What to do About Plantar Fasciitis

Experiencing heel pain can be a telltale sign of plantar fasciitis. As a leading cause of foot discomfort, finding an effective plantar fasciitis treatment is important for those seeking relief. We will take a look at home remedies like stretching and physical therapy, which aim to alleviate inflammation and heel pain, and also discuss more advanced treatments for persistent cases.

Understanding Plantar Fasciitis

Plantar fasciitis is inflammation in a band of tissue, called fascia, that connects your heel bone to the base of your toes. Symptoms include heel pain, arch discomfort, stiffness, and swelling. The pain may vary throughout the day, worsening after periods of rest. This condition is the principal cause of heel pain, affecting more than 2 million people in North America annually. Overuse or excessive stretching can damage this ligament-like attachment, leading to inflammation and discomfort.

Causes

1. Overuse: Engaging in activities that place excessive strain on the foot.
2. Inadequate Footwear: Shoes lacking proper support can contribute to the condition.
3. Physical Conditions: High arches, flat feet, or rapid weight gain can increase risk.
4. Lifestyle: Occupations requiring prolonged standing or walking on hard surfaces.

What are the Treatment Options? 

1. Engage in Physical Therapy: A physical therapist can tailor exercises specifically to stretch the plantar fascia and Achilles tendon, and strengthen lower leg muscles, providing stability and pain relief.
2. Home Exercises: Incorporate daily stretches for your calves, Achilles tendon, and the bottom of your foot. Strengthening exercises for your hips, lower leg, and foot muscles can prevent recurrence.
3. Shoe Inserts and Orthotics: Utilize over-the-counter or custom-made insoles for added cushion and support. Remember, firmer insoles with good arch support are ideal.
4. Choose the Right Footwear: Opt for shoes with adequate cushioning, appropriate arch support, and a firm sole. Avoid flat soles and high heels.
5. Ice Therapy: Apply a cloth-covered ice pack over the painful area three to four times a day to reduce inflammation.
6. Weight Management: Losing weight can alleviate pressure on your feet, reducing the risk of plantar fasciitis.
7. Activity Modification: Switch to low-impact exercises like swimming or cycling that don’t exacerbate the condition.
8. Stretching Routine: Regularly stretch your calves and the bottom of your foot to maintain flexibility and prevent tightness.

Advanced Treatment

When first-line therapies don't help, a doctor should be consulted with respect to other, more advanced treatments.

Steroid Injections and Needle Tenotomy

Steroid injections are commonly used to ease pain and swelling in the affected area, providing relief for up to 6 months. However, it's important to note that these injections do not cure plantar fasciitis and should be administered sparingly. Another approach is needle tenotomy, which involves making small punctures in the plantar fascia to stimulate healing and blood circulation.

Extracorporeal Shock Wave Therapy

Extracorporeal shock wave therapy (ESWT) is a non-surgical treatment that uses shock waves to stimulate healing in injured tissues. This therapy can be beneficial for patients with chronic plantar fasciitis who have not responded well to other treatments. ESWT can be administered as either high-energy or low-energy waves, depending on the severity of the condition. High-energy treatments may require local anesthesia due to the intensity of the waves, while low-energy treatments are less intense and typically do not require anesthesia. Studies have shown that combining ESWT with other treatments, such as physical therapy, can enhance the effectiveness and lead to better long-term outcomes.

Surgical Options for Chronic Cases

Surgery is considered a last resort for those with persistent and severe plantar fasciitis symptoms that do not improve with other treatments. The most common surgical procedures include plantar fascia release and gastrocnemius recession. Plantar fascia release involves cutting part of the plantar fascia to relieve tension and inflammation. This procedure can be performed through open surgery or more minimally invasive endoscopic methods.

Prevention Strategies and Maintaining Foot Health

Importance of Proper Footwear

Choosing the right footwear is important in preventing plantar fasciitis. Shoes with minimal heel height, thin soles, and hard insoles without built-in arch support contribute to the development of this condition. To avoid severe heel pain, opt for shoes that offer adequate cushioning, proper arch support, and a firm sole. A slight change in your shoe selection can prevent substantial discomfort and disability. It's also vital for shoe designs to prioritize comfort and foot health, ensuring long-term protection against plantar fasciitis.

Regular Stretching and Conditioning

Incorporate foot and ankle exercises into your routine to strengthen and improve flexibility, important for preventing plantar fasciitis. Activities such as big toe stretches, toe splays, and Achilles stretches can be beneficial. Regular exercise and stretching ensure that your muscles provide the best support and increase the range of motion in your feet. Simple exercises can be performed at home or in the gym, requiring no complicated equipment. To maintain healthy feet and ankles, wear supportive footwear during day-to-day activities and sports, and replace worn-down shoes frequently.

Monitoring and Managing Weight

Obesity is a significant risk factor for plantar fasciitis, with a high Body Mass Index (BMI) and large plantar heel spurs identified as independent factors associated with this condition. Losing weight can significantly reduce the pressure on your heels, lessening the risk of plantar fasciitis. Alongside weight management, investing in good shoes with proper arch support is essential. If you engage in high-impact activities, consider alternating with low-impact exercises like cycling or swimming to give your plantar fascia a break from constant stress. Regular stretching of your feet and calves is also recommended to prevent further flare-ups.