How do doctors treat plantar fasciitis. What are the most effective over-the-counter medications for plantar fasciitis. Can cortisone injections help with severe plantar fasciitis pain. Which home remedies are recommended for managing plantar fasciitis symptoms. Are stretching exercises beneficial for plantar fasciitis recovery. How do orthotics and night splints aid in plantar fasciitis treatment.

Understanding Plantar Fasciitis: Symptoms and Diagnosis

Plantar fasciitis is a common foot condition that affects millions of people worldwide. The primary symptom is a sharp, stabbing pain in the heel, particularly noticeable when taking the first steps in the morning or after prolonged periods of rest. As the day progresses, the pain often subsides but may intensify following extended periods of activity.

Diagnosing plantar fasciitis typically involves a physical examination and a thorough review of the patient’s medical history. In some cases, imaging tests such as X-rays or MRI scans may be ordered to rule out other potential causes of heel pain, such as stress fractures or bone spurs.

Key Symptoms of Plantar Fasciitis:

• Intense heel pain, especially in the morning
• Pain that increases after prolonged standing or activity
• Discomfort when climbing stairs or standing on tiptoes
• Tenderness along the arch of the foot

Is plantar fasciitis a serious condition? While plantar fasciitis can be extremely painful and disruptive to daily activities, it is generally not considered a serious medical condition. With proper treatment and care, most cases resolve within a few months to a year.

Over-the-Counter Medications for Plantar Fasciitis Relief

When it comes to managing the pain and inflammation associated with plantar fasciitis, over-the-counter (OTC) medications are often the first line of defense. These readily available medicines can provide significant relief for many sufferers.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are the most commonly recommended OTC medications for plantar fasciitis. They work by reducing inflammation and alleviating pain. Popular options include:

• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve)
• Aspirin

How effective are NSAIDs for plantar fasciitis? Many patients find significant relief with these medications, especially when combined with other conservative treatments. However, it’s important to note that long-term use of NSAIDs can lead to side effects.

Potential Side Effects of NSAIDs

While generally safe when used as directed, prolonged use of NSAIDs can cause various side effects, including:

1. Digestive issues (heartburn, nausea, stomach ulcers)
2. Increased risk of heart attack or stroke
3. Kidney problems
4. Allergic reactions

Given these potential risks, it’s crucial to use NSAIDs as directed and consult with a healthcare provider if symptoms persist or worsen.

Cortisone Injections: A Powerful Tool for Severe Cases

For patients who experience severe pain and inflammation that doesn’t respond to OTC medications, doctors may recommend cortisone injections. These powerful anti-inflammatory drugs can provide significant relief when injected directly into the affected area.

How Cortisone Injections Work

Cortisone, a type of corticosteroid, works by reducing inflammation in the plantar fascia. When injected into the painful area, it can provide rapid and long-lasting relief for many patients.

Do cortisone injections cure plantar fasciitis? While cortisone injections can provide significant pain relief, they do not cure the underlying condition. They are typically used as part of a comprehensive treatment plan that includes other therapies and lifestyle modifications.

Risks and Limitations of Cortisone Injections

Despite their effectiveness, cortisone injections come with potential risks, especially when used repeatedly:

• Plantar fascia rupture
• Atrophy of the fat pad covering the heel bone
• Weakening of tendons and ligaments
• Skin discoloration at the injection site

Due to these risks, doctors typically limit the number of cortisone injections a patient can receive in a given period.

Home Remedies and Conservative Treatments for Plantar Fasciitis

Many effective treatments for plantar fasciitis can be performed at home. These conservative approaches often form the foundation of a treatment plan and can provide significant relief for many patients.

Rest and Activity Modification

Resting the affected foot is crucial for healing. This may involve:

• Reducing high-impact activities like running or jumping
• Taking breaks during long periods of standing
• Using supportive footwear, even at home

How long should you rest with plantar fasciitis? The duration of rest varies depending on the severity of the condition. Some patients may need only a few days of reduced activity, while others might require several weeks. It’s essential to listen to your body and gradually return to normal activities as pain subsides.

