Oh, My Aching Feet! Nurses, Plantar Fasciitis and Finding Relief

J.Adderton, BSN, MSN

Foot pain is no stranger to nurses and the pain caused by plantar fasciitis can be intense. In search of relief, we often try different styles and brands of shoes, specialty socks, wraps, tropical agents and more. But once you develop symptoms, it often seems like nothing will help. Fortunately, there are steps you can take to prevent, treat and ease the pain of plantar fasciitis.

What is Plantar Fasciitis?

The condition, often found in athletes (especially runners), is an overuse injury. It is also one of the most common causes of heel pain. Nurses are susceptible to the condition since they are on their feet much of a shift or workday. The plantar fascia is a thick sheet of connective tissue that runs across the bottom of your foot and connects your heel bone to your toes. Overuse causes small tears in plantar fascia leading to inflammation, pain and tenderness.

What are the Symptoms?

It is a familiar scene, Nurse Y is seen limping down the hall as she tries to keep weight off her painful heel. Let’s take a closer look at other common symptoms typical of plantar fasciitis:

Heel pain and tenderness on the foot’s sole (bottom)
Pain and difficulty bearing weight on the affected foot, especially few steps after waking
Pain commonly described as burning, sharp and can be severe
Warmth, swelling and/or tenderness at the bottom of foot and heel
Pain after a few steps walking after sitting for extended periods

Symptoms may come on gradually or acutely after activity

You May be at Higher Risk

In many cases, the reason a person develops plantar fasciitis is unknown. However, the following risk factors can make you more prone acquire the condition:

Obesity
Diabetes
Female Gender
Very high arch or flat feet
New or increased activity
Spending long periods of time on feet
High impact activity (running, sports)
Increasing age (decreases fascia flexibility and thins heel’s protective fat pad)

Also, tight calf muscles, that make it difficult to flex the foot and bring toes up toward the shin, can increase your risk.

How is Plantar Fasciitis Diagnosed?

A diagnosis is usually made with a review of symptoms, health history and physical examination. Although imaging is not routinely needed for initial diagnosis, it may be used to rule out other heel conditions, such as bone damage or changes.

Treatment May Be As Simple As R.I.N.E.

There is good news in that 90% of plantar fasciitis cases will improve with conservative treatment, including:

Rest

This is difficult for nurses because of our job requirements. However, when possible, decrease activities where your feet pound on hard surfaces (i.e. running).

Ice

Rolling your foot over a cold water bottle or ice for 20 minutes will help ease the discomfort. This can be repeated 3-4 times a day.

NSAIDs

Medications such as ibuprofen or naproxen will help reduce pain and inflammation. Be sure to notify your primary doctor if NSAIDs are used consistently for more than 2 weeks.

Exercise

The most effective way to relieve the pain of plantar fasciitis is to stretch your calves and plantar fascia. Check out this link from Washington University Orthopedics for easy exercises to help you beat the pain.

**Before beginning any home remedies, be sure to discuss your it with your primary physician.

Are There Other Treatment Options?

There are actually many other treatment and pain relief options available for plantar fasciitis, such as:

Steroid injections
Platelet rich plasma injections (PRP)
Shock-wave therapy
Tenex procedure
Surgical interventions
Physical therapy
Splints
Shoe inserts (the firmer, the better)
Heel cups

What Can Nurses do to Prevent Plantar Fasciitis?

It would be unrealistic for nurses to significantly reduce the amount of walking and standing during a day’s work. However, there are a few lifestyle changes that could prevent the pain from returning.

If overweight, lose weight to reduce the pressure placed on the bottom of your feet.
Choose shoes with good support and replace your work and athletic shoes regularly
Learn more from this Husson University article.
Avoid going barefoot on hard surfaces
Do low impact exercises and stretch out your calves and feet.
Keep doing the leg and foot exercises found here.

Bottom Line

We have all heard the phrase “nurses make the worst patients”. In the case of plantar fasciitis, ignoring or masking the pain may make it worse and add further ligament strain. Podiatrists have proven that more than 90% of cases can be improved with conservative, at-home remedies. And, only in extreme cases will invasive treatment be necessary. So next time you say “oh my aching foot” take early action and avoid the intense pain of plantar fasciitis.

Additional Resource

American Academy of Orthopaedic Surgeons- Plantar Fasciitis and Bone Spurs