What's the treatment for plantar fasciitis?
Conservative treatment is almost always successful, given enough time. Duration of treatment can be anywhere from several months to 2 years before symptoms resolve, although about 90% of patients will be better in 9 months. Initial treatment usually consists of heel stretching exercises, shoe inserts, night splints, and anti-inflammatory medications. If these fail, casting the affected foot in a short leg cast (a cast up to but not above the knee) for 3-6 weeks is very often
successful in reducing pain and inflammation. Alternatively, a cast boot (which looks like a ski boot) may be used. It is still worn full time, but can be removed for bathing. To alleviate the stress and pain on the fascia, the person can take shorter steps and avoid walking barefoot. The person may need to lose weight. Stretching the calf muscles often accelerates healing. Orthotics placed into well-fitting supportive shoes can help to cushion, elevate, and support the heel.
Some physicians will offer steroid injections, which provide lasting relief in about 50% of people. However, this injection is very painful and not for everyone. Other measures that may be needed include use of adhesive strapping or arch-supporting wraps, ice massage, use of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections into the heel, physical therapy, use of orthotics, and splinting at night to stretch the calf muscles and fascia during sleep. If these measures do not help sufficiently, surgery is occasionally required to attempt to partially release pressure on the fascia and remove any heel spurs.
In a few patients, non-surgical treatment fails and surgery to release the tight, inflamed fascia becomes necessary. Surgery is a last resort and should not be entertained before one year of conservative therapy has failed. The surgical procedure which is most successful in these patients is a complete transverse release of the plantar fascia insertion on the calcaneus. Removal of the heel spur is not necessary, since it is not a source of pain. Postoperatively, non-weight bearing is maintained for two to three weeks followed by a gradual return to activities.
More information on plantar fasciitis
What is plantar fasciitis? - Plantar fasciitis is an inflammation of the thick tissue on the bottom of the foot that causes heel pain and disability.
What causes plantar fasciitis? - An abnormal step causes the plantar fascia to stretch irregularly, become stressed, and develop small tears, which results in inflammation (plantar fasciitis).
What're the symptoms of plantar fasciitis? - The most common symptom of plantar fasciitis is pain in the bottom of the heel, usually worst in the morning and improving throughout the day.
How is plantar fasciitis diagnosed? - Typical physical exam to diagnose plantar fasciitis include tenderness on the bottom of the heel, closer to the midline, and mild swelling and redness.
What's the treatment for plantar fasciitis? - Initial treatment for plantar fasciitis usually consists of heel stretching exercises, shoe inserts, night splints, and anti-inflammatory medications.
How to prevent plantar fasciitis? - The best way to prevent plantar fasciitis is to wear shoes that are well made and fit your feet. Exercises that stretch the heel cord may help.