Ice Therapy for Pain Relief

Applying ice to the affected area can help reduce pain and inflammation. Here are some effective methods:

1. Ice pack wrapped in a thin towel applied to the heel for 15-20 minutes
2. Rolling a frozen water bottle under the arch of the foot
3. Ice bath for the foot (10-15 minutes)

For optimal results, ice therapy should be performed 3-4 times daily, especially after activities that exacerbate symptoms.

Stretching and Strengthening Exercises for Plantar Fasciitis

Exercise plays a crucial role in the treatment and prevention of plantar fasciitis. Properly executed stretches and strengthening exercises can help alleviate pain, improve flexibility, and promote healing of the plantar fascia.

Effective Stretching Exercises

Regular stretching can help loosen tight muscles and increase flexibility in the foot and calf. Some beneficial stretches include:

• Calf stretches against a wall
• Plantar fascia stretch (pulling toes back towards shin)
• Rolling a tennis ball or frozen water bottle under the arch

How often should you stretch for plantar fasciitis? For optimal results, perform these stretches 2-3 times daily, holding each stretch for 30 seconds and repeating 3-5 times.

Strengthening Exercises for Foot and Ankle

Strengthening the muscles that support the foot and ankle can help prevent future occurrences of plantar fasciitis. Some effective exercises include:

1. Toe curls (picking up marbles or scrunching a towel with toes)
2. Heel raises
3. Ankle circles and point-and-flex exercises

Perform these exercises 3-4 times a week, gradually increasing repetitions as strength improves.

Orthotics and Supportive Devices for Plantar Fasciitis Management

Orthotic devices can play a significant role in managing plantar fasciitis by providing support, cushioning, and proper alignment to the foot. These devices can help distribute pressure more evenly and reduce strain on the plantar fascia.

Types of Orthotics for Plantar Fasciitis

There are various types of orthotics available, ranging from over-the-counter inserts to custom-made devices:

• Heel cups: Provide cushioning and support to the heel area
• Arch supports: Help maintain proper foot alignment
• Full-length insoles: Offer support and cushioning for the entire foot
• Custom orthotics: Tailored to an individual’s foot shape and specific needs

Are custom orthotics necessary for plantar fasciitis? While many patients find relief with over-the-counter orthotics, those with severe cases or unique foot structures may benefit from custom-made devices prescribed by a podiatrist or orthopedic specialist.

Night Splints: A Nocturnal Solution

Night splints are devices worn while sleeping that keep the foot in a dorsiflexed position, gently stretching the plantar fascia and Achilles tendon. Benefits of night splints include:

1. Preventing morning stiffness and pain
2. Maintaining flexibility in the plantar fascia
3. Promoting healing by reducing micro-tears during sleep

While effective, some patients find night splints uncomfortable. It may take some time to adjust to sleeping with the device.

Advanced Treatment Options for Persistent Plantar Fasciitis

When conservative treatments fail to provide adequate relief, doctors may consider more advanced interventions. These options are typically reserved for chronic cases that have not responded to other therapies.

Extracorporeal Shock Wave Therapy (ESWT)

ESWT uses sound waves to stimulate healing in the plantar fascia. This non-invasive procedure can be effective for some patients with chronic plantar fasciitis.

How does ESWT work for plantar fasciitis? The shock waves create microtrauma in the affected tissue, which triggers the body’s natural healing response. This can lead to increased blood flow and tissue regeneration in the plantar fascia.

Platelet-Rich Plasma (PRP) Injections

PRP therapy involves injecting a concentration of the patient’s own platelets into the affected area. This treatment aims to accelerate healing by delivering growth factors directly to the injured tissue.

While promising, more research is needed to fully understand the effectiveness of PRP for plantar fasciitis. It’s typically considered an experimental treatment and may not be covered by insurance.

Surgical Interventions

In rare cases where all other treatments have failed, surgery may be considered. Surgical options for plantar fasciitis include:

• Plantar fascia release: Partially cutting the plantar fascia to relieve tension
• Gastrocnemius recession: Lengthening the calf muscle to reduce strain on the plantar fascia

Surgery is generally considered a last resort due to potential complications and extended recovery time.

Preventive Measures and Long-Term Management of Plantar Fasciitis

While treating existing plantar fasciitis is crucial, preventing its recurrence is equally important. Implementing certain lifestyle changes and adopting good foot care habits can significantly reduce the risk of developing plantar fasciitis or experiencing a relapse.

