Plantar Fasciitis: Causes, Symptoms, and Treatment Options

Confusing plantar fasciitis?

Hello Doctor: For the past decade or so, I have been accustomed to walking barefoot in muddy areas (not on concrete).
A week before the Lunar New Year, I wore leather shoes, which led to pain in the joints of my big toes.
After that, I switched back to my old sneakers; a few days later, I experienced a sensation in my left foot as if it were being electrocuted while walking.
In the days leading up to the Lunar New Year, I also developed a rheumatic-like soreness in both ankles that lasted for over a month.
In mid-March, I visited an orthopedic doctor who suspected gout; blood tests indicated elevated rheumatoid factor.
Further examinations, including electromyography, showed everything was normal.
A few weeks ago, I experienced severe pain in the sole of my right foot, almost rendering me unable to walk, accompanied by symptoms of shock.
Later, I realized that the foot pain was likely caused by wearing shoes, so I started wearing slippers again.
Surprisingly, the intense pain in my foot disappeared.
However, after two or three days, the symptoms of numbness and shock in the sole of my right foot returned.
During this time, I consulted several orthopedic specialists; some suggested that I had an allergic reaction in my bones, while others indicated tendon inflammation.
It wasn't until I visited a family medicine department at a certain hospital that I received a clear diagnosis: plantar fasciitis.
It has been about four months since my symptoms began, which have progressed from pain in the big toe joints, electric shock-like sensations while walking, soreness in the ankle joints, and sharp, needle-like pain in the bones, to difficulties in walking.
The questions I would like to consult are: 1.
Are these symptoms indicative of plantar fasciitis? 2.
Are there any medical conditions caused by wearing shoes? 3.
During this period, I have also developed tendonitis in my knee and tennis elbow.
Could these be related to issues in other organs or deficiencies in my body? I would greatly appreciate your response.
Thank you!

Mr. Zhang, 50~59 year old female. Ask Date: 2008/05/09

Dr. Pan Yingda reply Rehabilitation

Hello Mr.
Zhang! That's a big question! I'm afraid I can't answer your inquiry! From your message, I can't determine what the issue is! Are you still experiencing pain?
1.
I cannot confirm whether your symptoms are indicative of plantar fasciitis.
If this is the case, the pain is usually localized and does not move around, and based on your description, it doesn't seem to fit that pattern!
2.
Plantar fasciitis, also known as plantar fascia syndrome, is similar to tennis elbow or other tendinitis conditions; the different names reflect the different locations of the inflammation (so it is also correct to say tendonitis).
Ill-fitting shoes and overuse can both contribute to this condition!
3.
If you are an athlete or engage in physical labor, it may simply be tendon or joint inflammation.
If not, systemic diseases such as autoimmune disorders or gout should be considered! If it is due to degeneration or aging, at 50 years old, I think it might be a bit early for that! As for deficiencies in your body, based on my limited knowledge and understanding, it seems unlikely that this would present in such a manner!
If you are still in pain, it would be best to consult a physician again! If the pain has subsided, you might want to set it aside for now; if it returns, then seek medical attention! Due to the lack of information, it is difficult to pinpoint your issue, such as your weight, alcohol consumption, the specific location of the pain (is it in the joint, tendon, or periosteum?), any swelling, and whether pain relief medications are effective...
Gout does not always correlate with high uric acid levels!

Reply Date: 2008/05/09

More Info

Plantar fasciitis is a common condition that affects the heel and bottom of the foot, characterized by pain and inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes. Understanding the causes, symptoms, and treatment options for plantar fasciitis can help in managing this painful condition effectively.

Causes of Plantar Fasciitis
Plantar fasciitis is often caused by repetitive strain on the plantar fascia. Several factors can contribute to this condition:
1. Foot Mechanics: Flat feet, high arches, or an abnormal walking pattern can place extra stress on the plantar fascia. This mechanical imbalance can lead to inflammation and pain.

2. Age: The risk of developing plantar fasciitis increases with age, particularly for individuals over 40. The plantar fascia can lose elasticity and strength over time.

3. Activity Level: Engaging in activities that place excessive stress on the heel and attached tissue, such as running, dancing, or standing for long periods, can increase the risk.

4. Footwear: Wearing shoes that lack proper arch support or cushioning can contribute to the development of plantar fasciitis. In your case, switching from sandals or flip-flops to dress shoes may have triggered your symptoms due to inadequate support.

5. Weight: Excess body weight can put additional stress on the plantar fascia, increasing the likelihood of inflammation.

Symptoms of Plantar Fasciitis
The primary symptom of plantar fasciitis is heel pain, which may be sharp and stabbing, especially with the first steps in the morning or after prolonged periods of sitting. Other symptoms may include:
- Pain that worsens after exercise or activity, rather than during it.

- Swelling in the heel area.

- Discomfort that may radiate along the arch of the foot.

Treatment Options
Treatment for plantar fasciitis typically begins with conservative measures:
1. Rest and Ice: Reducing activities that exacerbate the pain and applying ice to the affected area can help reduce inflammation.

2. Stretching Exercises: Stretching the calf muscles and the plantar fascia can alleviate tension and improve flexibility.

3. Footwear Modifications: Switching to shoes with better arch support and cushioning can significantly reduce symptoms. Custom orthotics may also be beneficial.

4. Physical Therapy: A physical therapist can provide tailored exercises and treatments to strengthen the foot and improve mechanics.

5. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.

6. Injections: In some cases, corticosteroid injections may be recommended to reduce inflammation.

7. Surgery: If conservative treatments fail after several months, surgical options may be considered to release the tension in the plantar fascia.

Other Considerations
Regarding your additional concerns about knee joint inflammation and tennis elbow, it is possible that these conditions could be related to compensatory movements due to your foot pain. When one part of the body is in pain, individuals often alter their gait or posture, which can lead to strain on other joints and muscles. It is essential to address the root cause of your foot pain to prevent further complications in other areas.

In summary, plantar fasciitis is a common and treatable condition that can significantly impact your quality of life. By understanding its causes and symptoms, and by implementing appropriate treatment strategies, you can effectively manage and alleviate the pain associated with this condition. If symptoms persist, it is advisable to consult with a healthcare professional for a comprehensive evaluation and personalized treatment plan.

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