Treatment Options For Plantar Fasciitis

February 23, 2011 Posted by Dr.Murray

Plantar fasciitis remains one of the most common problems I treat.  I see plantar fasciitis in factory workers, teachers, nurses and athletes in great numbers.  These, and others, who are on their feet a lot are susceptible to this condition.  It is very frustrating to have and can be frustrating to treat.  It is technically an overuse injury.  The cause is usually multifactorial with the combination of foot structure, activity level, shoes worn, body weight frequently coming into play.  Several of the factors contributing to plantar fasciitis can be modified (activity, shoes worn) while others cannot (job requirements, foot structure).

For runners, tennis players, those who do aerobics or other impact weight bearing activity you usually have to take time off from your activity while being treated for this.  This is a time to cross train.  Swimming, bike riding, rowing machines, lifting weights on machines can usually be continued during treatment.

Shoes worn during treatment should be modified to include running shoes, good work boots or hiking shoes.  Shoes worn should have rigid soles with adequate shock absorption.  A key ingredient in shoes is a removable liner.  We can then put in either a very supportive over the counter orthotic or a custom made functional orthotic into the shoe.  This will provide extra support as well as shock absorption.  Going barefoot should be avoided as well.

If the change in shoes and inserts do not help more aggressive treatment will be needed. An x-ray will sometimes be taken to rule out a stress fracture.  A combination of taping, anti-inflammatories, orthotics, and corticosteroid injections might be needed to quiet the condition down.  It can take 6 months to a year for bad cases to respond to treatment.  Surgery is only considered when the above have failed to give relief.  When surgery is performed I do a partial release of the plantar fascia.  This can take several months to heal from.  As stated, the procedure is reserved for those not getting better with more conservative care.  For those who do need surgery you should know that the procedure works very well.

I had chronic plantar fasciitis in 1990 after the New York City Marathon and ended up being in the small group of patients not responding to care.  In 1993 I had a partial release done and have not had problems since.  Hopefully, you will not require this level of care but if you do we can help you.

Posted by Kevin Murray, DPM

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