If you ever felt a stabbing pain in your heel or lower part of your foot after waking up or a long period of rest, you most likely have Plantar Fasciitis. It’s a condition more and more people face on a daily basis and it’s anything but fun.
Basically, Plantar Fasciitis is, is an injury of your Plantar Fascia, the ligament that connects your toes to your heel and supports the arch. If your arch is overstressed – and it can be for a variety of reasons, such as rolling your feet inwards when you walk, being overweight, being on your feet for a long period of time, etc. – small tears can appear, which result in inflammation, swelling, and pain.
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You might think that you can handle a bit of pain and just wait for it to go away on its own. First of all, I think all of the Plantar Fasciitis patients out there agree that the pain is rarely “a bit”. And, second, not being proactive about your Plantar Fasciitis treatment can do you a lot of damage.
Just think about it. If your feet hurt at a specific point, you change the way you walk to alleviate the pain. If you do this for a longer period of time, there can be negative consequences on your ankles, knees, hips and even back. It’s like a chain reaction and before you know it your entire body hurts, your energies are low, you never feel comfortable and don’t even know what to start fixing first.
Preventing Plantar Fasciitis
First of all, there are things you can do to prevent Plantar Fasciitis from ever appearing or coming back (if you’re unfortunate enough that you had it at some point). Prevention is much less painful, but consistency is key.
Having the optimal weight for your height and body type and maintaining a healthy exercise regime and lifestyle can make all the difference in the world when it comes to preventing Plantar Fasciitis. You can also invest in high-quality footwear, stretch your feet and strengthen the muscles that support your arches. You’ll find more details about all of this in the home remedies treatment options part of the article.
Therefore, if you already had Plantar Fasciitis, or if you’re living with any of the risk factors (overpronating, overweight, staying on your feet, etc.), it’s extremely recommendable to take the time and do the necessary work to prevent this condition.
Treating Plantar Fasciitis
If you’re unlucky enough to be in the middle of a full-on Plantar Fasciitis, I’m guessing there are very little things you wouldn’t do to make the pain go away. The good news is that you can you can do a lot of things on your own at home, and many of them don’t involve any money-spending. The bad news is that nothing will make the pain go away overnight. Stay consistent with the treatment and if you see it’s really not improving or that it’s even getting worse, consult with a professional on how to proceed.
Non-surgical Treatment Options
Home Remedies
This is usually where every fight against Plantar Fasciitis begins. Normally, the first recommendation is to rest, to keep your foot off the ground. However, let’s be honest, it’s rarely possible to just lay down with your foot elevated and wait around for the pain to reduce or disappear. But just because you don’t have the time to spend off your feet doesn’t mean there’s nothing you can do.
We’ll be talking about a variety of tricks and tips you can do on your own, at home, while you’re watching your favorite TV series at night, for example.
Shoes and Footwear
First off, you have to review the shoes and footwear you’re wearing. Especially if you’re on your feet most of the day, or if you enjoy running or walking as your daily dose of exercise, you need to get good shoes. According to American Family Physician, 14% of all patients stated that changing their footwear was what worked best in their struggle with Plantar Fasciitis.
The general idea with shoes and footwear is to have your feet protected against impacts, cushioned and that your arches are supported at all times. This doesn’t mean just while you work or when you go for a run. It also includes owning a good pair of slippers for when you’re walking around the house, or a pair of flip flops for when you walk the dog or go to the beach.
Once you’ll start researching, you’ll notice that there are a lot of different features that are always mentioned – arch support, cushioning, shock absorption, perfect fit, sometimes even motion control. These are the most important ones when it comes to choosing the best option for you.
However, be careful when choosing and never settle for something that kinda feels right. Selecting a shoe, slipper or flip flop that doesn’t fit perfectly can do more damage than good, despite its amazing features and reviews. Not all footwear works for everybody, and you need to make sure that the product you decide to buy is, in fact, the best one out there for you.
Orthotic Insoles
In case you don’t want to buy new footwear or can’t afford every piece of the recommended products (shoes, slippers, flip flops), orthotic insoles are an amazing option that you can use in most of your footwear.
As in the case of shoes and footwear, you should be careful when choosing the best orthotic insole for you, since there are many good options out there, but not all are meant for everyone. Check that the arch support is perfect for you, that the cushioning feels great and that your foot isn’t wobbling around when you walk.
