitis develops over time due to prolonged stress on the plantar fascia. This type is characterised by persistent, ongoing heel pain lasting months or even years.
How is Plantar Fasciitis Diagnosed?
If your symptoms of plantar fasciitis gradually worsen, you should seek a medical assessment. This includes:
Clinical Evaluation
A thorough clinical evaluation is the first step in diagnosing plantar fasciitis. This includes:
- Medical History: A detailed medical history will be taken, focusing on the onset, duration, and characteristics of your heel pain. The doctor will ask about any factors that worsen or alleviate the pain, your physical activity levels, occupation, footwear choices, and any previous injuries to the foot or ankle.
- Physical Examination: During the physical examination, your doctor will press the bottom of your foot to identify areas of tenderness, particularly near the heel and along the plantar fascia. They will also assess your foot structure, range of motion, and walking pattern to identify any abnormalities that may be causing your discomfort.
Imaging Tests
To confirm the diagnosis of plantar fasciitis and rule out other potential causes of heel pain, your doctor may order imaging tests such as:
- X-rays: X-rays can detect and rule out fractures or arthritis that may cause heel discomfort. They show bone structure and assist in spotting anomalies.
- Ultrasound: Ultrasound imaging can visualise the plantar fascia, showing thickening, inflammation, or tears that are indicative of plantar fasciitis.
- MRI Scan: An MRI scan may be helpful in complicated cases to rule out other disorders, such as stress fractures or nerve entrapment, and to provide detailed images of the soft tissues, including the plantar fascia.
Minimally Invasive Treatments We Use To Treat
Plantar Fasciitis
Coreflex is used to treat chronic plantar fasciitis and muscle imbalances in the foot, ankle, and lower leg.
Enhances foot and ankle muscle alignment and function, improves stability, flexibility, and strength
Little to no recovery time. Patients can resume normal activities promptly.
PRP therapy is used for chronic heel pain unresponsive to conservative treatments, as well as tendon and ligament injuries.
Promotes natural healing by stimulating tissue repair, reduces inflammation and pain
Minimal downtime, allowing a quick return to normal activities. Initial soreness at the injection site, typically resolving within a few days.
Viscosupplementation is used for persistent pain and mobility issues due to plantar fasciitis.
Provides lubrication and cushioning, reduces friction and stress on the plantar fascia, alleviates pain, and enhances mobility
Quick procedure with minimal downtime. Mild discomfort at the injection site, typically subsiding within a few days.
Radio-frequency therapy is used for chronic plantar fasciitis with nerve-related pain.
Targets and disrupts nerve impulses causing pain, promotes tissue repair, and reduces chronic inflammation
Short recovery period with minimal discomfort. Minor soreness or swelling at the treatment site.
Low-level laser therapy is used for persistent inflammation and pain associated with plantar fasciitis.
Enhances blood flow and cellular activity, reduces inflammation, accelerates tissue repair
No downtime required; can resume normal activities immediately. Gradual improvement over the course of treatment.
Dr Chiam Tut Fu
(詹达夫医生)
MBBS (Singapore)
MSS (Sports Medicine) (USA)
MMed (OM) (Singapore)
GDOM (Singapore)
DWD (Singapore)
Dr Chiam is a MOH accredited Specialist in Sports Medicine and has practised medicine for over 30 years.
Dr Chiam Tut Fu obtained his MBBS from National University of Singapore in 1990. He went on to obtain his Masters in Sports Science (Sports Medicine) from the United States Sports Academy, graduating as the year’s outstanding student, and Masters of Medicine (Occupational Medicine) from the National University of Singapore.
Key Interests:
- Non-surgical treatment of sports injuries
- Non-surgical treatment of degenerative conditions
- Nutraceuticals for healthy ageing and exercise performance
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Paragon Medical Centre, #18-03
290 Orchard Road, Singapore 238859
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Frequently Asked Questions
Are there any long-term complications of untreated plantar fasciitis?
If left untreated, plantar fasciitis can lead to chronic pain and other issues, such as compensatory injuries in the knees, hips, or back due to altered walking patterns. Early diagnosis and treatment are crucial to prevent long-term complications.
How long does plantar fasciitis last?
The duration of plantar fasciitis varies in different people. With proper treatment, many people experience significant improvement within a few months. However, the condition can take six to twelve months to resolve completely.
Do I have to miss work or school if I have plantar fasciitis?
Not necessarily. Many people with plantar fasciitis can manage their symptoms and continue with their daily activities, including work or school, by following a treatment plan that includes rest, proper footwear, and other conservative measures. However, adjustments may be needed based on the severity of symptoms and the activities involved.
When should I see a doctor for plantar fasciitis?
You should see a doctor if you experience persistent heel pain that does not improve with home treatments, if the pain is severe, or if it interferes with your daily activities. Early medical intervention can help manage the condition effectively.