Plantar Fasciitis In Singapore

Heel pain that greets you with your first morning steps can significantly impact your daily activities and quality of life. While plantar fasciitis can be frustrating and persistent, understanding its nature and available treatment options can help you take the right steps toward recovery. Our orthopaedic surgeon specialises in diagnosing and treating plantar fasciitis, offering comprehensive care tailored to your specific needs and lifestyle.

Dr Zackary Chua

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (Aus)MMed (SG)MRCS (Glasgow)FRCSEd (Orth)

Causes & Risks Symptoms When to see a Doctor Diagnosis Treatment Complications Prevention FAQ Conclusion

What is Plantar Fasciitis?

Plantar fasciitis is an inflammatory condition affecting the plantar fascia, a thick band of tissue that runs along the bottom of your foot, connecting your heel bone to your toes. This tissue acts as a shock absorber and supports the arch of your foot during walking and running. When the plantar fascia experiences excessive stress or repetitive strain, small tears can develop, leading to inflammation and pain.

Causes

The primary cause of plantar fasciitis is excessive strain on the plantar fascia tissue. This strain can result from:

Sudden increases in physical activity or exercise intensity
Repetitive impact from running or jumping activities
Prolonged standing on hard surfaces
Biomechanical issues affecting foot mechanics
Degenerative changes in the plantar fascia tissue associated with ageing

Risk Factors

Several factors can increase your likelihood of developing plantar fasciitis:

Age between 40-60 years, when tissue elasticity naturally decreases
Excess body weight, which places additional stress on the plantar fascia
Occupations requiring prolonged standing
Foot structure issues, including flat feet or high arches, affecting weight distribution
Tight calf muscles limiting ankle flexibility
Wearing unsupportive footwear regularly
Participating in high-impact activities without proper conditioning or gradual progression
Having certain medical conditions, such as rheumatoid arthritis or diabetes

Signs & Symptoms

Mild Symptoms

Sharp pain in the heel with first steps in the morning
Heel discomfort after prolonged sitting
Mild aching in the arch of the foot
Slight stiffness in the heel area
Pain that eases with light activity

Moderate Symptoms

Persistent heel pain throughout the day
Increased pain after exercise or activity
Noticeable limping or altered walking pattern
Swelling around the heel
Pain extending into the arch of the foot
Difficulty walking on stairs or inclines

Severe Symptoms

Intense, stabbing heel pain limiting daily activities
Inability to bear weight on the affected foot
Constant pain even at rest
Visible swelling and warmth in the heel
Night pain disrupting sleep
Pain affecting both feet simultaneously

Symptoms often start gradually, with minor heel discomfort that worsens over time if untreated. The hallmark symptom is sharp heel pain with the first steps of the day, caused by tightening of the plantar fascia during rest.

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When to See a Doctor

You should seek medical attention if you experience persistent heel pain lasting more than two weeks despite rest and home remedies. Immediate consultation is recommended if you notice severe pain preventing normal walking, noticeable swelling or redness in the heel area, or numbness and tingling in the foot. People with diabetes or circulation issues should seek evaluation promptly, as heel problems can lead to complications..

During your first consultation, our orthopaedic surgeon will conduct a thorough examination of your foot, assess your walking pattern, and discuss your symptoms and activity levels. This comprehensive evaluation helps determine the severity of your condition and guides the development of an effective treatment plan. Early intervention often leads to faster recovery and prevents the condition from becoming chronic.

Diagnosis & Testing Methods

Diagnosing plantar fasciitis begins with a detailed medical history and physical examination. Our orthopaedic surgeon will palpate specific areas of your foot to identify points of tenderness and assess the flexibility of your plantar fascia and Achilles tendon, and check your foot’s range of motion. Walking patterns are also observed to identify abnormal stress on the heel and arch.

While plantar fasciitis can often be diagnosed through clinical examination alone, imaging tests may be recommended to rule out other conditions or assess the severity. X-rays can help identify heel spurs or stress fractures that might be causing similar symptoms. Ultrasound imaging provides detailed visualisation of the plantar fascia thickness and any tears or inflammation. MRI scans may be ordered for chronic cases or when the diagnosis is uncertain. These diagnostic tools help ensure accurate diagnosis and appropriate treatment planning, with results typically available within a few days.

Treatment Options Overview

Non-Surgical Care

The foundation of plantar fasciitis treatment involves rest and activity modification. Reducing or temporarily stopping activities that aggravate symptoms allows the inflamed tissue to heal. Applying ice for 15-20 minutes several times daily can help reduce inflammation and pain. Choosing proper footwear with adequate arch support and cushioning is essential for daily comfort and recovery.

Physiotherapy and Stretching

Structured physiotherapy programmes focus on stretching the plantar fascia and Achilles tendon while strengthening the intrinsic foot muscles. Exercises targeting calf flexibility and foot muscle strength help reduce stress on the plantar fascia. Manual therapy techniques, such as massage and mobilisation, may be used to improve tissue flexibility. Patients typically attend sessions 1–2 times per week for 6–8 weeks, with daily home exercises recommended.

Orthotic Devices

Custom or prefabricated orthotic insoles help distribute pressure evenly across the foot and support the arch. Night splints maintain the foot in a dorsiflexed position during sleep, preventing morning stiffness and pain. Heel cups or cushions provide additional shock absorption. These devices are often used alongside other conservative treatments.

Injection Therapies

Corticosteroid injections deliver anti-inflammatory medication directly to the affected area, providing temporary pain relief. Platelet-rich plasma (PRP) injections use your body’s own healing factors to promote tissue repair and regeneration. These injections are typically considered when conservative measures haven’t provided adequate relief after several weeks.

