Is Leg Pain Caused by Plantar Fasciitis?
Plantar fasciitis is generating “a lot of discomfort in the foot.” Many patients complain to me about how much it affects their lives. It’s difficult to stand, walk, run, or work. Plantar fasciitis pain can be highly distressing for many individuals, making it difficult to work with this foot ailment. As a result, what appears to be little “foot pain” can have far-reaching consequences.
What Is Plantar Fasciitis and How Does It Affect You?
Is Leg Pain Caused by Plantar Fasciitis?
The story begins by addressing the source of the problem: the plantar fascia, a broad, web-like ligament on the bottom of the foot. The plantar fascia is located immediately beneath the epidermis and can be seen and felt by lifting the toes up. This causes the fascia to tighten and stand out, making it easier to see and feel, particularly in the arch area. There appears to be a tight band there.
Anatomically, the plantar fascia connects from the calcaneus (the heel bone) to the base of the toes which means it stretches almost the full length of the foot. It links bones like a ligament, but it’s more like a tendon in structure, with minimal blood and nerve supply. These factors contribute to the fact that healing following damage is generally sluggish. The plantar fascia is formed of collagen-based connective tissue and is referred to as an Aponeurosis because it reaches out in a wide band.
The fascia connects the toes to the heel and functions as a tie-rod to hold the foot together. The fascia is shorter when the arch is at its maximum height because the foot is shorter. The foot lengthens and stretches as a person stands and the arch drops, elongating and tightening the fascia. When walking or running, the toes flex back as the person pushes off, causing the fascia to contract and raise the arch to support the foot for propulsion. This is referred to as the “windless mechanism.” Plantar fasciitis is caused by a malfunction in this activity, which will be explained later in this blog.
Plantar Fasciitis Symptoms
Plantar fasciitis is a type of fasciitis that causes discomfort anywhere on the fascia, including the bottom of the heel. The most common situation is pain upon first standing, which often improves immediately after moving around, only to deteriorate as activity continues. The more time spent on one’s feet, the worse the pain becomes. It is more of a micro trauma damage to the fascia with some structural collapse owing to being overworked or stressed than it is an inflammation. Periostitis of the heel bone, or inflammation of the periosteum, the bone’s covering, can also occur. Plantar fasciitis occurs when the fascia joins to the periosteum and becomes completely involved. This is more common than pain further up the fascia in the arch in my 31 years of treating heel pain.
Neuritis or nerve pain is another sort of discomfort on the bottom of the foot, as the heel has multiple nerve branches that run along and under it. When these nerves get irritated, a searing pain can radiate around the heel and up the leg. Neuritis is frequently associated with fasciitis, resulting in foot and leg pain. The fat pad on the bottom of the heel thins out as we get older, which can cause to periostitis (bone/periosteum trauma) and/or neuritis (nerve compression between the bone and the floor).
Plantar Fasciitis: What Causes It?
This syndrome can be caused by a variety of factors. There are frequently multiple causes in a patient.
A primary cause is malfunction in the above-mentioned windless system. When the mechanism fails, the fascia is overworked and strained, resulting in micro tears, structural damage, and pain. The dysfunction of the big toe joint to the foot is a main cause of the windless mechanism malfunctioning. The windless mechanism will not work effectively if the big toe doesn’t flex properly, which can harm the fascia. Over pronation, which occurs when the arch flattens during stance and jams the joint, can cause big toe joint trouble.
Weight gain, which puts physical stress on the foot, is another cause of plantar fasciitis. The fascia, which acts as a tie-rod to stabilize the foot, will be overworked as it tries to cope with the increased physical force. Fat pad shrinkage with aging can produce pain in the heel at the fascia insertion, as previously described. Overpronation, or a drop in the arch, causes the foot to extend, putting a stretch force on the fascia as it tries to hold the foot together. The fascia is overworked, resulting in micro damage and pain. Poor shoes or soft, worn-out shoes can exacerbate this problem, as pronation is generally worse with soft or poor shoes.
Plantar Fasciitis Isn’t Heel Spur Syndrome!