Proper Footwear Selection

Choosing appropriate footwear is essential for preventing plantar fasciitis. Key considerations include:

• Adequate arch support
• Cushioned heel area
• Proper fit (neither too tight nor too loose)
• Replacement of worn-out shoes regularly

What types of shoes are best for plantar fasciitis? While individual needs may vary, many people find relief with supportive athletic shoes, cushioned walking shoes, or sandals with built-in arch support.

Maintaining a Healthy Weight

Excess body weight puts additional stress on the plantar fascia. Maintaining a healthy weight through proper diet and regular exercise can help reduce the risk of developing plantar fasciitis or exacerbating existing symptoms.

Regular Stretching and Foot Exercises

Incorporating foot and calf stretches into your daily routine, even when not experiencing symptoms, can help maintain flexibility and prevent future occurrences of plantar fasciitis. Some beneficial exercises include:

1. Toe stretches
2. Calf raises
3. Ankle rotations
4. Plantar fascia massage with a tennis ball

How long should you continue exercises after plantar fasciitis symptoms subside? It’s recommended to continue these exercises indefinitely as part of a regular fitness routine to maintain foot health and prevent recurrence.

Gradual Increase in Activity Levels

When starting new exercise routines or increasing physical activity, it’s important to do so gradually. Sudden increases in high-impact activities can strain the plantar fascia and lead to injury. Tips for safe progression include:

• Slowly increasing duration and intensity of workouts
• Incorporating low-impact activities like swimming or cycling
• Using proper warm-up and cool-down techniques
• Listening to your body and resting when necessary

By implementing these preventive measures and maintaining good foot care habits, many individuals can effectively manage their plantar fasciitis symptoms and reduce the likelihood of future flare-ups.

Plantar Fasciitis Treatment | Everyday Health

Plantar Fasciitis Medication

The most common symptom of plantar fasciitis is heel pain, particularly when patients take their first steps in the morning or after resting for a long period of time. The pain usually subsides over time, but it can increase after activity.

Over-the-Counter Pain Relievers

Treatment usually begins with medication to manage the pain and underlying inflammation associated with the condition. Common over-the-counter (OTC) medicines, such as ibuprofen (Advil) and naproxen (Aleve), can help reduce plantar fasciitis pain and swelling.

But these nonsteroidal pain relievers can have side effects, particularly when they are taken over a long period of time. Digestive system complaints, such as heartburn and nausea, are most common. Less common but serious side effects include allergic reactions, hypertension, and liver or kidney damage. (4)

Cortisone Injections for Plantar Fasciitis

For severe pain and inflammation that do not respond to nonsteroidal medication, your doctor may prescribe cortisone injections. Cortisone drugs or corticosteroids are used to treat a range of conditions, including arthritis, bursitis, and gout, as well as allergic reactions.

These drugs can treat inflammation throughout the body or in specific areas, as is the case with plantar fasciitis. Cortisone can be injected into the plantar fascia, the band of tissue that becomes inflamed in plantar fasciitis.

Cortisone is a powerful anti-inflammatory drug, and it can have severe side effects. Multiple injections can lead to a rupture of the plantar fascia or shrink the fat pad covering the heel bone. (5)

Home Remedies for Plantar Fasciitis

Many of the conservative treatment options for plantar fasciitis are things you can do at home. They involve a combination of resting the foot, avoiding activities that can aggravate the condition, therapies to manage the pain, and techniques to strengthen foot muscles during recovery.

Resting the Foot

In one study, roughly one-quarter of patients with plantar fasciitis cite rest as the treatment that works best. Avoiding weight-bearing activities and pressure applied to the foot helps relieve pain during the healing process.

Still, rest can be especially difficult for athletes and people whose jobs require a lot of walking and standing. Active individuals can achieve “relative rest” by choosing activities that minimize impact and pressure on the plantar fascia, such as swimming and upper body weight machines. (7)

Icing the Foot

Like certain medicines, ice can be an effective anti-inflammatory. Typically, cold is applied to the area that hurts or is inflamed for intervals of 15 to 20 minutes.

Cold therapy can be achieved by applying an ice pack to the painful heel or by soaking the heel in an ice bath for 10 to 15 minutes. Icing can be especially helpful after exercise or at the end of a workday.

