Pain on the bottom of your foot can make walking and performing daily tasks difficult, even if the pain improves once you start moving. For people with multiple sclerosis (MS) symptoms, this pain can be even more challenging. MS symptoms like dizziness and muscle weakness put you at a higher risk for trips, falls, and injuries.

Pain in the heel or arch of the foot is often caused by plantar fasciitis. This condition results from inflammation of the plantar fascia, a ligament that connects the heel to the front of the foot. While plantar fasciitis is not a symptom of multiple sclerosis (MS), some people with the condition also experience plantar fasciitis. There are several causes of plantar fasciitis in people with MS — and luckily, there are several ways to manage the inflammatory pain and treat the condition.

Walking Problems and Foot Health in Multiple Sclerosis

A study in the International Journal of Public Health compared foot health in people with MS to that of the general population. While foot pain levels were similar between the two groups, people with MS had significantly poorer overall foot health, which impacted their quality of life as a result. Walking problems are major concern for 85 percent of people with MS.

MS-related symptoms like loss of balance and changes in sensation can eventually cause muscle imbalances. Over time, this can lead to strain on various muscles, including the plantar fascia.

Can MS Cause Plantar Fasciitis?

Plantar fasciitis is one of the most frequent causes of heel pain. It’s known for causing sharp, stabbing foot pain that often starts in the morning and improves with movement throughout the day.

The plantar fascia supports the arch of the foot when you’re walking and acts as a shock absorber. Injury to this ligament can cause inflammation, leading to plantar fasciitis. In many cases, the exact cause of plantar fasciitis is not known. However, repetitive stretching and tearing of the plantar fascia is a known source of its inflammation.

Plantar fasciitis doesn’t develop as a symptom of MS itself but rather as a result of walking-related issues common to the condition. Here are some that may be related to plantar fasciitis.

Loss of Balance

Maintaining proper balance depends on many body parts and processes. These include the eyes, ears, sensory nerves, cerebellum (the part of the brain that coordinates voluntary movement), and various muscles. MS can affect all these parts of the body.

Other symptoms of MS, such as fatigue and spasticity (muscle stiffness and tightness), can also contribute to balance problems. Loss of balance typically appears as an unsteady side-to-side walk, sometimes called a “drunk” walk. Damage to some areas like the cerebellum can lead to ataxia, a neurological condition that can cause this altered gait. The side-to-side swaying puts extra pressure on the feet, causing strain on the plantar fascia.

Changes in Sensation

Sensory problems are among the earliest MS symptoms, occurring in 20 percent to 50 percent of people with MS. These sensory disturbances include numbness and paresthesia (burning, tingling, and increased sensitivity.)

Numbness, in particular, can reduce sensation in the feet. This makes it harder to feel objects like shoes, or the ground. As a result, some people with MS walk with heavy, stomping steps, which can strain the plantar fascia.

Muscle Tightness and Spasticity

Spasticity in MS is caused by mixed-up signals between your muscles and nerves. Spasticity makes your muscles feel stiff and heavy, which can make moving difficult.

If your legs are weak, muscle tightness caused by spasticity might actually help you move more easily by providing extra support. But for most people with MS, spasticity makes it harder to move.

Spasticity can also affect your posture, leading to misalignment in your feet and ankles. This puts extra strain on the plantar fascia.

Leg Weakness

The relationship between muscle weakness and plantar fasciitis is also related to inactivity and poor posture.

Due to symptoms of multiple sclerosis like imbalance, chronic pain, and fatigue, people with MS often become less physically active than they used to be. Over time, lack of physical activity can weaken the muscles, making it harder for them to support the body.

Muscle weakness can also happen when MS lesions (areas of damage) strip away the myelin the protects nerve fibers. These nerves are responsible for stimulating muscles and controlling movement. In some cases, this damage can make it hard to lift the front of the foot and toes when walking, a condition known as foot drop.

Weak leg muscles can change your normal walking pattern. This change can lead to strain and pain, making walking even more difficult.

Fatigue

Fatigue is one of the most common and debilitating symptoms of MS—and one of the hardest to explain.

