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You might have heard Dolly Parton sing, "Tumble out of bed and stumble to the kitchen ..." in her song 9 to 5. If that sounds like you when you first hit the floor in the morning, you might have plantar fasciitis. That is a fancy way of saying heel and instep pain.

Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move more, the pain normally decreases, but it might return after long periods of standing, or after rising from sitting.

The plantar fascia is a thick band of connective tissue that originates at the heel bone and runs along the bottom of the foot, attaching to the base of each of the toes. This is your foot's shock absorber. When it becomes inflamed or torn, there can be pain with literally every step.

Causes of Plantar Fasciitis

Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament, which can lead to pain and swelling.

  • Plantar fasciitis is most common in middle-aged people, but also effects those who are on their feet a lot, such as athletes, soldiers, those who stand on hard surfaces for long periods of time.
  • Having high arches.
  • Being overweight.
  • Wearing ill-fitting or worn out shoes.
  • Having tight Achilles tendons or calf muscles.
  • Increasing activity.

The course of plantar fasciitis is very unpredictable. It can last a few days or months. It can disappear for several weeks, only to reappear full-blown down the road.

Diagnosis
The diagnosis of plantar fasciitis is made based on your medical history and physical examination. During the exam, your doctor will check for areas of tenderness in your foot. Pinpointing where your pain is located can help determine its cause.

Usually no tests are necessary. Your doctor might suggest an X-ray or magnetic resonance imaging (MRI) to make sure your pain isn't being caused by another problem, such as a stress fracture or a pinched nerve.

Treatment
Rest the foot. Limit your weight-bearing activities.
Never go barefooted. Protect your arches by wearing shoes with good support.
Ice the painful area. Do this several times a day, but do not apply the ice directly to your foot. Use an ice pack or a towel.
Stretching and strengthening exercises. Your physician may refer you to a physical therapist to guide you through these.
Splints and orthotics. Your doctor or physical therapist can advise you on the best ones for you.
Over-the-counter medications. Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) can ease the pain and inflammation associated with plantar fasciitis.
Injections. Injecting a type of steroid medication into the tender area can provide temporary pain relief.
Surgery. Rarely is surgery recommended. It's generally an option only when the pain is severe and all else fails.

Ignoring the problem is not a good idea as it could lead to permanent foot pain. See your physician for diagnosis and treatment before it gets to this point.

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