Plantar fasciitis is one of the most prevalent and painful conditions affecting the feet, characterised by inflammation of the thick band of tissue (the plantar fascia) that runs along the bottom of the foot, connecting the heel bone to the toes. This condition often results in intense heel pain and significant discomfort during walking. While certain physical activities can increase the risk, plantar fasciitis can develop without a clear cause, impacting a wide range of individuals.

You may be at risk of developing plantar fasciitis if you engage in physical activities that place stress on your heel, although it can occur without an obvious cause. Risk factors include age (most commonly those between 40 and 60 years), certain types of exercise (such as long-distance running, ballet, and aerobic dance), flat feet or high arches, obesity, and occupations that require long periods of standing (like teaching, waiting tables, or factory work).

Ignoring plantar fasciitis can lead to chronic heel pain that disrupts daily activities. To avoid the pain, you might change the way you walk, which can cause foot, knee, hip, or back problems. Tension and stress on the fascia can cause small tears, and repeated stretching and tearing can further irritate or inflame it, although the precise cause often remains unclear.

Diagnosis typically involves a medical history review and physical exam, where a healthcare professional will check for tender areas in your foot. The pain location helps determine its cause, and while tests are rarely needed, an X-ray might reveal a bone spur, which was once thought to cause heel pain but is now known to be an incidental finding.

Most individuals with plantar fasciitis recover within several months with conservative treatments such as icing the painful area, resting, stretching, and avoiding activities that cause pain. Over-the-counter pain relief, like ibuprofen and naproxen sodium, can help manage pain and inflammation, but it's best to consult a doctor for a personalised treatment plan.

Physical therapy and special devices can significantly relieve symptoms. Treatment may include:

• Exercises to stretch the plantar fascia and Achilles tendon and strengthen lower leg muscles, with a therapist teaching you to apply athletic taping for support.
• Wearing a night splint to keep the plantar fascia and Achilles tendon stretched overnight.
• Using off-the-shelf or custom-fitted arch supports (orthotics) to distribute pressure evenly across your feet.
• Walking boots, canes, or crutches to temporarily reduce weight on your foot.

If conservative measures fail after several months, your healthcare professional might suggest a steroid injection into the tender area for temporary pain relief, though the procedure can be costly and painful. For chronic cases unresponsive to other treatments, extracorporeal shock wave therapy (using sound waves to stimulate healing) or ultrasonic tissue repair (using ultrasound to break up and remove damaged tissue) may be options worth exploring.

In severe cases where other treatments have failed, surgery to detach the plantar fascia from the heel bone may be considered. This procedure can be performed as an open surgery or through a small incision with local anaesthesia.

Plantar fasciitis, while painful and potentially debilitating, can often be managed effectively with early intervention and conservative treatments. Understanding the risk factors and seeking timely medical advice can prevent chronic pain and complications. With the range of treatments available, from physical therapy to advanced surgical options, those suffering from plantar fasciitis can find relief and regain their quality of life.