What is fasciitis?

Fasciitis is the inflammation of the fascia, which is a thin layer of connective tissue that surrounds muscles, nerves, and organs. This condition can cause pain, stiffness, and restricted movement depending on the affected area. Fasciitis may be acute or chronic and can result from overuse, injury, infection, or underlying health conditions.

What are the common types of fasciitis?

There are several forms of fasciitis, with the most common including:

• Plantar fasciitis – Inflammation of the fascia on the bottom of the foot, often causing heel pain
• Necrotizing fasciitis – A rare but serious bacterial infection that destroys fascia and surrounding tissues (often called “flesh-eating disease”)
• Eosinophilic fasciitis – A rare autoimmune condition causing thickening and inflammation of the fascia, especially in arms and legs
• Palmar/Plantar fibromatosis (Ledderhose/Dupuytren’s disease) – Thickening of fascia in the palms or soles, sometimes classified under fibrous fasciitis

What causes fasciitis?

The causes vary depending on the type, but may include:

• Overuse or repetitive strain (e.g., running, standing for long periods)
• Injury or trauma to the affected area
• Infections, particularly in necrotizing fasciitis
• Autoimmune or inflammatory diseases (e.g., eosinophilic fasciitis)
• Poor footwear or foot mechanics in plantar fasciitis
• Surgical complications or chronic wounds

What are the symptoms of fasciitis?

Symptoms depend on the specific type but can include:

• Localized pain (especially in the heel, foot, or limbs)
• Stiffness and swelling
• Tenderness to touch
• Difficulty walking or using the affected area
• In necrotizing fasciitis: rapid progression, severe pain, fever, skin discoloration, and systemic symptoms (emergency)

How is fasciitis diagnosed?

Diagnosis typically involves:

• Medical history and physical examination
• Imaging tests like X-ray, ultrasound, or MRI to assess tissue inflammation
• Blood tests (for autoimmune markers or signs of infection)
• Biopsy in rare or unclear cases, especially eosinophilic fasciitis

Necrotizing fasciitis is a medical emergency and is diagnosed rapidly based on clinical signs and confirmed with surgical exploration and cultures.

How is fasciitis treated?

Treatment depends on the cause and severity:

For Plantar fasciitis:

• Rest and ice application
• Stretching exercises and physical therapy
• Supportive shoes or orthotic inserts
• Anti-inflammatory medications
• Steroid injections in severe cases
• Surgery (rarely needed)

For Necrotizing fasciitis:

• Emergency surgical removal of infected tissue
• IV antibiotics
• Intensive care and supportive treatment
• Sometimes, multiple surgeries are needed

For Eosinophilic fasciitis:

• Corticosteroids to reduce inflammation
• Immunosuppressive medications if needed
• Physical therapy to maintain mobility

Can fasciitis be prevented?

While not all cases are preventable, you can reduce risk by:

• Wearing proper footwear (especially for runners or workers on their feet)
• Stretching before exercise
• Avoiding overuse or repetitive strain
• Treating infections early
• Managing chronic diseases (like diabetes or autoimmune conditions)

When should you see a doctor?

Seek medical attention if:

• You have persistent foot or limb pain that doesn’t improve
• There’s swelling, redness, or warmth over the fascia area
• You notice signs of infection (fever, rapidly spreading pain)
• You develop difficulty moving or walking
• You suspect necrotizing fasciitis – seek emergency care immediately