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Treatments and drugs
By Mayo Clinic staffAbout 90 percent of the people who have plantar fasciitis recover with conservative treatments in just a few months.
Medications
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve), may ease pain and inflammation, although they won't treat the underlying problem.
- Corticosteroids. This type of medication may be delivered through a process called iontophoresis, in which a corticosteroid solution is applied to the skin over the painful area and the medication is absorbed with the aid of a nonpainful electric current. Another delivery method is injection. Multiple injections aren't recommended because they can weaken your plantar fascia and possibly cause it to rupture, as well as shrink the fat pad covering your heel bone. Ultrasound guidance is sometimes used for more accurate placement of the corticosteroid injection.
Therapies
- 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 doctor may recommend wearing a splint fitted to your calf and foot while you sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight so that they can be stretched more effectively.
- Orthotics. Your doctor may prescribe off-the-shelf or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly.
Surgical or other procedures
- Extracorporeal shock wave therapy. In this procedure, sound 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. This procedure may cause bruises, swelling, pain, numbness or tingling, and has not been shown to be consistently effective.
- Surgery. Only a small percentage of people need surgery to detach the plantar fascia from the heel bone. It's generally an option only when the pain is severe and all else fails. Side effects include a weakening of the arch in your foot.
References
- Plantar fasciitis. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cf,?topic=A00149. Accessed Jan. 2, 2009.
- Sheon RP, et al. Plantar fasciitis and other causes of heel and sole pain. http://www.uptodate.com/home/index.html. Accessed Jan. 2, 2009.
- Pasquina PF, et al. Plantar fasciitis. In: Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/115323583-3/0/1678/89.html#4-u1.0-B978-1-4160-4007-1..50088-2_1412. Accessed Jan. 2, 2009.
- Thomas JL, et al. Clinical practice guideline: The diagnosis and treatment of heel pain. The Journal of Foot and Ankle Surgery. 2001;40:329.
- Running and jogging injuries. American Orthopaedic Society for Sports Medicine. http://www.sportsmed.org/secure/reveal/admin/uploads/documents/ST%20Running%20and%20Jogging%2008.pdf. Accessed Jan. 5, 2009.
- Stracciolini A, et al. Sports rehabilitation of the injured athlete. Clinical Pediatric Emergency Medicine. 2007;8:43.
