Plantar fasciitis etiology

Written by Wang Cheng Lin
Orthopedics
Updated on September 25, 2024
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The most common cause of plantar fasciitis is excessive weight-bearing walking, which leads to a type of nonspecific chronic aseptic inflammation of the plantar fascia, resulting in pain on the medial side of the foot when weight-bearing. This is the most common reason. The second cause is degeneration, which is most commonly seen in middle-aged and elderly female patients. The degeneration of the fascia can cause pain and may also be accompanied by heel spurs. Currently, there are two main treatments for plantar fasciitis. The first is conservative treatment, which includes rest, acupuncture, and local injection therapy to relieve pain. If conservative treatment does not work after more than six months or the condition gradually worsens, then surgical treatment becomes necessary. Surgical treatment can remove local inflammatory tissue and release the plantar fascia to achieve the purpose of relieving pain.

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Written by Guan Yu Hua
Orthopedic Surgery
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What causes plantar fasciitis?

Plantar fasciitis is mostly caused by prolonged standing, such as wearing high heels or leather shoes for extended periods. The fascia remains tense under these conditions, leading to tenderness in the sole's fascia upon examination. Pain tends to intensify while walking or bearing weight and alleviates when resting as the fascia relaxes. It is best to diagnose and treat this condition early. Applying heat, reducing the movement of the affected limb, and avoiding tension in the fascia are advisable. Consuming medications that invigorate blood circulation and relieve pain can also help, generally improving symptoms within 7 to 10 days. Recovery might be slow in some cases due to fascial damage. Furthermore, repeated pulling or tension from standing and working can lead to recurrent episodes. Rest is recommended for such individuals, and wearing softer sports shoes during activities can be beneficial. Resting and taking blood-invigorating medications usually lead to gradual recovery. For severe cases ineffective with conservative treatment, surgical cutting of the fascia may be performed to relieve pain. (Please use medication under the guidance of a professional physician.)

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Written by Guan Yu Hua
Orthopedic Surgery
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What should I do if plantar fasciitis is very painful?

Plantar fasciitis is mainly characterized by worsened symptoms after activity, with pain at the bottom of the foot, which tends to ease during rest. Typically, the most intense pain occurs when stepping down for the first time in the morning or when the affected foot bears weight painfully, possibly due to tension in the plantar fascia. This condition frequently arises in individuals who wear leather shoes or high heels for extended periods, stand for long durations, or walk on cobblestone pathways in flat shoes. Pain occurs when the plantar fascia is tense and gradually worsens, but rapidly alleviates when the fascia relaxes upon resting. Local heat application is recommended as it promotes dilation of the surrounding vessels, effectively stimulating blood circulation and thereby easing the symptoms. Additionally, it is suggested to reduce the amount of time standing and the frequency of activities, and to rest as much as possible in bed. Recovery is typically slow, generally improving gradually over about 3-4 weeks. For significant pain, medications that promote blood circulation and alleviate pain may be taken. If necessary, encapsulation therapy can be performed. In cases where repeated treatment is ineffective, fasciotomy might be considered, which can impact the function of the foot to various extents, yet the benefits outweigh the downsides and might be the last treatment option chosen. Many patients find that rest, along with medications that promote blood circulation and alleviate pain, physiotherapy, heat application, electric baking, massage, and others, help in alleviating the symptoms.

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Written by Wang Cheng Lin
Orthopedics
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Can you still exercise with plantar fasciitis?

Patients with plantar fasciitis can exercise, but there are definite restrictions on the type of exercise. For instance, it is best to avoid weight-bearing exercises such as running, weightlifting, or mountain climbing. For patients with plantar fasciitis, we recommend swimming because it involves limb, muscle, and fascia activities in a non-weight-bearing situation, which is greatly beneficial and not harmful to the fascia. Swimming is our recommended approach, as it can also appropriately stretch the plantar fascia during the process, thereby helping to alleviate foot pain.

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Written by Wang Cheng Lin
Orthopedics
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How long does it take to recover from plantar fasciitis?

For the disease of plantar fasciitis, if treated under normal conventional methods, the recovery time is generally around four to six weeks. However, during the treatment period, it is crucial to strictly follow the treatment principles, such as prohibiting excessive weight-bearing walking, strenuous exercise, and overworking. At the same time, some physical therapy methods should be coordinated, such as massage, acupuncture, electrotherapy, and magnetotherapy. In more severe cases, occlusion methods can be used to alleviate local pain. Generally, the time frame is four to six weeks. If the results from regular conservative treatment are not satisfactory, surgical treatment may be required later on.

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Written by Wang Cheng Lin
Orthopedics
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Plantar fasciitis symptoms

The main symptom of plantar fasciitis is pain on the inner side of the foot when bearing weight and walking, which severely affects weight-bearing walking. Over time, this pain during weight-bearing walking can turn into what is known as rest pain, which is pain in the foot even when it is not bearing weight. The treatment of plantar fasciitis is currently divided into two parts in clinical practice. The first part is conservative treatment, which mainly involves massage, acupuncture, electrotherapy, magnet therapy, and occlusive methods to relieve the symptoms of foot pain when bearing weight. If this conservative treatment is ineffective and the pain worsens, severely affecting weight-bearing walking, surgical treatment may be necessary. The goals of surgical treatment are, firstly, to release the plantar fascia, and secondly, to remove heel spurs, as a significant number of patients with plantar fasciitis also have heel spurs. Thus, the aim of surgery is to release the plantar fascia and remove the heel spur to alleviate the pain during weight-bearing walking.