Plantar fasciitis is a common cause of heel pain that is caused by degeneration the plantar fascia collagen. The cause of this degeneration is repetitive micro tears to the plantar fascia from excessive standing, physical activity, improper footwear and faulty foot mechanics. Fortunately, plantar fasciitis improves on its own, but since it’s not an injury a person can easily deal with, we’ve rounded up several plantar fasciitis treatment options that can help you improve pain and speed up recovery.
There’s a reason this comes first on the list. Rest is absolutely critical for the treatment of plantar fasciitis. You need it to prevent re-injury and speedy recovery.
Activity modification and a certain degree of rest is recommended but not complete rest, as this may not be practical for most people who are more active or have to do their jobs on their feet.
To avoid inactivity and muscle and joint stagnation, experts recommend doing alternative exercises and avoiding all types of activities that would worsen pain and other symptoms of plantar fasciitis. If you have severe pain, immobilization may be necessary using a walking boot. Studies show that 25% of the time, rest is the ultimate form of treatment adults need while dealing with plantar fasciitis.
Modifying your activities means you have to decrease the intensity, frequency and overall amount of the activity. Most patients comply better with their treatment regimen if they’re instructed to decrease the level of activity that caused the injury and increasing non-aggravating activities instead of completely going on a rest period. A great low-impact option is swimming. You can also rest your feet while working out by performing activities that involve your upper body only. Some great examples include, seated boxing, rope pulling, hand bikes and rowing.
How in the world can you get rid of that excruciating pain? Luckily, we have pain killers for that. Note that taking pain killers is not an alternative to rest as it is an integral part of your treatment routine that cannot be replaced by anything.
Pain relievers such as NSAIDs are a great option for controlling pain and inflammation. 79% of patients were treated successfully with NSAIDs in one study but it’s important that you stick to consistent, daily dosing during the treatment’s acute phase. If you’re pregnant, you’ll have to avoid oral NSAIDs and the elderly should be cautious as well due to possible drug interactions.
For some people, rubbing an anti-inflammatory cream or gel may provide some relief. In addition, it’s important that you place an ice pack or a bag of ice (or frozen peas) for about 15 to 20 minutes every 4 hours to help improve pain and inflammation.
Another anti-inflammatory technique is using an ice bath. Fill a shallow pan with water and ice and soak your heels for 10 to 15 minutes. Make sure you use a neoprene toe cover to prevent your toes from coming in contact with the ice water thereby, preventing cold-related injuries. Icing is typically done after stretching, strengthening or other restorative exercises. You can also place an ice bag under your feet after a day’s work to soothe them and ease pain.
Note that you shouldn’t use heat to heal your feet, such as from a heat pack or heating pad for the first 2-3 days at least. Heat may exacerbate symptoms but if you are using contrast baths in which you have to alternate between cold and hot, be sure to end with a cold water soak. Use a low setting if you are using heat.
Corticosteroids are another option that is used when primary conservative treatments fail to perform. Corticosteroids can be either taken orally or through an injection.
Make sure your shoes offer adequate arch support and cushioning. Be sure to wear protective footwear at all times. There are slippers for people with heel pain that can be worn at home. Instead of wearing sandals, just stick to a pair of plantar fasciitis shoes depending on your activity, for example, running, walking, athletics activity etc.
Avoid worn out shoes as they may not provide proper cushioning for your aching heels. If you’re a runner, make sure you replace your shoes every 250 to 500 miles in order to maintain your shoe’s cushioning. In addition, if your feet over-pronate, pick motion control shoes that will correct your foot mechanics.
Padding and shoe insets can be useful in cushioning your heel and providing support to the arch of your foot. They’re most effective if used at all times. The goal is to raise your heel by 1 cm. Other common supports for plantar fasciitis are described below.
Most people have their feet in a plantar-flexed position while they’re asleep. This causes the fascia to shorten. To prevent this from happening, a night splint can be used to maintain a neutral right angle between foot and leg while providing constant stretching to your Achilles tendon and fascia. Constant stretching provides rest and relief to your plantar fascia, so that it hurts less. Furthermore, it prevents micro trauma to the plantar fascia and bone interface – this will reduce the pain you feel while making the first steps in the morning.
Orthotics and Taping
A supportive midsole and heel counter are essential components of shoes designed for those suffering from plantar fasciitis heel pain. Fashion footwear often do not come with this support and tend to worsen the problem even further – this is especially the case with high heels and worn out shoes.
In general, it’s best to stick to your plantar fasciitis shoes for maximum support if you’re susceptible to heel pain or at least until your plantar fasciitis heals completely.
You can get a pair of shoe inserts or orthotics over the counter or get them custom made. In most cases, OTC and custom provide equal support to your feet. Studies show that supportive orthotics improve pain much more effectively than softer orthotics that don’t provide much support to your feet.
People with low arches and flat feet experience higher amounts of stress on their plantar fascia compared to others when the foot strikes the ground. The low arch support also reduces the foot’s ability to absorb forces during each foot strike. You can use mechanical correction techniques such as taping of the arches. OTC arch supports may also be used. Heel pads are also commonly used for shock absorption but aren’t as effective as other options for structural control and support.
