How To Treat Plantar Fasciitis
Plantar fasciitis is a condition that afflicts roughly 3-5% of the population at any time. It affects the connective tissue that supports the arch of the foot and causes pain in the heel and along the bottom of the foot. The pain is usually most severe when you take your first steps after waking up. This can be either in the morning after sleeping or after a daytime nap. In this text, we will first explain the causes and symptoms of plantar fasciitis. We will also discuss risk factors that increase your chances of getting this condition. We will then discuss how to treat plantar fasciitis, including acute cases of the condition, and how to do so at home using non surgical methods.
Causes of Plantar Fasciitis
An understanding of how to treat plantar fasciitis must include a discussion of the causes of the condition. Plantar fasciitis is the result of inflammation of your plantar fascia. The plantar fascia is a thick strip of fibrous tissue that covers the sole of your foot and joins your toes at the front to your heel bone at the back. It functions like the string of a bow and supports the arch of your foot as you walk. It absorbs the shock that you would otherwise feel as your feet hit the ground while walking.
Plantar fasciitis occurs when the plantar fascia experiences excessive stress and tension and small tears appear in it. The stress and tearing can cause inflammation of the plantar fascia. This is the condition known as plantar fasciitis.
Plantar fasciitis can be either an acute or chronic injury. Acute plantar fasciitis is the result of a sudden injury that damages the plantar fascia. One example of this is landing awkwardly in a manner that tears the plantar fascia. Chronic plantar fasciitis is the classic condition that develops over time. It has the risk factors discussed in the next section. To treat acute plantar fasciitis, you would employ many of the same strategies you use to address a chronic case of the condition.
However, you should note that, with many cases of this condition, the cause of plantar fasciitis cannot be determined with certainty.
Risk Factors For Plantar Fasiitis
Together with understanding its causes, an understanding of plantar fasciitis’ risk factors can be helpful to understanding how to treat the condition. This is especially true if you would like to treat your plantar fasciitis at home.
Common risk factors for plantar fasciitis include extensive running, either for exercise or as part of a sport that you play. Other activities that keep you on your feet for long hours at a time can also contribute to the condition, e.g. teaching, working as an air hostess. In addition, other activities that may not require extended periods standing, but that place great demands on the feet, can be contributory factors. These may include ballet dancing or aerobic dancing.
Plantar fasciitis can also be a result of your style of walking or standing e.g. if these activities cause your weight to be unevenly distributed along your plantar fascia. Having flat feet (fallen arches) or high arches (also known as hollow foot) can also contribute to the condition. If you have flat feet and your shoes do not provide adequate arch support, this can contribute to the onset of pain from plantar fasciitis.
Another factor is excessive body weight that places excessive pressure on the plantar fascia.
Finally, age is also believed to be a contributory factor. Most cases of plantar fasciitis occur between the ages of 40 and 60.
How To Treat Plantar Fasciitis
We outline below a number of steps you can take to treat your plantar fasciitis at home. Applied properly, these steps can help you to effectively treat even acute cases of plantar fasciitis. However, in extreme cases of the condition, you may wish to discuss more aggressive treatment options with your doctor, including corticosteroid injections and/or surgery.
Stretching & Strengthening Exercises
These are a key part of a plan to treat plantar fasciitis, especially if you are trying to do so at home. The aim should be to strengthen your foot muscles and improve the flexibility of the calf muscles. Appropriate exercises should include the following:
- Wall stretches;
- Stair stretches;
- Dynamic stretches (rolling your foot over small cylindrical metal can, foot roller or even a tennis ball). Please see the featured image for an illustration of this;
- Towel stretches (which you can do just before getting out of bed to relieve the pain of the first few steps of the day).
We discuss these and other therapeutic exercises for plantar fasciitis in greater detail here.
Change Your Footwear
If your plantar fasciitis is a result of flat arches, consider switching to shoes with better longitudinal arch support. In some cases, the problem may be caused by the age of your running shoes; getting a new pair with better shock absorption may help. In some other cases, patients have found that switching to a slightly larger shoe size can help.
If you decide to try shoes with better longitudinal arch support, you should consider motion control shoes. This is a type of footwear with features such as an external heel counter, wider flare and additional medial support. You may find these to be an effective way to treat your plantar fasciitis at home.
Try Arch Supports Or Orthotics
Many cases of plantar fasciitis are the result of low arches that reduce your foot’s ability to absorb the impact of foot strikes while walking. There are a number of devices that are available to potentially deal with this problem:
- A podiatrist can prescribe custom orthotics that improve arch support to reduce the impact of foot strikes;
- Over the counter arch supports (such as those from Oppo Medical or Mueller Sports Medicine) are less expensive than custom orthotics but may be somewhat effective in treating your plantar fasciitis;
- Arch taping products (such as Mueller Sports Medicine PFTape system) are also available to improve arch support and ease the problem.
Consider Using Plantar Fasciitis Night Splints
Night splints will help to keep your ankles in a neutral position while you sleep. Keeping the calf and plantar fascia in stretched positions during sleep will reduce the pain you feel when taking your first few steps after awakening in the morning. A dorsiflexion night splint like the Bio Skin Night Splint or the Darco Body Armor Night Splint will achieve this. The Darco DCS Plantar Fasciitis Sleeve applies continuous compression and arch support to achieve a similar effect.
Anti Inflammatory Agents
Using an anti inflammatory agents is another option available to those trying to treat their plantar fasciitis at home. The agents used can be ice, non steroidal anti inflammatory drugs (NSAIDs) or cortisone injections. It is important to appreciate that these “treatments” only reduce the pain of plantar fasciitis and do not actually treat its underlying cause.
Ice treatment can take the form of an ice massage, an ice bath or something as simple as an ice pack or cold compress (e.g. the Dunbar Medical Instant Cold Compress). It is usually applied after you have completed a period of exercise or some other strenuous activity.
NSAIDS can be effective and some patients prefer the fact that they can be taken orally. However, they are sometimes accompanied by side effects such as gastric pain, gastrointestinal bleeding or even kidney damage. For this reason, we would not suggest these drugs as an option if you want to treat your plantar fasciitis at home. Consult your doctor before trying them and use them user his or her close supervision. Their benefits may outweigh their risks if the plantar fasciitis you are looking to treat is an acute case.
Cortisone injections usually show significant benefits if you receive them in the early stages of your plantar fasciitis. However, they do carry the risk of side effects. As a result, you should consult your doctor before trying this option. In addition, you should consider if only if your disease has resisted the other treatments we have suggested above. The risks include rupture of your plantar fascia and fat pad atrophy.
The final option for treatment of a plantar fasciitis condition is surgery. You should consider this option only after all the more conservative alternatives above have been tried and found to be unsuccessful.The surgeon will detach your plantar fascia from your heel bone in order to eliminate the pain. The operation can be done via either an open procedure or by making a small incision and using only local anasthesia.
Undergoing surgery to treat your plantar fasciitis is not a risk free option. There are risks of complications due to the flattening of your longitudinal arch support, the rupture of your plantar fascia and even the use of anasthesia for the operation. If your plantar fasciitis is severe enough and other options have failed, you should discuss this treatment option thoroughly with your doctor to understand its pros and cons.