Plantar fasciitis is a condition usually characterised by a chronic sharp pain in the heel of your foot. This injury to the plantar fascia, which is the large, fibrous band of tissue that connects your heel bone to your toes, limits the normal biomechanical functions of the foot. Arch support and shock absorption will also be affected when there is a tear or injury to the plantar fascia tissue. Heel spurs (bony growths in the heel area) may develop as a result of this condition.
Causes of Plantar Fasciitis
Plantar fasciitis most commonly afflicts certain groups of people, including females, people aged 40-60 and those who are obese. People who spend many hours standing daily or with structural abnormalities in their feet such as having tight Achilles tendons, flat feet or usually high arches are also at higher risk for this condition. Having weakened muscles in the calf can also hinder the ability to absorb shock which increases pressure on the plantar fascia when walking or running.
Certain shoes can also contribute to these conditions, such as wearing open-toed high-heeled shoes, or footwear with thin and worn-out soles. Participation in sports is also a common cause of plantar fasciitis. This is especially true for sports that require a lot of running or jumping on hard surfaces, for example, basketball, sprinting or ballet dancing. Plantar fasciitis can also be aggravated if you begin a high-intensity activity after a period of inactivity, or scale up the intensity of exercise too quickly. The overuse and repeated overloading of the plantar fascia tissue can lead to a tear or injury that can then cause inflammation that results in plantar fasciitis.
Symptoms of Plantar Fasciitis
Pain from plantar fasciitis is usually most acute upon taking your first steps in the morning, after a period of sitting, or after exercise. You may unconsciously find yourself walking on your toes in an attempt to alleviate the pressure from your heel area. If left untreated, plantar fasciitis may develop into a chronic condition. Additionally, you may develop symptoms of other foot, knee injuries or back strains because the pain from plantar fasciitis can affect the way you walk to compensate for the pain.
Plantar Fasciitis Treatment
Simple treatments for plantar fasciitis include icing, athletic taping, and pain relief medications to ease the inflammation of your condition. Physical therapy such as stretching and exercise can also help to stretch the plantar fascia and Achilles tendon, which then strengthens the lower leg’s muscles.
For more severe cases, special devices may be needed. These devices include:
- Night splints: Wearing these splints overnight will hold the plantar fascia and Achilles tendon in a lengthened position to promote stretching.
- Orthotics: This is a custom-made arch support to distribute the pressure on your feet more evenly.
- Walking boots, canes or crutches: These devices prevent you from moving your foot or placing your full weight on your foot.
If the above conservative plantar fasciitis treatments do not relieve the symptoms, we recommend:
- Injections: Steroid injections provide temporary pain relief. However, multiple shots may weaken your plantar fascia and cause it to rupture. Plasma injections obtained from your own blood can also be considered to promote tissue healing.
- Extracorporeal shock wave therapy: For chronic plantar fasciitis, sound waves are directed at the pain area to stimulate healing.
- Ultrasonic tissue repair: A probe will be inserted into the damaged plantar fascia tissue using ultrasound imaging. The tip will then vibrate quickly to break up the damaged tissue, which will be suctioned out.
- Surgery: If the pain is severe and all other plantar fasciitis treatments fail, surgery will be conducted.
Receive Your Plantar Fasciitis Treatment in Singapore Today
Plantar heel pain is one of the most common orthopaedic conditions. Your orthopaedic specialist will usually diagnose this condition based on a physical examination, your physical activity history and pain symptoms. Non-operative treatments include rest and activity modifications, as well as physical therapy, orthotics or prescriptions of non-steroidal anti-inflammatory medications. In severe cases, operative treatment may be needed. Receiving timely treatment will help prevent your condition from turning chronic. Orthopaedic foot and ankle specialist, Dr. Gowreeson Thevendran from Orthofoot MD Singapore, will find the most effective treatment for your plantar fasciitis. Book an appointment to treat your plantar fasciitis before it is too late!