Taping is a cost-effective method that can be used during acute plantar fasciitis.
On the other hand, OTC supports are more cost-effective for chronic and recurrent plantar fasciitis and foot injuries.
A walking cast for your lower leg may help improve the condition but it is typically more expensive and less convenient comp aired to other conservative treatment methods. Once the cast is removed, you’ll have to perform rehabilitation exercises as your legs haven’t been active during the entire period of treatment. Exercises will help restore range of motion, flexibility and strength of your foot. However, note that a cast is a surefire way to rest your foot.
Common tools and devices to improve plantar fasciitis pain include:
- Icy feet: Icy feet is a molded ice pack that delivers a required level of cold to hard to reach places in your feet – something you won’t get from a DIY ice pack such as a bag of frozen peas. In addition, “icy feet” has a deep heel cup and raised arch so that it is in complete contact with the underside of your foot.
- Moji 360 Foot Massager: This massager comes with steel balls in varied sizes that knead and massage the entire length of your foot thoroughly. While the larger balls in the massager work your arch and give you a deeper massage, the smaller balls are especially there to massage and soothe your plantar fascia.
- Strassburg Sock: This sock helps maintain a gentle fascia stretch while you sleep and works similar to a night splint. It reduces the pain in your heel, especially while making the first steps in the morning and increases your flexibility. Try both night splints and this specialized sock and see which one works for you better.
- BRD Sport Plantar Fasciitis Brace: This brace comes with a strap that wraps your mid-foot, giving ample support to the arch. The silicone inserts give you a snug hold and help relieve heel pain.
Stretching your plantar fascia and Achilles tendon regularly and gently may help improve symptoms associated with plantar fasciitis. Stretching the Achilles tendon may help because it tends to be slightly tight in most plantar fasciitis sufferers. In addition, your plantar fasciitis becomes tight overnight while you’re asleep, which is the main reason why your feet are extremely painful when you make your first steps in the morning.
During extracorporeal shock-wave therapy, doctors use a machine that delivers high-energy sound waves through the skin to the region of your foot where it hurts. Although, experts don’t exactly know how it works, it is thought to trigger the healing process of your plantar fascia. In most cases, one or more sessions of extracorporeal shock-wave therapy are needed.
It’s not certain how it works due to lack of large-scale clinical trials but it appears to be a safe procedure. Talk to your doctor regarding its benefits and risks to determine whether this is the best treatment for you.
Some problems are possible as a result of the treatment, such as pain during extracorporeal shock-wave therapy, reddening of the skin, bruising or swelling. Theoretically, another problem could be that the condition may worsen because of the procedure damaging tissues in your foot or rupturing your plantar fascia.
More research is definitely needed to determine whether extracorporeal shock-wave therapy is an effective therapy in treating plantar fascia however, so far, no long-term risks have been reported.
In 5 to 10 percent of cases, plantar fasciitis may have to be rectified with surgery. Surgery is considered as a last resort for those going through six to twelve months of conservative treatment, without any positive results.
Plantar fascia release has been the foundation of treatment where the fascia is sectioned with an open or endoscopic procedure. However, partial and complete fascia release leads to instability of the foot’s medial column. This is accompanied by pain and lateral column overload.
Surgical release has shown a 70 to 90 percent success rate in treatment people with plantar fasciitis.
In some cases, complications may result with surgical treatment. Some of them include heel hypoesthesia, flattening of the longitudinal arch and complications related to corticosteroid injection and plantar fascia rupture. 50 percent of chronic complications are linked to longitudinal strain.
If you have recurring heel pain or are recovering from plantar fasciitis, the following tips may help reduce pain and other symptoms related to the condition:
Maintain a healthy weight
If you’re overweight, your doctor might advise you to lose weight with a balanced, nutritious diet and 3 days of exercise per week. Excess weight adds more stress to your plantar fascia, increasing your risk of plantar fasciitis.
Avoid worn out shoes
Replace your old athletic shoes before they cease to cushion and support your feet. If you’re a runner, make sure you replace your shoes every 500 miles, as stated earlier.
Choose supportive footwear
Stay away from high heels and other shoes that may exacerbate the condition. However, don’t walk barefoot either. Wear protective footwear or shoes and slippers, designed for people with plantar fasciitis or heel pain.
Choose a different sport
Something that is low-impact such as swimming or cycling instead of jogging may be a better option if you have recurring heal pain.
Stretch your arches
Perform exercises at home every day to stretch your plantar fascia. These can be calf stretches, toe stretches and towel stretches, as explained above.
Anti-inflammatory treatments such as applying an ice pack over the affected area every 15 to 20 minutes and after activity will help reduce pain and inflammation. Ice massages are also a great way to soothe aching feet. Simply freeze a paper cup filled with water and roll it under your arch for about seven minutes. Regular massages can help reduce pain and inflammation and they’re easy to do at home and work.
We hope this plantar fasciitis treatment guide helped you to get a better understanding of how to treat plantar fasciitis.