Plantar fasciitis treatment: What is available?

Plantar fasciitis is a painful foot condition caused by tears in the plantar fascia ligament that runs along the bottom of the foot. This can be caused by a wide range of factors, from ill fitting shoes to flat feet, and in most cases it will heal itself with rest. But what other plantar fasciitis treatments are available and how do they work?

This article on plantar fasciitis treatment is written by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

What is plantar fasciitis?

The plantar fascia ligament runs along the bottom of the foot, from the heel to the toes. Plantar fasciitis occurs when this ligament becomes torn and inflamed, causing pain at the heel. This pain is often at its most acute when the tissue is cold and taut, especially first thing in the morning, and will ease as the tissues warm and loosen up. 

There are many causes of plantar fasciitis, including flat feet, pronation (where the ankle rolls in as the foot strikes the ground), obesity and age. Poorly fitting shoes that do not provide sufficient support for the foot are another common contributory factor. Plantar fasciitis often affects people who do a lot of sport as a result of repetitive strain or excessive exercise.

In many cases, simply identifying and rectifying the underlying reasons for the problem will provide adequate plantar fasciitis treatment. Losing weight, running on softer surfaces and using different footwear can all make a marked difference.

Initial plantar fasciitis treatment

As with most muscle and ligament injuries, the best form of plantar fasciitis treatment in the first instance is rest. The plantar facia ligament plays a large role in absorbing the weight and pressure created by walking and running. To give it time to heal, you need to literally take the weight off your feet. This rather pleasant form of plantar fasciitis treatment can be supplemented by ice packs and anti-inflammatory drugs, such as ibuprofen, to reduce swelling.

In many instances, this fairly basic plantar fasciitis treatment will be all that you need to allow the ligament to heal, and the majority of cases will resolve within a few weeks. After that, you need to make sure you make some changes to prevent recurrence.

When to seek further plantar fasciitis treatment

If your heel pain does not go away with rest and anti inflammatory treatment, it is important to consult your GP or a qualified podiatrist. Prolonged plantar fasciitis can cause greater damage and require more aggressive medical plantar fasciitis treatments. If you don’t investigate plantar fasciitis treatment early enough, you may find that you change the gait of your walking or running to compensate for the pain, causing an imbalance that leads to problems elsewhere in the system, including your back and hips.

There is a range of plantar fasciitis treatments that your GP or podiatrist can offer to promote healing and then prevent the pain coming back.  

Plantar fasciitis treatment – night splints

One of the most effective plantar fasciitis treatments is a night splint. When we rest, especially overnight as we sleep, the plantar fascia ligament tightens up, causing pain to plantar fasciitis sufferers as they take their first steps. Night splint plantar fasciitis treatment keeps the ligament stretched overnight preventing this tightening and promoting healing in the tissues.

A similar affect can be achieved with careful taping, which stretches the ligament, easing the pain and promoting healing. Your podiatrist or physiotherapist will show you how to do this plantar fasciitis treatment for yourself.

Plantar fasciitis treatment – orthotics

Another common plantar fasciitis treatment, both in the short term for pain relief and as an ongoing preventative measure, is the use of orthotics. These are insoles that are inserted into the shoes to correct the gait of the stride or movement of the foot, by providing arch and heel support. Padded or gel orthotics can be highly effective in pain relief as they spread the weight and absorb the impact of walking or running, while carbon fibre insoles are often used in the long term to prevent recurrence of plantar fasciitis.

Plantar fasciitis treatment – injections

In severe cases, where the pain is extreme or persistent, corticosteroid injections can be used as a plantar fasciitis treatment. These are often administered in conjunction with a local anaesthetic with the injection guided by an ultrasound scanner to ensure that it is delivered to exactly the right place. There are, however, significant risks with this kind of plantar fasciitis treatment, including the weakening and possible rupture of the plantar fascia. For this reason, injections may be limited to maximum of three in six months.

Plantar fasciitis treatment – ESWT

A relatively new plantar fasciitis treatment uses sound waves to treat the damaged tissue. This treatment is called extra-corporeal shock wave therapy (ESWT) is similar to ultrasound treatment used elsewhere on the body to stimulate tissue and encourage healing.

Plantar fasciitis treatment – surgery

As a last resort, your podiatrist may consider plantar fasciitis treatment by surgery, although this is generally avoided wherever possible due to the risk of nerve damage. The less invasive the surgery the better; the most recent techniques have been developed with this in mind. In an ultrasound guided needle fasciotomy, for example, a small needle is inserted into the ligament and moved from side to side to disrupt the fibrous tissue that grows around the damaged areas, allowing the surrounding tissue to heal much quicker.

Staying positive about plantar fasciitis treatment

If you are used to being very active and doing a lot of sport and exercise having to rest, wear night splints or having more invasive plantar fasciitis treatment can be very frustrating. But, you have to remember that the earlier and more consistently you stick to the recommended treatment, the more chance you have of healing.

Profile of the author

Dr Kathryn Senior is an acclaimed medical journalist who has written over 500 feature articles for leading international journals within The Lancet group. As Senior Writer at Freelance Copy she produces high quality scientific and medical content for websites and printed publications for companies and organisations in the health, medical and pharmaceutical sectors. 

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