MS-related fatigue is not just ordinary tiredness; it is an overwhelming physical and mental exhaustion that doesn’t improve with rest or sleep. This can make it difficult to stay active or walk for extended periods. When fatigue sets in, walking may become unsteady, and you might drag one leg. This uneven gait can strain the plantar fascia, potentially leading to irritation and inflammation.

How Walking Problems Impact Quality of Life With MS

Difficulties with walking can significantly affect daily life for people with MS. For instance, a 2011 study found that only 34 percent of people with MS who had walking problems were employed. This shows how walking challenges can make it hard to complete everyday tasks, including work responsibilities.

Having limited walking abilities can make many activities more difficult. It’s not just long distances that are challenging — even riding a bike or driving a car can be hard.

Balance problems can also increase the risk of falls. People with MS often fall during routine activities like walking, bathing, or preparing meals. According to various studies, 50 percent to 70 percent of people with multiple sclerosis experience falls. About 30 percent to 50 percent of those people report falling multiple times and sustaining injuries. These injuries can further limit a person’s mobility.

Walking problems can also affect mental health and social life. As a person’s ability to move around decreases, they may avoid leaving the house. This can mean missing out on social activities, hobbies, and quality time with loved ones. Withdrawal from social activities can lead to feelings of isolation and mental health problems like depression.

Other significant impacts of walking problems on people with MS include spasticity, which can cause discomfort and make it difficult to walk. Fatigue is also common and can cause loss of energy and motivation.

Treating Plantar Fasciitis in MS

If you’re diagnosed with plantar fasciitis, treatment may include medications, therapies, surgery, and home remedies.

Medications

Over-the-counter pain relievers can help relieve pain and inflammation caused by plantar fasciitis. Some examples include ibuprofen (Advil or Motrin), naproxen (Aleve), or acetaminophen (Tylenol). Always talk to your doctor before starting a new medication.

Therapies

There are several types of therapies that can help relieve plantar fasciitis.

• Physical therapy — Physical therapy for plantar fasciitis involves guided leg and foot exercises.
• Night splints — Wearing a splint while you sleep can help stretch your foot arch and calf.
• Orthotics — Arch supports are inserted into your shoes to distribute pressure evenly across your soles. These can be custom-made or bought at a drugstore.

Procedures or Surgery

Most cases of plantar fasciitis improve with conservative treatments like therapy and support devices. If conservative treatment doesn’t work after several months, your doctor might suggest a procedure or surgery, which may involve:

• Steroid injections — To temporarily relieve pain
• Sound wave therapy — To promote tissue healing
• Ultrasound therapy — To repair tissue by removing damaged tissue
• Surgery — To remove part of the plantar fascia

Home Remedies and Lifestyle Changes

Several self-care remedies and lifestyle changes may help manage the pain associated with plantar fasciitis.

Reducing Weight-Related Strain on Your Feet

The more weight your plantar fascia supports, the greater the strain and potential for pain. If your weight is contributing to your plantar fasciitis, talk to your doctor about healthy ways to reduce strain and support foot health.

Engaging in Stretching and Light Physical Activity

Simple range-of-motion exercises and stretches can help loosen your plantar fascia, calf muscles, and Achilles tendon.

Engaging in light physical activity can help relieve stiffness and tension too. Switching from high-impact exercise, such as running, to low-impact exercise, such as swimming or biking, can also help reduce pain.

Wearing Proper Footwear

Wear shoes that provide good support. Look for shoes with:

• A low to moderate heel
• Strong arch and heel support
• Extra cushioning

Avoid walking barefoot, as this can worsen symptoms.

Applyinh Cold Therapy

If you’re experiencing pain or stiffness, try applying an ice pack wrapped in a towel or cloth to the affected area for 15 minutes three or four times a day. This can help reduce pain and inflammation. You can also roll your foot over a frozen water bottle for plantar fasciitis relief.

Talk With Others Who Understand

MyMSTeam is the social network for people living with multiple sclerosis and their loved ones. On MyMSTeam, more than 218,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Are you living with MS and plantar fasciitis? How does it impact you? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with likeminded members in Groups.