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Plantar Fasciitis Treatment in Singapore
Dr Poh Seng Yew (傅圣耀)
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What is Plantar Fasciitis?
Plantar fasciitis is a condition characterised by the inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes and supports the arch of the foot. This tissue plays a role in absorbing stresses and strains experienced during daily activities.
The plantar fascia can become irritated and inflamed when subjected to excessive pressure, leading to discomfort and pain, typically felt in the heel.
Causes of Plantar Fasciitis
Plantar fasciitis arises from a combination of factors that exert stress and strain on the plantar fascia.
- Overuse
Athletes and others engaging frequently in activities like extensive walking or standing on hard surfaces may strain their foot arch, potentially leading to plantar fasciitis. - Foot Anatomy
Certain anatomical factors such as flat feet, high arches, and tight calf muscles can place additional stress on the fascia, making it more susceptible to inflammation. - Weight and Lifestyle Factors
Obesity and a sedentary lifestyle that lacks stretching exercises for calves may increase the risk of developing plantar fasciitis. Occupations requiring prolonged standing also contribute to this risk. - Improper Footwear
Footwear that lacks adequate cushioning and support can contribute to heel pain and the development of plantar fasciitis.
Symptoms and Signs
The typical symptoms and signs of plantar fasciitis include:
- Pain on the Bottom of the Heel: This is often the most noticeable symptom, where individuals experience discomfort at the bottom of their heel.
- Pain in the Arch of the Foot: Some individuals may also feel pain along the arch of the foot.
- Increased Pain After Exercise: The pain associated with plantar fasciitis often intensifies following physical activities, especially those involving extensive foot movement.
- Morning Stiffness: Some may experience increased pain and stiffness in the morning or after long periods of sitting.
- Tightness in the Achilles Tendon: The Achilles tendon, which connects the calf muscle to the heel, may also feel tight in individuals with plantar fasciitis.
- Swelling of the Heel: Occasionally, there may be noticeable swelling around the heel area.
Diagnosis
The diagnosis of plantar fasciitis primarily involves a review of medical history and a physical examination.
- Medical History Review: The foot specialist will inquire about the patient’s medical history, including any previous foot injuries or conditions that might influence the current symptoms.
- Physical Examination: During the examination, the foot specialist will check for areas of tenderness in the foot, particularly around the heel and arch. This is often where plantar fasciitis pain is localised.
- Imaging Tests: While not always necessary, an X-ray or MRI may be used in some cases to rule out other causes of heel pain, such as a stress fracture or arthritis.
Non-Surgical Treatment Options
Plantar fasciitis is usually treated using non-surgical methods. These options aim to alleviate symptoms and promote healing of the inflamed plantar fascia.
Physical Therapy |
The foot specialist may suggest engaging in exercises that stretch the plantar fascia and Achilles tendon and strengthen lower leg muscles. Athletic taping to support the foot may also be part of therapy. |
Supportive Devices and Splints |
Night splints, orthotics (custom-fitted or off-the-shelf arch supports), and assistive devices like walking boots or canes can be used to distribute pressure evenly across the feet and maintain the plantar fascia in a lengthened position, especially during rest periods. |
Medications |
To reduce inflammation and pain, the foot specialist may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen. |
Shockwave Therapy |
For persistent pain, shockwave therapy can be used to promote healing in the inflamed plantar fascia. |
Injections |
In cases of severe pain and swelling, steroid injections may be administered for rapid relief. Multiple injections are not recommended as they can weaken the plantar fascia. |
Surgical Treatment Options
Surgical intervention for plantar fasciitis is considered when non-surgical treatments have not provided adequate relief after six months. These typically involve minimally invasive approaches and can include the following:
Radiofrequency Ablation
This procedure targets the inflamed area. Radiofrequency energy is used to heat and remove the damaged tissue, providing relief from pain.
Partial Plantar Fascia Release
This involves a surgical release of part of the plantar fascia. It aims to reduce tension in the tissue and alleviate pain.
Prevention Strategies
Adopting certain strategies can help prevent the onset or recurrence of plantar fasciitis.
- Use Supportive Footwear to Protect the Feet - Wearing shoes with good arch support, cushioning, and a slightly raised heel can help distribute pressure and reduce stress on the plantar fascia. Custom or off-the-shelf orthotics can provide additional support and distribute pressure more evenly.
- Maintain a Healthy Weight - Keeping a healthy weight can help reduce the strain on the plantar fascia.
- Regular Stretching and Low-Impact Exercises - Daily stretching exercises for the calf, foot, and Achilles tendon can maintain flexibility and reduce tension in the plantar fascia. Engaging in low-impact activities like swimming or cycling can also prevent excess stress on the feet.
- Allow Adequate Rest for the Feet - Allow adequate rest and recovery time for the feet, especially after prolonged periods of standing or intense activities.
Dr Poh Seng Yew (傅圣耀)
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 20 years of experience, Dr Poh Seng Yew (傅圣耀) is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
Insurance
Shield Plans
Corporate Partners
Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
Can Plantar Fasciitis Affect Both Feet?
Plantar fasciitis can indeed affect both feet, though it is more commonly seen in one foot. Factors such as overuse and biomechanical issues can impact both feet, leading to symptoms in each. If you are experiencing symptoms in one or both feet, consider consulting a foot specialist for timely management and treatment.
Can I Walk on My Tiptoes if I Have Plantar Fasciitis?
While you may want to walk on your tiptoes to avoid heel pain, this is not recommended as it can exert additional strain on the plantar fascia. A consultation with a foot specialist can provide personalised guidance on activities and exercises that are safe and beneficial for your condition.
Can I Continue Physical Activities with Plantar Fasciitis?
Continuing high-impact physical activities with plantar fasciitis can delay recovery and worsen symptoms. Modify your activities to include low-impact exercises that do not strain the foot, like swimming or cycling.
What Happens if Plantar Fasciitis is Left Untreated?
If left untreated, plantar fasciitis can become a chronic condition, leading to prolonged pain and discomfort. Early treatment can help manage symptoms and may prevent long-term complications. If you are experiencing persistent heel pain, seek guidance from a foot specialist to ensure appropriate treatment and to avoid exacerbation of the condition.