Painful bottom of foot

Plantar fasciitis is a condition caused by repetitive microtears of the plantar fascia. The plantar fascia is a very strong layer of tissue on the sole that connects the heel to the toes. It serves an important role in normal foot function and helps to maintain the shape of the arches of the foot. Why some people develop plantar fasciitis is poorly understood. However, certain factors have been identified as potential causes of plantar fasciitis, these include: obesity, repetitive activities such as running, an abrupt increase in activity levels, calf tightness, and poor quality or unsupportive footwear. In a very small proportion of people with plantar fasciitis, there may be evidence of underlying inflammatory arthritis.

Plantar fasciitis sufferers most often experience pain under the heel when bearing weight. The pain is classically worst with the first few steps in the morning and then gradually improves through the day. The pain can, however, be made worse after periods of exercise.

Most people with plantar fasciitis see improvement in their symptoms without needing any treatment. Simple self-help measures can be very effective at relieving symptoms caused by plantar fasciitis. These include:

• Stretching exercises of your calf and Achilles tendon
• Wearing supportive, padded shoes
• Weight loss if you are overweight
• Anti-inflammatory medications
• Application of an ice pack after periods of exercise

If your symptoms have failed to improve despite these simple measures after six weeks, you should contact your doctor. Your doctor may refer you to a physiotherapist or podiatrist for further management. You may be offered a structured stretching and exercise program that effectively relieves your symptoms. Additional treatment options include wearing a specialized splint at night or ultrasound shockwave therapy.

The doctor will ask you about your symptoms and examine your foot. If they are satisfied that you have plantar fasciitis, they may refer you to a physiotherapist or podiatrist, depending on the local services available.

Very rarely, if your symptoms fail to improve despite physiotherapist/podiatry input, you may be referred to an orthopedic surgeon. An orthopedic surgeon may be able to offer additional treatment modalities; however, surgery is seldom an option for plantar fasciitis.