How do you treat plantar fasciitis?
Monday, July 14, 2014
Nearly 2 million patients are treated for plantar fasciitis each year. This common heel pain is caused when the plantar fascia – a bow-like tissue on the bottom of the foot – is damaged or torn. Inflammation, pain, and stiffness follow.
While the plantar fascia does have some elasticity, as we become older, the tendons do become more brittle and have a greater tendency to tear with overuse.
Common symptoms of plantar fasciitis:
- Deep, stabbing pain in the heel for a month or more
- Increased pain in the morning or after long periods of sitting
- Stiffness and pain tends to loosen throughout the day
The first visit
Most of my patients try over-the-counter inserts and/or anti-inflammatory medications, but inevitably end up in my office. At the initial consultation, I will typically have the foot x-rayed to see if there is any bony pathology. I also recommend some icing and stretching exercises at home, along with an anti-inflammatory medication.
I give my patients removable arch padding and strap to decide if an arch support would help them. If this seems to help, the patient should call their insurance to ask about coverage on orthotics.
Orthotic devices are custom-made shoe inserts that provides arch support. The insert gives patients the support they need if they are standing on their feet all day.
Ongoing heel pain
If there is no improvement on the second visit, we will then consider physical therapy or a cortisone injection. If the patient is still in pain during the subsequent visits, I begin to look at other causes of heel pain, such as nerve entrapments, gout, a stress fracture, rheumatoid arthritis, or psoriatic arthritis. We may need to do an MRI, CT scan, EMG, or blood work to differentiate what the diagnosis might be.
If you know of someone who has persistent heel pain, have him/her give us a call for a consultation.