Stretching and Strengthening Exercises

Exercise can help relieve plantar fasciitis pain, while also loosening tight muscles, increasing flexibility, and building muscle strength in the foot.

Simple stretching techniques may incorporate stairs, walls, boards, and objects that the arch of the foot can be rolled over. Strengthening exercises may involve picking up small objects like marbles or coins with the toes. A physical therapist can show you how to perform specific exercises to stretch and strengthen your lower leg and foot muscles, which will help stabilize your ankle and heel.

Studies have shown that many plantar fasciitis patients cite stretching and strengthening exercises as the most helpful part of their treatment. (6)

Orthotics, Arch Taping, and Night Splints

Orthotics, or orthoses, are devices that are worn in a shoe or on the foot to manage pain and walking problems. They include foot pads or heel cups that cushion a sensitive area on the foot like a callus, and shoe inserts that provide support and correct ankle or heel movement.

Arch taping involves applying athletic tape to the foot to reduce stress on the ligament by keeping the fascia from moving too much. Some people tape their arch only before physical activity, while others apply the tape to reduce strain throughout the day.

Night splints are devices that gently stretch your calf and the arch of your foot. They are worn at night and work by supporting your foot with the toes pointing upwards while you sleep.

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Plantar Fasciitis Treatments: How to Treat Plantar Fasciitis

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.

Other Therapies

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.

Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

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Plantar fasciitis

Plantar fasciitis is an inflammation of the ligament that supports the arch of the foot and connects the heel to the toes.

Plantar fasciitis is the most common cause of heel pain, which is especially severe at the beginning of walking (in the morning with the first steps). In addition, plantar fasciitis can cause pain in the arch of the foot and ankle.

Against the background of the inflammatory process in plantar fasciitis, the appearance of a bone spike-like growth – a heel spur is possible. Another common complication of this disease is tendonitis (inflammation) of the Achilles tendon.

In the presence of hallux valgus, plantar fasciitis contributes to the accelerated development of this disease, an increase in deformity with increased inflammation and pain.

How to treat plantar fasciitis?

Plantar fasciitis responds well to shock wave therapy (SWT). Particularly fast and lasting results are achieved by combining SWT with other physiotherapy procedures used in our clinic:

• relieves heel pain and other symptoms of plantar fasciitis,
• relieves tension in the ankle, redness, inflammation and swelling disappear,
• disease complications are prevented,
• in the presence of a heel spur, it disappears without surgery, valgus deformity decreases, inflammation of the Achilles tendon is removed,
• the lameness disappears, the gait improves, the quality of life increases.

The main effect of using shock wave therapy for plantar fasciitis is achieved due to the anti-inflammatory and anti-edematous effect of acoustic waves of infrasonic frequency. These waves are concentrated in the focus of inflammation and act on the border of the plantar fascia and calcaneus, increasing the blood supply to the tissues of the aponeurosis and Achilles tendon, improving metabolic processes and stimulating recovery processes.

Thanks to this complex effect of shock wave therapy, it not only quickly relieves pain and inflammation, but also strengthens the ligamentous apparatus, increasing its resistance to physical stress.

In the presence of bone growth, acoustic waves contribute to its destruction and the natural excretion of calcium salts from the body.

Why does plantar fasciitis occur?

The main reasons why plantar fasciitis occurs are prolonged, regular overstrain of the ligament that supports the arch of the foot and multiple microtraumas (ligament microtears). Therefore, this disease is called “runner’s heel”.

Plantar fasciitis most often affects people whose daily life involves running, jumping (eg professional athletes), long walking, carrying heavy loads, standing on their feet.

Factors contributing to the development of plantar fasciitis also include being overweight, having flat or high arched feet, and wearing improper, tight shoes.
The use of non-steroidal anti-inflammatory drugs (NSAIDs) for plantar fasciitis can only temporarily relieve pain and is not a true cure for the disease. Traditional medicine methods and other types of self-treatment, as a rule, are also ineffective.

Really stable and fast results in the treatment of plantar fasciitis are achieved through the complex use of physiotherapy, primarily shock wave therapy. An important advantage of this procedure is that it not only eliminates pain and inflammation, but also improves metabolic processes and the condition of tissues, strengthening ligaments and tendons and increasing their endurance.

