Q: I suspect I have plantar fasciitis. My right heel is most painful in the morning but remains sore throughout the day. What are some home treatments I can try?
A: What you describe does indeed sound like plantar fasciitis.
The cause of the pain is inflammation of the plantar fascia, a band of tendon-like tissue that extends along the bottom of the foot (the plantar surface) from the heel bone to the ball of the foot, where it fans out to attach to the toe bones. Pressure and strain can overstretch and damage the plantar fascia, which leads to swelling, tearing or bruising.
Plantar fasciitis often results from high-impact activities, such as running and jumping, but it can also occur after prolonged periods of standing. It’s more common in people who are flat-footed and also in older people, because the plantar fascia loses its elasticity with age, making it more vulnerable to injury.
Most plantar fasciitis improves with home-based treatments — usually within weeks, although it can take several months. It may be sufficient to avoid activities that put excessive strain on the heel — jumping or running, for example — for two weeks. But be careful not to stop exercising entirely, because inactivity can cause the plantar fascia to stiffen and then become painful again when you start to move around. Instead of jogging or aerobics, substitute bicycling or swimming.
Recommended home treatments have the following goals:
Reduce pain and inflammation. Apply ice to the bottom of the foot near the heel for 20 minutes, several times a day. You can also wear a splint at night that is designed to hold the foot upright and flexed back slightly while you sleep, stretching the plantar fascia to relieve morning pain.
Protect the heel. Putting orthotic devices into all your shoes can help decrease any impact on the heel and reduce the chance of further inflammation. Various heel cushions and cups are available in most drugstores.
Support the foot. The time to recovery and the chance of re-injury are affected by the kind of footwear you use. Athletic shoes are a good choice, because most have cushioned soles and internal arch support. Avoid going barefoot or wearing slippers.
Stretch the foot. A gentle plantar fascia-stretching exercise can restore flexibility and reduce pain. Grasp the toes of the affected foot at the point where they meet the ball of the foot and pull back gently, in the direction of the shin, until you feel a stretch in the plantar fascia. Hold the stretch for 10 seconds, and repeat 10 times per set, three times per day.
(For additional consumer health information, please visit www.health.harvard.edu.)