Treatment of heel pain (plantar fasciitis)

What is Plantar Fasciitis?

In the running community, plantar fasciitis is the primary cause of pain in the heel and affects as much as 10% of runners.

As you run, the Achilles tendon works with plantar fascia (a thick band at the bottom of your feet) to help store energy. Due to its strong attachment with the base of the toe, the fascia stabilizes the forefoot and helps while push off. Unfortunately, stress on the heel causes tear of the fascia, inflammation and pain while running or walking.

How can You Treat it?

The first thing you need to do is not put too much pressure on heal of the affected foot, otherwise it will worsen your injury.

The plan of treatment, whether invasive or conventional, should allow you to:

  • Comfort the heel pain and its inflammation.
  • Heal the damaged fascia and neighboring muscles.
  • Bring your activity level back to normal.

95 out of 100 people recover from the pain and inflammation of plantar fasciitis within a span of a year without undergoing any surgery. The recovery time depends on how quickly you opt for a treatment method.

Initial home therapy

Here are some tips that can give you quick relief from pain and inflammation:

  • Rest your feet and stop or limit your routine activities that cause pain in your heel.
  • Avoid running on hard surfaces.
  • Stop using worn out shoes or shoes with a thin sole. Limit your footwear to very cushioned, good condition lace-up shoes.
  • Wearing slippers or walking barefoot can worsen your pain, so try to wear athletic shoes. It will support your feet and relieve your pain.
  • Relieve your pain and overcome heel inflammation by putting ice on the sore areas. A good method is to freeze a small water bottle and roll your heel and arch onto the bottle.
  • If the above methods don’t work, apply topical anti-inflammatory gels or at times, you may need to resort to oral anti-inflammatories.
  • Do calf and plantar fascia stretches. It will comfort your muscles and give flexibility to your ligaments.
  • Roll your heel and arch onto a round object such as a tennis ball.

Non-Invasive Therapies

The Podiatrist will also analyze and evaluate why you got the heel pain by reviewing your medical history, current training regime, footwear, lifestyle, foot alignment and gait. Once the cause of the plantar fasciitis is found, the treatment focuses on addressing the cause.

There are a number of treatment that give relief from plantar fasciitis pain.

-Stretches: The podiatrist will guide you by telling how to stretch your leg muscles, which help in stabilizing your heel and ankle muscles.

-Sports Tape: They can also apply taping to support your heel which is very effective in immediate pain relief.

-Cushioning and compression socks: The podiatrist will instruct you about gel heel cups, and other forms of ‘bandaid’ treatment to reduce the pressure under the heel.

-Orthotics: They can help reduce the heel pressure by re-aligning your foot correctly and supporting the plantar fascia.

-Radial Shock-Wave-Therapy: In this therapy, intense pulsating beats are applied over the plantar fascia to promote healing and flexibility.

-Surgical boot: In cases where the plantar fascia has a tear, a boot may be required for upto 6weeks to use to rest the area. The boot can also be used in slow-healing cases.

-Radiology imaging: The podiatrist may refer you off for Xray or Ultrasound or MRI to confirm the severity and detail of the injury which further assists in treating the area.

 

Injections

Medication in the form of steroids is injected into the tender area, it gives relief from pain temporarily. Long term use of steroids is not suitable because it weakens your plantar fascia and may cause its rupture. Cortisone injections are reserved for cases where the plantar fascia does not respond to non-invasive treatment.

Another injection available for non-responding plantar fasciitis is platelet-rich-plasma. Its effects are different to cortisone, in that it encourages healing to occur by injecting your own blood platelets into the site. The results are not immediate but more-long lasting than cortisone. This injection is performed by sports physicians and can cost about $600.

 

Surgical Procedures

Surgery is the last resort if nothing else works. The procedures vary depending on the type and severity of the injury. However, plantar fascia surgery is rarely required.