By Corie Richter, PA | Article Featured on PPP
If you feel the sharp pain of plantar fasciitis in your heel, rest assured—you may just be a few days away from pain relief. Your doctor and physical therapist can make great strides in just a couple of visits, and you’ll probably be pain-free within a few months.
Your doctor and physical therapist will tailor your treatment according to your symptoms.
Most Effective Plantar Fasciitis Treatments
The best treatment for plantar fasciitis is stretching the plantar fascia ligament, while alternately stretching your calves. If you have access to a gym, this stretch can be enhanced by using a leg press machine to further extend your stretch. Your physical therapist can teach you this exercise. Most people experience dramatic improvements after 1 or 2 stretch sessions.
- Physical therapy. A physical therapist can instruct you in a series of exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles, which stabilize your ankle and heel. A therapist may also teach you to apply athletic taping to support the bottom of your foot.
- Night Splints: Your physicians may recommend you wear a night splint. This splint is designed to stretch the calf and arch of the foot while you are sleeping.
- Consider your shoes. If you’re not wearing shoes that have a good arch support and sufficient padding, your plantar fasciitis may get worse instead of healing. You can also incorporate a heal pad or orthotic into your shoes for additional comfort and reinforcement.
- Apply ice. Applying ice to the bottom of your foot is an excellent treatment for reducing inflammation.
Medications for Plantar Fasciitis
Because plantar fasciitis is inflammation, the best medication is usually an anti-inflammatory medication. If your case is mild or moderate, your physician will probably recommend over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
If you don’t respond well to stretching and over-the-counter NSAIDS, your doctor may prescribe celecoxib, diclofenac, meloxicam, or another prescription NSAID. However, your doctor will probably transition you off NSAIDs as soon as practical to reduce the risk of developing side effects, such as digestive problems or heart complications.
If medications, stretching, and other treatments don’t relieve your plantar fasciitis after a year, you many need more invasive therapy.
- Steroid shots. Injecting a corticosteroid into the tender area of the heel can provide temporary pain relief. Note that having multiple injections may weaken your plantar fascia and possibly cause it to rupture, as well as shrink the fat pad covering your heel bone.
- Extracorporeal shock wave therapy. In this procedure, ultrasound waves are directed at the area of heel pain to stimulate healing. It’s usually used for chronic plantar fasciitis that hasn’t responded to more-conservative treatments. In a recent study of 100 patients, >90% reported improvement in symptoms that lasted for 6 months. This procedure may cause bruises, swelling, pain, numbness or tingling .
- Surgery. Your orthopedic surgeon or podiatrist may perform a procedure to cut some of the inflamed ligament—a plantar fascia release—and ease some of the tightness in the tissue. Another procedure, called the gastrocnemius recession, stretches one of your calf muscles to relieve the strain between the plantar fascia ligament and the calf. Few people require surgery, and it is generally an option only when the pain is severe and all else fails. Side effects of surgery include a weakening of the arch in your foot.
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