Extracorporeal Shockwave Therapy (ESWT)

This non-invasive treatment uses acoustic waves to stimulate healing in the plantar fascia tissue. The procedure requires no anaesthesia and takes about 15-20 minutes per session, with patients undergoing 3-5 weekly sessions. Shockwave therapy is particularly effective for chronic plantar fasciitis that hasn’t responded to other conservative treatments.

Surgical Options

Surgery is considered only when conservative treatments fail to provide relief after 6-12 months. The most common procedure is plantar fascia release, which involves partially cutting the plantar fascia to relieve tension. This can be performed through traditional open surgery or minimally invasive endoscopic techniques. Post-surgery recovery involves limited weight-bearing followed by a gradual return to normal activities.

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Complications if Left Untreated

Untreated plantar fasciitis can lead to chronic heel pain that persists for months or years, significantly impacting quality of life. To avoid pain, patients may alter their walking patterns, which can lead to secondary problems in the ankle, knee, hip, or back. These compensatory changes can contribute to conditions such as Achilles tendinitis or knee pain.

Long-term inflammation may cause degeneration of the plantar fascia, making the condition more difficult to treat. Some patients develop heel spurs, though these are often a result rather than a cause of the condition. Chronic cases may also lead to plantar fascia tears, requiring more intensive treatment and longer recovery periods. The persistent pain can affect work productivity, limit recreational activities, and impact overall physical fitness.

Prevention

Preventing plantar fasciitis involves maintaining a healthy weight to reduce stress on your feet and wearing supportive shoes with good arch support and cushioning. Regular stretching of the calf muscles and plantar fascia, especially before and after exercise, helps maintain flexibility. Gradually increase exercise intensity rather than making sudden changes to your activity level.

For those in occupations requiring prolonged standing, using anti-fatigue mats and taking regular sitting breaks can help. Runners should replace worn shoes regularly and consider running on softer surfaces when possible. Maintaining good overall foot health through proper hygiene and addressing any biomechanical issues early can significantly reduce the risk of developing plantar fasciitis. Regular foot exercises to strengthen the intrinsic muscles also play a preventive role.

Plantar Fasciitis

Frequently Asked Questions

How long does plantar fasciitis typically take to heal?

Most cases of plantar fasciitis improve within 3-6 months with conservative treatment. Recovery time varies depending on the severity of the condition, adherence to treatment, and individual factors. Some patients experience improvement within weeks, while chronic cases may take up to a year. Early intervention and consistent treatment compliance generally lead to faster recovery times.

Can I continue exercising with plantar fasciitis?

While high-impact activities should be avoided during the acute phase, complete inactivity isn’t recommended. Low-impact exercises like swimming, cycling, or water aerobics can maintain fitness without aggravating the condition. Our orthopaedic surgeon can provide specific guidance on activity modification based on your condition’s severity and your fitness goals. Gradual return to regular activities is important once symptoms improve.

Is plantar fasciitis the same as heel spurs?

No, though they’re often confused. Plantar fasciitis is inflammation of the plantar fascia tissue, while heel spurs are bony growths on the heel bone. Many people with heel spurs don’t experience pain, and not everyone with plantar fasciitis develops heel spurs. The two conditions can coexist, but heel spurs are typically a result of long-term plantar fasciitis rather than the cause of heel pain.

Will I need surgery for plantar fasciitis?

Surgery is rarely needed for plantar fasciitis. Surgery is only considered after 6-12 months of failed conservative treatment. Surgery is considered only after 6-12 months of conservative treatment has not provided sufficient relief. Our orthopaedic surgeon will provide a thorough explanation of any procedure if surgery becomes necessary.

Can plantar fasciitis come back after treatment?

Yes, plantar fasciitis can recur, especially if contributing factors are not addressed. Maintaining a healthy weight, wearing supportive footwear, continuing stretching exercises, and gradually increasing activity levels can help reduce the risk of recurrence. Some patients may need to use orthotics long-term or modify certain activities. Regular follow-up care can help identify and address any signs of recurrence early.

What’s the difference between custom and over-the-counter orthotics?

Over-the-counter orthotics provide general arch support and cushioning, suitable for mild cases or prevention. Custom orthotics are specifically moulded to your foot’s unique shape and biomechanics, addressing individual structural issues. Custom orthotics often provide more precise support for moderate to severe cases. Our orthopaedic surgeon can recommend the most suitable option based on your condition.

Conclusion

Plantar fasciitis, though painful and potentially limiting, is a manageable condition with a range of effective treatment options. From conservative measures like stretching and orthotics to therapies such as shockwave treatment, most patients achieve improvement without requiring surgery. Early intervention, accurate diagnosis, and adherence to a treatment plan tailored to your needs are key to successful outcomes. With proper care and guidance from our orthopaedic surgeon, you can address heel pain and return to your daily activities comfortably.

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Dr Zackary Chua (蔡克祥医生)

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (AUS)|MMed (Singapore)|MRCS (Glasgow)|FRCSEd (Orth)

A senior consultant orthopaedic surgeon with dual specialisations in Foot & Ankle Surgery and Paediatric Orthopaedics. Backed by his extensive years of training and experience, Dr Chua brings the necessary knowledge and skills to ensure a smooth recovery journey.

Rooted firmly by two fundamental philosophies: “When one’s feet hurt, one hurts all over” and “Children are not little adults”, Dr Chua’s approach to patient care reflects his compassionate care for adults and children.

Singhealth Quality Excellence Award – Silver (2011)
Service From the Heart Award (2021)
Singapore Health Quality Service Award – Gold (2023)
NUS Medicine Dean’s Award for Teaching Excellence (2023)

His active participation in the medical community extends to mentoring, research supervision, and contributions to key professional forums and symposiums, both locally and internationally.