JAMA PATIENT PAGE | Bones, Joints, and Muscles Plantar Fasciitis

Plantar fasciitis is a common cause of foot and heel pain. The plantar fascia is a band of tissue that runs along the bottom What is the plantar fascia? of the foot. It is attached to the heel bone and connects to each of The plantar fascia is a fibrous the toes, and it provides strength and support to the arch of the band on the bottom of the foot foot. Plantar fasciitis occurs when this band of tissue gets strained that connects the heel bone to each of the toes. or irritated.

Symptoms Plantar fasciitis most often causes pain in the heel or in the arch of Plantar fascia the foot. The pain is usually most noticeable when first standing up and walking or after walking, running, or standing for long periods. Arch of foot The pain is usually sharp at first, and it may decrease or become duller Plantar fasciitis after light activity. One or both feet may be affected. In plantar fasciitis, the plantar fascia becomes irritated and inflamed. This causes pain in the heel and arch of the foot. Cause In general, plantar fasciitis occurs when the plantar fascia is injured Treatments for plantar fasciitis fromtoomuchpressureoractivity,butthereisoftennotaclearcause Stretching Icing the foot calf muscles 2-3 times per day or triggering event. People who are overweight and people who have and feet tight calf muscles, high-arched feet, or flat feet are at risk of plantar fasciitis. Plantar fasciitis is also more common in people who fre- quently run or perform other high-impact activities like jumping or dancing because these activities may cause small repeated injuries to the plantar fascia over time. Plantar fascia Arch support Anti-inflammatory inserts and medications Diagnosis supportive shoes Plantar fasciitis is diagnosed based on a medical history and physical examinationperformedbyahealthcarepractitioner.Theexaminermay Heel bone pressonthebottomofthefoottoconfirmthatthepainiscomingfrom theplantarfascia.Imagingstudiesorothertestsarenotneededtomake the diagnosis, but they are sometimes used to rule out other causes of foot pain such as a broken bone or nerve injury. most people experience improvement or resolution of symptoms over time, surgery may be considered in rare cases if the pain does Treatment not improve after several months of conservative treatments. Simple measures can often be taken to lessen the symptoms of plan- tar fasciitis. If a clear trigger—such as a sudden increase in high- impact exercise—can be identified, then decreasing the amount of FOR MORE INFORMATION physical activity may be helpful. Daily stretching of the plantar fas- cia and the calf muscles should be performed, and ice can be ap- • National Library of Medicine medlineplus.gov/ency/article/007021.htm plied to the affected area for 10 to 20 minutes at a time 2 to 3 times per day. Wearing shoes with good arch supports can also improve • Mayo Clinic symptoms, and taping the bottom of the feet or using shoe inserts www.mayoclinic.org/diseases-conditions/plantar-fasciitis/home /ovc-20268392 called orthotics are other ways to provide additional foot support. Over-the-counter anti-inflammatory medications such as To find this and other JAMA Patient Pages, go to the For Patients ibuprofen may provide short-term relief. If pain persists, steroid in- collection at jamanetworkpatientpages.com. jections may be given into the foot to reduce the pain. Although

Author: Christopher C. Muth, MD The JAMA Patient Page is a public service of JAMA. The information and Sources: National Library of Medicine, American Academy of Orthopaedic Surgeons recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

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