Plantar Fasciitis
Treatment Overview
The goals of treatment for plantar fasciitis are to:
- Relieve inflammation and pain in the heel.
- Allow small tears in the plantar fascia ligament to heal.
- Improve strength and flexibility and correct foot problems such as pronation
so that you don't stress the plantar fascia ligament.
- Allow you to resume your normal activities.
About 8 in 10 people recover completely within a year. Out of 100 people with plantar fasciitis, about 95 are able to relieve their heel pain with nonsurgical treatments. Only about 5 in 100 need surgery.1, 2
Treatment that you start when you first notice symptoms is more successful and takes less time than treatment that is delayed.
Initial treatment
There are many methods you can try to relieve the heel pain of plantar fasciitis. While their effectiveness has not been proven in scientific studies, these methods, used alone or in combination, work for most people.3
- Rest your feet. Limit or, if possible, stop daily activities that are causing your heel pain. Try to avoid running or walking on hard surfaces, such as concrete.
- To reduce inflammation and relieve pain, put ice on your heel. You can also try an anti-inflammatory drug such as ibuprofen (Advil or Motrin, for example), naproxen (Aleve, for example), or aspirin.
- Wear shoes with good shock absorption and the right arch support for your foot. Athletic shoes or shoes with a well-cushioned sole are usually good choices.
- Try heel cups or shoe inserts (orthotics
- Put on your shoes as soon as you get out of bed. Going barefoot or wearing slippers may make your pain worse.
- Do simple exercises such as calf stretches
Avoid using only heat on your foot, such as from a heating pad or a heat pack. Heat tends to make symptoms worse. If you use contrast baths, which alternate hot and cold water, make sure you end with a soak in cold water.
If your weight is putting extra stress on your feet, your doctor may encourage you to try a weight-loss program.
Ongoing treatment
If nonsurgical methods such as rest, ice, and stretching exercises help relieve your plantar fasciitis symptoms, continue using them. If you have not improved after 6 weeks, your doctor may recommend that you continue those methods but add other nonsurgical treatments, such as:
- Custom-made shoe inserts (orthotics
- Night splints. A night splint holds the foot with the toes pointed up and with the foot and ankle at a 90-degree angle. This position applies a constant, gentle stretch to the plantar fascia.
- A walking cast on the lower leg. Casting is somewhat more expensive and inconvenient than other nonsurgical treatments. And after the cast is removed, you will need some rehabilitation to restore strength and range of motion. But a cast forces you to rest your foot. Some people report that it is the most helpful of nonsurgical treatments.
Your doctor may recommend corticosteroid shots if you have tried nonsurgical treatment for several weeks without success.1 Shots can relieve pain, but the relief is often short-term, the shots themselves are painful, and repeated shots can damage the heel pad and the plantar fascia.
Treatment if the condition gets worse
If nonsurgical treatments for plantar fasciitis do not relieve your heel pain, you may need to try other treatments. These may include corticosteroid shots, custom shoe inserts, or a walking cast if you have not already tried one. Formal physical therapy instruction can help to ensure proper stretching of the Achilles tendon and plantar fascia ligament. Doctors usually consider surgery only for severe, persistent cases.
Out of 100 people with plantar fasciitis, about 95 are able to relieve their heel pain with nonsurgical treatments. Only about 5 in 100 need surgery.1 If you are one of the few people whose symptoms don't improve in 6 to 12 months with other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and relieve the inflammation of the ligament. For more information on surgery, see:
What To Think About
If you are trying to lose weight and you develop plantar fasciitis when you begin exercising, especially jogging, talk with your doctor about other types of activity that will support your weight-loss efforts without making your heel pain worse. An activity like swimming that doesn't put stress on your feet may be a good choice.
If your plantar fasciitis is related to sports or your job, you may have trouble stopping or reducing your activity to allow your feet to heal. But resting your feet is very important to avoid long-lasting heel pain. Your doctor or a sports medicine specialist may be able to suggest a plan for alternating your regular activities with ones that do not make your pain worse.
If you exercise frequently, ask your doctor questions about exercising during plantar fasciitis treatment, such as whether physical therapy or referral to a sports medicine specialist, podiatrist, or orthopedist is appropriate.
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| Author: | Shannon Erstad, MBA/MPH | Last Updated: July 23, 2007 |
| Medical Review: | William M. Green, MD - Emergency Medicine Adam Husney, MD - Family Medicine Barry L. Scurran, DPM - Podiatric Surgery | |
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