Another thing you should keep in mind are the shoes you want to use the orthotic insoles with. Can you remove the original insole? Is there enough space for a thick insole or should you look for a thinner one? Is the shoe wide or narrow?
All of these details matter and I highly recommend you take your time when shopping, try on as many insoles as you need to to find the perfect one for you, and try to wear or take with you the shoes you’ll normally wear the insoles with.
Taping
Taping refers to a technique where you use tape (as the name implies) to help support the fascia in your foot by limiting its movement and thus relieve any unnecessary tension to your arch. It’s a technique that’s widely used by athletes, and it can be done in a few minutes in the comfort of your home.
If you decide to try taping your foot, make sure you use high-quality athletic tape and that you avoid leaving any wrinkles on the skin. You can see detailed instructions on how to tape your foot correctly in order to support your foot here.
Make sure that you don’t leave the tape on your foot for longer than a day (for example, if you tape your foot in the morning, remove it in the evening before you go to bed) because the skin on your foot can’t breathe properly when taped. And I’m sure you don’t want to cure your Plantar Fasciitis on the cost of ending up with skin issues on the same foot.
If you’re at the peak of your Plantar Fasciitis related pain, just taping might not do the trick completely, but it can do wonders in combination with other treatment techniques and options since limiting your fascia’s movements helps prevent new micro tears and assures the existing ones don’t get even worse.
Stretching Exercises
Stretching exercises are amongst the most effective things you can try to alleviate the pain and help with the healing process. They help by making the muscles in your foot and calves more flexible and stronger, so they can better support your arch.
When you first start with these exercises they feel a bit uncomfortable, but as you go along it’ll get better. The great part is that they’re really easy to do, you don’t need a lot of space and you can do them anywhere, even in the office. There are a lot of exercises you can do, but for the purposes of this article, I’ll mention the 3 most commonly recommended ones.
One of the most recommended stretching exercises is towel stretching. Sitting down you roll the towel (or a piece of fabric as strong as a towel) under the ball of your feet and then pull on each end towards your chest. Hold the position for 15-30s, release and repeat.
Another great stretching exercise is the so-called toe stretch. And, yes, it is exactly what it sounds like. Sitting on a chair and resting your foot on your heel, you bend over and pull your toe up and back. Once again, hold for 15-30s, release, and repeat.
The last one is calf stretch and you don’t even have to sit down or take off your shoes for this one. All you need to find is a wall to serve as support while you put the leg you’d like to stretch about a step behind the other one, lean towards the wall and start bending the front knee until you feel the stretch in your calf. Once you feel the deep stretch, hold for 15-30s, release and repeat on the other leg.
Strengthening Exercises
There are additional exercises you can do that focus only on strengthening the muscles that support your arch. Just remember that these are exercises like any other and you should always warm up and stretch the muscles before starting to prevent injuries.
An excellent exercise you can do is the towel pickup. Which consists of trying to pick up a towel with your toes, releasing and repeating. If after a while you notice that the towel is too easy, you can use a number of different objects, just make sure it’s something you can grab with your toes.
You can also do heel raises – just stand on your tippy toes and lower back to supporting your foot on the ground. It’s best if you do this with a chair or next to a wall, so you can grab on to something for balance purposes, but if balance is not an issue for you, you can do it anywhere, anytime.
To help control excess pronation you can do the doming exercise. Keep your heel on the ground while standing, and start pressing your toes into the ground until your foot starts forming a dome or an arch. Release and repeat.
Icing
Using ice if you have Plantar Fasciitis makes perfect sense and is often the go-to remedy for when the pain is truly too much. Ice is great for reducing inflammation and pain, and, as such, I believe it’s a great idea to always have an ice pack in your freezer for when you need it.
There are different things you can do with ice. You can massage your arch and heel with an ice cube. There are also a lot of ideas like freezing a bottle, a can or even a tennis ball and rolling your foot over it to massage the arch.
You can prepare yourself an ice bath, mix water with ice and rest your heel and arch in the bath for 15-20min. When opting for an ice bath, make sure your mind doesn’t wander off. Exposing your skin and your toes to freezing temperatures for an extended period of time can have some serious consequences. To prevent them you can use neoprene toe covers or try to find a way to keep your toes out of the water. In any case, at the first sign of any cold exposure related issues, you should stop with your ice batch.
Another great icing technique is using an ice pack. You can make your own (crushed ice in a plastic bag wrapped in a towel) or buy one and have it in the freezer. There are even products that are mean specifically for your feet, such as Icy Feet.