This serves as the best prevention of the recurrence of plantar fasciitis and other inflammatory and degenerative-dystrophic diseases of the ankle, heel and foot.

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symptoms, diagnosis, treatment with SWT

Plantar fasciitis is a disease that can strike at any age. Treatment of plantar fasciitis with UVT is offered by the Health Plus medical center.

Heel pain is not uncommon. This symptom causes great discomfort and seriously limits motor activity. Pain can be caused by plantar fasciitis. What is this disease and how to get rid of pain in the heel?

Plantar or plantar fasciitis is an inflammation of the tough fibrous tissue, the fascia, located along the underside of the foot. The role of this connective tissue in the body is difficult to overestimate – it is the fascia that connects the heel bone with the metatarsal bones and, as it were, supports the longitudinal part of the foot.

Plantar fasciitis is dangerous because if left untreated, a bone growth appears in the heel area, popularly referred to as a heel spur. And this is a serious pathology, requiring in some cases surgical intervention.

What causes this disease? The reasons may be different. One of them is the development of flat feet. When the foot becomes flat, the fascia becomes tensed and tears appear. Also, the fascia is adversely affected by excess weight, excessive physical activity, uncomfortable shoes, especially high heels. Plantar fasciitis usually affects people over the age of 40, more often women.

1. Symptoms of plantar fasciitis

2. Methods of treatment of plantar fasciitis

3. Prevention of plantar fasciitis

Symptoms of plantar fasciitis

The signs of this disease are quite typical, which makes it easy to recognize it. Patients usually present with the following symptoms:

• acute pain in the heel in the morning after getting out of bed;
• regular occurrence of pain in the heel with increasing load;
• Pain in the heel after standing for a long time or sitting for a long time.

Examination of the foot and analysis of the patient’s complaints to the surgeon or osteopath is enough to diagnose plantar fasciitis. If there is suspicion of the formation of a heel spur, an x-ray is prescribed.

Methods of treatment of plantar fasciitis

This disease cannot be left untreated – even if the pain subsides for a while, then it returns with a vengeance. Therefore, you should first eliminate the cause of the disease: reduce stress (including those associated with excess weight), give up high heels and tight shoes, and purchase comfortable shoes with shock-absorbing soles. Then you should move on to eliminating the inflammatory process. There are several treatments for plantar fasciitis. In each case, the therapy is selected by the doctor. As a rule, treatment is complex.

First of all, you should unload the foot when walking. To do this, use special heels and insoles. An effective method, especially if the disease is not running, can be night tires – orthopedic devices in the form of a plastic boot. They are worn at bedtime. Such devices (orthoses) help to avoid acute pain when getting out of bed. Special gymnastics will also bring some relief, during which the muscles of the foot are stretched and the calf muscles are worked out.

Physiotherapy is an effective method. Usually, doctors prescribe massage, warming rubbing, baths with mineral water, mud applications. With a complex clinical picture, ultrasound treatment, low-intensity laser therapy, X-ray therapy are indicated. Sometimes locally administered corticosteroids – diprospan, flosteron.

If plantar fasciitis is complicated by a large heel spur, shock wave therapy (SWT) is indicated. The method is based on the impact on the affected area of ​​sound waves of the desired frequency, generated by a special apparatus. As a result of such an impact, the growths are destroyed (as if dried), the process of restoration of adjacent tissues begins. The procedure is practically painless and has recently become increasingly popular in orthopedics.

Treatment of the plantar fascia with UVT is possible in any clinic of the Health Plus Medical Center. The course of treatment will help to finally defeat the disease, and a decrease in pain syndrome is observed after the first SWT sessions. Patients quickly return to their usual way of life.

Plantar Fasciitis Prevention

There is no unique formula to avoid plantar fascia. But if you follow the basic rules, the risk of becoming a victim of this disease is significantly reduced.

• If you decide to go in for fitness, distribute the load on all body systems evenly. A sharp transition from a sedentary lifestyle to an overly active one can have a detrimental effect on the state of the fascia.
• Avoid uncomfortable shoes. Do not abuse wearing high-heeled shoes – the unnatural position of the foot injures the fascia.
• Watch your weight – excess body weight puts more pressure on the foot. Not surprisingly, plantar fasciitis is often diagnosed in overweight people.