Plantar Fasciitis – What to know and why it can be misleading!
Plantar fasciitis is commonly diagnosed based on symptoms like heel pain and tenderness, particularly in the morning. However, not all heel pain is due to inflammation of the plantar fascia. For example, vascular issues or nerve entrapments could present similarly but require different treatments. This can often lead to misdiagnosis and confusion on how to treat. As performance physical therapists, we treat off a variety of factors – client pain, expressed symptoms, SFMA assessment, mobility limitations are just to name a few. Rather than treating the diagnosis, we focus on your concerns and helping you get back to movement!
However if you do have plantar fasciitis, you may experience a few of these:
- Circulation Issues: If there is a problem with blood flow to the feet, it could cause pain that mimics the symptoms of plantar fasciitis. Conditions like peripheral artery disease (PAD) can cause cramping or pain in the feet and legs due to reduced blood flow, and this might be misinterpreted as plantar fasciitis. An article published by JOSPT (Chen, Ming-Ho, Ying, & Fu), found that individuals with chronic planter fasciitis symptoms had greater blood flow to the plantar fascia as well as increased overall fascia thickness compared to their asymptomatic side and control group.
- Oxygen Supply: Insufficient oxygenation to the tissues can lead to pain and discomfort, which might be mistaken for the inflammation characteristic of plantar fasciitis. This could be especially relevant in people with underlying health conditions that affect circulation.
- Nerve Entrapment: Conditions affecting the nerves in the foot, such as tarsal tunnel syndrome, can cause symptoms that overlap with plantar fasciitis. If nerve issues are not identified, the diagnosis might remain focused on the fascia.
- Vascular Occlusion: Occlusions or blockages in blood vessels, either due to conditions like thrombosis or other circulatory problems, might also cause foot pain. These issues can affect the overall health of tissues, leading to pain that might be attributed to plantar fasciitis.
Misdiagnosis can lead to treatment problems as well. Here are a few factors to take into consideration:
- Inappropriate Treatments: If the diagnosis is solely focused on plantar fasciitis, treatments like stretching, orthotics, or anti-inflammatory medications might not address the root cause if it’s related to vascular issues. Proper treatment would need to target the underlying problem, which might involve addressing circulatory health or other systemic issues.
- Comprehensive Evaluation: For a more accurate diagnosis, it’s crucial to consider a wide range of potential causes, including vascular and neurological factors, especially if traditional plantar fasciitis treatments are ineffective.
Suppose you suspect a vascular or occlusion issue might be the root cause of foot pain rather than just plantar fasciitis. In that case, it’s important to seek a thorough evaluation from a healthcare provider who can assess both vascular and musculoskeletal health. This might involve imaging studies, vascular tests, or consultations with specialists in orthopedics, podiatry, or vascular medicine to ensure a comprehensive diagnosis and appropriate treatment plan. At Empower U, our team of performance physical therapists are skilled and have extensive experience when it comes to treating plantar fasciitis or similar-symptoms like pain. Request an appointment today to work with our team!
J Orthop Sports Phys Ther 2013;43(10):727–734. Epub 25 July 2013. doi:10.2519/jospt.2013.4774