Frequently Asked Questions About Plantar Fasciitis Treatment in Singapore
1. How do I know if I have plantar fasciitis?
As heel pain can be caused by different conditions, it is advisable to seek the help of a professional orthopaedic doctor to diagnose the specific condition causing you pain. In addition to plantar fasciitis, other causes of heel pain may include nerve compression, loss of fatty tissue, stress fractures, corns and calluses, and Achilles tendinitis. In fact, many individuals might suffer from a few of these conditions all at the same time.
2. How do physicians diagnose plantar fasciitis?
If diagnosing your condition, and if it is indeed plantar fasciitis, your physician will take into consideration your medical history, conduct a physical examination of your foot and/or order additional imaging tests to better understand the reasons for your heel pain. These may include questions about your athletic history, any prior or concurrent foot injuries you may be experiencing, when in your foot the soreness began as well as other questions about your health and wellness. A physical examination for plantar fasciitis will usually include the physician putting pressure on the bottom of your feet or bending your toes and foot upward. The shape of your foot will also be taken into consideration. Bone spurs are a common side effect accompanying plantar fasciitis. If your physician suspects you have bone spurs, X-rays may be ordered to confirm this diagnosis.
3. Will plantar fasciitis go away by itself?
It is unlikely for heel pain to go away by itself. If plantar fasciitis is left untreated, the pain may worsen and turn into a chronic condition. In general, the longer you wait to seek plantar fasciitis treatment for your heel pain, the longer it will take to heal. This is why it is advisable to seek out the learned opinion of a professional physician as soon as symptoms manifest in order to ensure that your pain is managed well for the best chance of a successful recovery.
4. Can I continue running or sports training with plantar fasciitis?
It would be unwise to continue running or engaging in activities that place excessive compression or a high tensile load on your plantar fascia. Pain is an indication that something in your body isn’t functioning the way it’s supposed to. It is best to listen to your body and adjust your activities accordingly to place less stress on your plantar fascia. Only when your body is physically healed will you be able to invest yourself fully in doing the things you love.
5. What shoes should I wear if I have plantar fasciitis?
Certain shoes can help alleviate the heel pain caused by plantar fasciitis. While the best shoe for your condition will vary from individual to individual, in general, those who are searching for shoes to help with plantar fasciitis should prioritise a pair that provides good arch support, a firm but flexible midsole, and ample cushioning and shock absorption. Steer clear from shoes that are too restrictive or tight, high heels or other shoes that lift the ball of your foot high above the toes, and shoes that don’t provide enough cushioning or support.
6. What is the fastest way to cure plantar fasciitis?
While plantar fasciitis can be a self-limiting condition, it can heal over the course of 6 to 18 months even without treatment. However, this requires consistent non-operative treatment to facilitate relief and eventual full recovery. To treat plantar fasciitis at home, it is advised to follow the RICE treatment, which includes resting, icing, compressing, and elevating. Using the proper footwear that provides optimal support can also help alleviate the pain and prevent further damage.
7. How do I permanently get rid of plantar fasciitis?
Gaining up to 90% recovery within six months of consistent non-operative treatment is possible for those suffering from plantar fasciitis. Besides the aforementioned RICE treatment, medicating with prescribed anti-inflammatory drugs, as well as, physical therapy can help alleviate the symptoms of plantar fasciitis. If after prolonged conservative therapy the patient is still suffering from immense pain, surgery may be recommended.
8. Can a GP help with plantar fasciitis?
When it comes to plantar fasciitis treatment, a GP can offer medication to relieve the pain as quickly as possible. However, given the difference between an orthopaedic doctor and a GP, seeing an orthopaedic specialist in Singapore is advisable before the pain becomes chronic, one is struggling with performing everyday activities, is experiencing instability while walking or standing, or has reduced motion or stiffness.
Dr Gowreeson Thevendran is currently an orthopaedic surgeon with Island Orthopaedic, a one-stop care centre for orthopaedic health under Healthway Medical Group. He specialises in treating lower limb orthopaedic conditions, as well as trauma and fracture surgery of both the upper and lower limbs. Prior to establishing his private practice, Dr Gowreeson was Chief of Foot & Ankle Surgery at the Department of Orthopaedics at Tan Tock Seng Hospital (TTSH). Today, he continues to serve the Orthopaedic Department at TTSH as a visiting consultant.