Understanding Plantar Fasciitis Causes, Symptoms & Diagnosis

What Is Plantar Fasciitis?

Plantar fasciitis is an inflammation of the plantar fascia, which is a thick band of connective tissue that runs along the bottom of the foot from the heel bone to the base of the toes. Its job is to support the arch and absorb the shock of walking and running. When this tissue is subjected to repeated stress, small tears can develop, leading to irritation and inflammation at the heel.

Causes & Risk Factors

The most common underlying cause of plantar fasciitis is faulty foot mechanics. People with flat feet or unusually high arches are more prone to placing excessive strain on the plantar fascia with every step. Other common contributing factors include:

• Standing or walking on hard surfaces for long periods
• Wearing unsupportive footwear
• Tight calf muscles or Achilles tendons
• A sudden increase in physical activity
• Excess body weight, which increases the load on the foot with every step

Symptoms

The hallmark symptom of plantar fasciitis is heel pain that's worst first thing in the morning or after periods of rest. Many patients describe a sharp, stabbing sensation with their first few steps that gradually eases as they walk and the tissue warms up. Pain may also return after prolonged standing or activity. Over time, without treatment, the discomfort can become more constant and more severe.

Diagnosis

Dr. Barnes diagnoses plantar fasciitis through a thorough physical examination of your foot structure and biomechanics. He evaluates how you walk, assesses the flexibility of your calf and Achilles tendon, and identifies the precise location of your pain. Diagnostic ultrasound may be used to evaluate the plantar fascia itself and assess the degree of inflammation.

Plantar Fasciitis Treatment Options Available in Council Bluffs

How Dr. Barnes Treats Plantar Fasciitis

Treatment for plantar fasciitis is tailored to each patient's symptoms, lifestyle, and how the condition has progressed. Dr. Barnes typically starts with conservative approaches and advances to more involved options only when needed.

Conservative Care Options

• Stretching: Stretching exercises that target the calf muscles and plantar fascia help relieve tension on the fascia, reduce morning pain, and support long-term recovery.
• Physical Therapy: Physical therapy may be recommended to improve strength and flexibility.
• Footwear Modifications: Supportive footwear with good arch support and a slightly elevated heel can meaningfully reduce stress on the plantar fascia.
• Orthotics: Dr. Barnes may prescribe custom orthotic devices that fit into your shoes and correct the underlying biomechanical issues driving the condition.
• Padding and Strapping: Shoe padding and strapping techniques provide additional cushioning and support, softening the impact of walking and reducing strain on the fascia during daily activity.
• Injection Therapy: Corticosteroid injections can be used to reduce inflammation and ease pain.
• Night Splints: A night splint holds the foot in a gently stretched position while you sleep, which helps prevent the plantar fascia from tightening overnight.

Shockwave Therapy

For cases that aren't responding to more standard conservative care, EPAT shockwave therapy is available at our office. EPAT stands for Extracorporeal Pulse Activation Technology, and it's an FDA-cleared, non-invasive treatment that uses targeted pressure waves to stimulate blood flow, boost cellular metabolism, and accelerate the body's natural healing process in the damaged tissue.

Treatment sessions typically take just five to ten minutes. Most patients require at least three sessions, spaced about a week apart. Some patients notice pain relief fairly quickly after beginning treatment, though it can take up to four weeks for results to fully develop. Over 80% of patients treated with EPAT report significant pain reduction or full relief.

EPAT is a great option for patients who want to avoid surgery or who haven't found lasting relief through other conservative methods. You can walk immediately after each session and typically return to normal daily activities within one to two days. Strenuous activity is generally resumed after about four weeks.

Surgical Options

A small percentage of patients with plantar fasciitis do not achieve adequate relief from non-surgical treatment. For those patients, Dr. Barnes may recommend one of two surgical procedures depending on the nature of the problem.

A plantar fasciotomy involves making a small release in the plantar fascia to relieve the tension that's causing chronic pain and inflammation. By partially cutting the fascia, the procedure reduces the pulling force at the heel and allows the tissue to begin healing. Most patients experience significant pain relief following recovery, and the procedure can be performed endoscopically, meaning through very small incisions with minimal disruption to surrounding tissue.

In some cases, plantar fasciitis is accompanied by damage to the plantar plate, a thick ligament that supports the ball of the foot near the base of the toes. When the plantar plate is torn or significantly weakened, a plantar plate repair may be performed to restore stability and relieve pain in that area. Dr. Barnes will evaluate whether this is a contributing factor during your workup and will discuss all surgical options fully before any decisions are made.