What Are the Main Causes of Plantar Fasciitis?

Reviewed on 1/6/2021

What is plantar fasciitis?

The main causes for plantar fasciitis include obesity, physical activity, occupation, pregnancy, and foot structure.
The main causes for plantar fasciitis include obesity, physical activity, occupation, pregnancy, and foot structure.

The plantar fascia is a long, thin ligament that runs along the bottom of your foot. It provides arch support and connects the heel to the front of the foot. It is a major component of the foot that enables you to walk.

Plantar fasciitis happens when the plantar fascia becomes irritated or inflamed, causing pain in the heel and limiting your ability to walk normally. There are many causes for plantar fasciitis, and it is one of the most common foot injuries in humans.

It is estimated that 1 in 10 people will develop plantar fasciitis in their lifetime. Middle-aged obese women and young male athletes have higher incidences than the rest of the population.

Signs of plantar fasciitis?

The first noticeable sign of plantar fasciitis is a pain in the heel or the arch of the foot. Often with initial signs of plantar fasciitis you will experience pain first thing in the morning. Pain tends to gradually decrease over the course of the day, only to be worse the following morning.

Pain symptoms can become worse if there is a prolonged period of time bearing a lot of weight or remaining in a standing position. Additionally, it is likely that a tightening in the Achilles tendon will be felt by someone experiencing plantar fasciitis.

Causes of plantar fasciitis

There are several potential causes for plantar fasciitis, including:

Obesity

People who are overweight or obese tend to be at greater risk of developing plantar fasciitis due to the increase in pressure on the foot. This is especially true if your weight gain was sudden.

Physical activity

Recreational factors can play a role in increasing the risk of plantar fasciitis. If you’re a long-distance runner, for example, you are more likely to eventually develop plantar fascia problems.

Occupation

People with jobs that require prolonged periods of standing and walking, like a waiter or factory worker, have higher instances of getting plantar fasciitis.

Pregnancy

Studies have shown that plantar fasciitis is more prevalent in women and that pregnant women commonly develop it, especially during the third trimester.

Foot structure

Structural foot problems like flat feet or very high arches can increase your chances of developing plantar fasciitis, as can a tight Achilles tendon.

Diagnosis for plantar fasciitis

Your doctor will be able to assess whether or not you have plantar fasciitis after asking you a series of questions and performing a physical exam. Your doctor will examine the foot for these signs:

  • A high arch
  • Areas of pain on the bottom of your foot, specifically in front of your heel bone
  • Pain that worsens when your foot is flexed, but subsides when your toes are pointed down
  • Limited "up" motion of your ankle

Your doctor may also order imaging tests like an X-ray or magnetic resonance imaging (MRI) scan to help make sure your heel pain is caused by plantar fasciitis and not something else.

QUESTION

All ___________ have flat feet. See Answer

Treatments for plantar fasciitis

Most treatments do not require surgery, and the vast majority of people fully recover within 12 to 18 months. Your doctor will likely recommend any or all of the following treatments:

Activity modification

Activities that require repetitive foot impact like running should be avoided. Non-weight bearing physical activities like cycling, swimming, or rowing can be done to maintain cardiovascular fitness. Returning to more impact-intensive activities may be allowed if you’ve not experienced any pain in the heel for 4 to 6 weeks.

Ice massage

Rolling the injured foot over a frozen can with moderate pressure for five minutes can help reduce the swelling and relieve the pain. This should be done once a day, at the end of the day.

Night splints

Wearing a tension night splint, also known as dorsiflexion splints, while sleeping has been shown to improve plantar fasciitis in about 4 to 12 weeks of use.

Orthotics

Feet supports that help reduce the weight load carried by the plantar fascia have been shown to be effective in resolving plantar fasciitis. There are many different types of feet supports and braces. Consult with your doctor or a specialist like a podiatrist to select the best one for you.

Steroid injection

A steroid injection directly into the plantar fascia has been shown to provide effective short-term relief for up to three months.

Stretching

Doing calf stretches is easy and can help release the tension and pain felt in the plantar fascia. To perform a proper stretch, hold the injured heel with one hand and stretch the toes of the foot upwards with the other hand. Hold for 30 seconds and then release. Repeat three times. This should be done first thing in the morning before getting out of bed.

If the above treatments aren’t successful in reducing or eliminating plantar fasciitis after 6 to 12 months, your doctor will likely refer you to an orthopedic surgeon for operative treatment.

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References
American Academy of Orthopaedic Surgeons: "Plantar Fasciitis and Bone Spurs."

Archive of Internal Medicine: "Effectiveness of Foot Orthoses to Treat Plantar Fasciitis."

Clinical Journal of Sports Medicine: "Plantar fasciitis: a prospective randomized clinical trial of the tension night splint."

Journal of Research in Medical Sciences: "Plantar fasciitis."

Physical Therapy: "Plantar Fasciitis: Are Pain and Fascial Thickness Associated With Arch Shape and Loading?"

Rheumatology: "Extracorporeal shock wave application for chronic plantar fasciitis associated with heel spurs: prediction of outcome by magnetic resonance imaging."

Rheumatology: "Steroid injection for heel pain: evidence of short-term effectiveness. A randomized controlled trial."

Seminars in Interventional Radiology: "Pregnancy and the Working Interventional Radiologist."

Singapore Medical Journal: "Management of plantar fasciitis in the outpatient setting."

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