Plantar fasciitis may cause heel pain among middleaged women By Sim Dong-Sik A menopausal woman experiences many changes to her body. Among these, some experience a sudden pain in their heels. Especially, many women experience pain upon getting up from bed in the morning. Such pain can be serious enough for many to avoid daily activities. In this case, plantar fasciitis, or painful heel syndrome, should be suspected. The plantar fascia plays an important role in maintaining the arch of the sole of the foot via its cord-like structure, and provides elasticity to the foot. In other words, it performs as an insole, sustaining our body weight. If too much force is placed on the plantar fascia, swelling and inflammation can occur. Such symptoms are indicative of plantar fasciitis. This usually occurs among menopausal women, as hormonal changes cause a thinning of the fat layer of the sole. Plantar fasciitis can also be caused by excessive exercise or wearing high-heels, sandals or flip-flops frequently. Recently, there are growing numbers of younger patients who experience plantar fasciitis and muscle damage to the sole due to intense exercise. Intense exercises such as running, requires the foot to bear twice the usual body weight, and thus makes a person susceptible to plantar fasciitis. Symptoms usually occur in the front or inner part of the heel, and pain occurs when weight is put on the foot. In particular, the pain is usually greater when the patient takes a first step in the morning after sleeping. While sleeping, the plantar fascia shrinks back to its normal status, and suddenly stretches in the morning due to weight bearing. This causes sudden and extreme pain in the heel. Additionally, the pain can occur when standing up after sitting down for long period of time, and in some cases the pain is so intense that it hinders walking. In some instances, the symptoms occur in both feet, on both sides of the plantar fascia. A patient should be carefully examined to rule out rheumatoid arthritis or
spondylarthritis. Symptoms may be alleviated by wearing soft and cushioned shoes or undergoing conservative treatment such as medication, injection therapy or physiotherapy. Furthermore, new treatment methods such as extracorporeal shock wave therapy (ESWT), can decrease pain and treat plantar fasciitis. ESWT treatment eliminates bodily waste that causes inflammation, and by doing so, stimulates the growth of new tissue and eliminates the inflammatory cells causing the pain. As the treatment is effective and quick, many patients prefer this method of treatment. Many patients do not realize that they have plantar fasciitis, but regard the pain as something temporary. Thus, many patients miss a timely opportunity for treatment. If this happens, it may take a long time to fully recover from plantar fasciitis. As the feet play an important role in balancing the body, imbalance may ultimately cause secondary problems to the ankle, knee, hip and back. Thus, it is recommended that attention be paid to the weight bearing stress placed on the feet. Frequent foot massages can help to maintain their health. The writer is specialist in orthopedic surgery at Bumin Hospital Seoul in Gangseo District.