I’d want to mention “heel spur syndrome” at this point because it’s commonly confused with plantar fasciitis, especially when the pain is on the bottom of the heel. Because the fascia links to the bottom of the heel, fascia pain can occur right at the insertion point. Because the fascia attaches to the periosteum, this might result in periostitis of the heel bone. On the tubercle on the bottom of the heel bone, where the fascia inserts, a heel spur frequently develops. The pain is usually unrelated to the spur. On x-ray, the non-painful foot had a larger spur than the hurting foot. I always remind my patients that the spur is more of a barometer for stress on the foot than it is the cause of their complaints. This means that we don’t need to treat the spur and don’t need to remove it to relieve discomfort.
When it comes to plantar fasciitis treatment, I almost always start with SHOES. For their initial appointment and any subsequent pain, we urge patients to bring in the majority of their shoes. As previously stated, shoes can be a significant contributor to fasciitis and other foot problems. If the shoes are worn out or inappropriate, I begin treatment by recommending that they buy new, more appropriate shoes. The shoes must be properly fitted, as I frequently see patients with shoes that are too short or too tight. This can harm the fascia by affecting the function of the big toe joint, as well as overpronation caused by inadequate footwear. I’ve seen several people recover in as little as two to three weeks after getting new, better-fitting shoes. Because each patient is unique, I can’t recommend a single shoe for everyone, but plantar fasciitis shoes should include a sturdy heel counter to control motion, a solid outer sole, and some motion control features. For unfettered toe movement and a pressure-free environment, many patients require additional depth and width. One such company is IDEASTEP, an orthopedic footwear manufacturer that creates plantar fasciitis shoes that are biomedically designed to relieve strain on the plantar fascia. They have ergonomic soles that decrease heel impacts and provide soft, safe cushioning. Click here to read more about IDEASTEP plantar fasciitis shoes and to see the many styles.
A plantar fasciitis insole or orthotic is frequently used as the following step in treatment. Because heel pain is a common complaint among patients, the insert should cup and cushion the heel while also supporting the arch. In general, a well-made footbed will aid to reduce pronation and improve the function of the big toe joint while also cushioning the heel. For the majority of these patients, this is where we begin in my office. I’ve been using the IDEASTEP non-custom orthotic as my first line of treatment, along with shoes, for over 25 years. This insole features a gel heel pad in the heel cup, anatomical arch support, and the ability to conform to the contour of your foot over time. I’ve tried a lot of various non-custom or temporary orthotics, but none of them have come close to these in terms of effectiveness and comfort. They are really comfy from the time they are placed in the shoes, which patients love and will actually wear. To see IDEASTEP orthotics, go here. If this treatment isn’t effective enough, I’ll investigate custom foot orthotics if the patient is a good candidate.
Injections of corticosteroids (sometimes known as “cortisone”) are another option. It could take up to three injections. I normally wait until the patient has the correct shoes and inserts before administering this since the injection success rate is better when the shoes and inserts are used together. Oral steroids like prednisone, as well as non-steroids like ibuprofen, are another option for plantar fasciitis pain alleviation.
If none of the following options work, I’ll have the patient wear an immobilizing boot for a few weeks. The insole is put into the boot to boost effectiveness even further. Simple night splints, according to my observations, are ineffective, but a walking boot worn at night has a significant influence.
Finally, if none of the other treatments work, shock wave therapy or surgery as a final resort may be necessary. The problem with surgery is that it may temporarily relieve symptoms, but it destabilizes the foot in the long run, resulting to fresh discomfort. Plantar fasciitis, for the most part, will go away in a year or less. It can be sped up with treatment.
Returning to the original question, does plantar fasciitis induce leg pain? The answer is unmistakably YES. There may be pain traveling up the leg in addition to foot pain. This can be caused by nerve pain in the calcaneus branches, which can radiate up the nerve tract in the leg, causing pain in the ankle and calf. Another type of leg discomfort is when the foot, particularly the heel, hurts. When this happens, people modify their stance and walk to avoid the uncomfortable area. Overuse injuries/pain to the muscles and tendons in the lower leg, as well as the upper leg, hip, and back, can occur as a result of this change in lower extremity mechanics. As a result, plantar fasciitis treatment can have an impact on more than just the foot.
Finally, plantar fasciitis affects a large number of people. The sooner you seek medical treatment, such as a podiatrist, if you have pain on the bottom of your foot, the better. Waiting longer only worsens the discomfort and makes treatment more difficult and time-consuming.
Plantar fasciitis is generally curable, which is excellent news. “A PAIN IN THE FOOT” should not be a part of anyone’s life.