The plantar fascia is a thick band of tissue that runs along the bottom of your foot, forming the arch. If you have plantar fasciitis, you are experiencing daily pain in your heel and possibly along the bottom of your foot because the plantar fascia has been strained. Because plantar fasciitis is one of the most common foot conditions, doctors and physical therapists see it frequently and offer several suggestions for treating the condition successfully.
Plantar Fasciitis Causes
Common causes for plantar fasciitis include a tight Achilles tendon, high arches, flat feet, running, being overweight or wearing shoes with soft soles or poor arch support. A strained plantar fascia develops tiny, repetitive tears where it connects to the heel bone. The plantar fascia tissue near the heel begins degenerating. Your daily heel pain may be so intense that you cannot stand or walk for long periods. The pain is usually worse when you first wake in the morning.
Early Treatments
Make an appointment with a podiatrist, a doctor who specializes in foot problems. While you are waiting to see your podiatrist, avoid standing and walking for long periods and do not run or engage in sports or carry heavy objects. Prepare an ice pack by placing crushed ice inside a plastic bag and wrapping a towel around the bag. Rest your feet on the ice pack for 15 to 20 minutes once or twice each day. Take nonsteroidal anti-inflammatory drugs daily. Wear running shoes with inside padding and good heel support instead of your regular shoes.
Noninvasive Treatments
Plantar fasciitis pain can last six to 18 months or longer, so it is important to be patient. Your podiatrist will evaluate your feet to determine if you need to have special supports, called orthotics, inserted into your regular shoes or your running shoes. You may be asked to stop carrying heavy weights or participating in sports until your foot heals. Your podiatrist may refer you to a physical therapist to start a series of exercises to strengthen and stretch your foot and calf muscles, including wall stretches and stair stretches. A typical plantar fasciitis exercise program is shown in a 2001 “American Family Physician” essay, “Treatment of Plantar Fasciitis.” Another noninvasive treatment is wearing a night splint while sleeping, which keeps your foot in a position that gently stretches the plantar fascia and your calf muscles.
Medical Interventions
If your foot pain does not respond within a reasonable amount of time to noninvasive treatments, your podiatrist may suggest other options, such as corticosteroid injections, extracorporeal shock wave therapy and iontophoresis. Extracorporeal shock wave therapy is thought to stimulate your plantar fascia tissue to accelerate its healing. Iontophoresis uses low-level electrical stimulation to push corticosteroid ointment into the soft tissues of your foot. You may be referred to a surgeon for a plantar fasciotomy, an operation in which part of your plantar fascia is cut away from your heel. The connective tissue then regrows, creating a longer plantar fascia.