Medical Treatments
If you find that none of the home remedies works for you, it might be time to consider seeing a doctor about some of the available medical treatments.
Anti-Inflammatories
The first medical treatment option to consider is the use of anti-inflammatory drugs. In most countries, these drugs, called NSAIDs (nonsteroidal anti-inflammatory drugs) can be purchased without a prescription, and according to American Family Physician, they can really alleviate the pain while there are doubts if they actually help with the healing process.
Taking NSAIDs, such as ibuprofen (Advil, for example) or naproxen (Aleve, for example) can be really comfortable since you can just keep the drugs with you and take one whenever you need it. No need to find space to do your exercises, change the insole to another shoe, or buying new shoes.
However, we are talking about drugs. And as all drugs, these too have side effects, many of which can be really uncomfortable. If you plan on riding out your Plantar Fasciitis pain with NSAIDs, I would highly recommend you visit physician or orthopedist before you start the treatment, always follow the instructions that come with the product, or maybe even consult with your doctor to be on the safe side.
Shock-Wave Therapy
In theory, it’s quite simple – sound waves are used to help speed up the healing process by directing them towards the center of your pain (in this case, the heel), and the results, in some cases, can be very encouraging.
The shock waves have 3 different functions:
- To improve the immune response, they stimulate the blood flow
- To stimulate healing they re-injure the damaged tissue
- To reduce pain by targeting the affected nerves
However, as with everything medic, there are possible side effects you should take into consideration before putting your foot up and starting the shock-wave therapy. They are not many, but they can be uncomfortable – for example, bruising, numbness, swelling or pain can be the result of shock-wave therapy.
Another downside to this therapy is that it can be quite expensive. If you have great health insurance which covers it, that’s great, but if you don’t, I reckon that once you see the price you might not feel very enthusiastic about trying it, especially if there are no guaranteed results.
It’s also a bit time consuming since it should be administered at least 2-3 times per week by a professional (podiatrist, athletic trainer or physical therapist).
Corticosteroid Injections
This is the most invasive of all non-surgical treatments. The doctor administrating the shot will inject corticosteroid directly into your fascia, using or not (depending on the doctor’s preference) ultrasound as a guiding system. I should mention at this point that recent researches show that using the ultrasound gives better results.
The results of these injections can be really good. According to MedScape, studies report 70% or higher success rates when it comes to using this treatment. The relief is, in most cases, instantaneous, but the treatment is more successful when it comes to dealing with Plantar Fasciitis for a month approximately (the results with patients who have had this condition for over 6 months weren’t encouraging).
However, despite the possible positive outcome, this treatment can have severe consequences if not done properly or too often (it’s not recommended to get the injection more than 3 times per year). The fascia can get weakened or it can even rupture, and there is also the possibility of the fat pad covering your heel bone to shrink.
Yes, corticosteroid injections can be very good for some patients, but the final outcome can also be completely opposite to what you wanted. Make sure you consult with your doctor in detail, that he gets a radiograph of your foot done before starting, and that you’ve tried a combination of home remedies and medical treatments before making the decision.
Surgical Plantar Fasciitis Treatment
Surgery should always be a last resort when dealing with Plantar Fasciitis, and it’s been reported that doctors don’t consider the option until everything else has failed after at least 6-12 months of trying.
The most common surgery to deal with Plantar Fasciitis is called Plantar Fascia Release and it consists in the surgeon partially detaching the fascia from the heel bone. As a result, the tension on your fascia is much less and the inflammation decreases.
This surgery tends to have a 70-90% success rate according to Medscape. However, once the plantar fascia is detached, the arch is not as supported and stabilized as it should be, which causes the medial arch to gradually destruct. Another negative outcome can be the rupture of the fascia (as in the case of corticosteroid injections) or heel hypoesthesia.
If you really can’t deal with the pain anymore and you feel like you’ve tried everything, but nothing worked, then surgery might be a last-resort-option for you. Make sure you consult with the most qualified surgeon you have access to, to see if actually makes sense to undergo such an invasive procedure and get as much information you need to feel comfortable with your decision.
After All Is Said And Done
If you’re struggling with Plantar Fasciitis and this isn’t the first experience you’ve had with it, you most likely have a few favorite treatment options you go to at the first sign of pain.
If you’re new to this stabbing pain in your heel, I believe this article provides you with a good number of ideas to create your own personal treatment regime. There are even some products out there (you can find some of them here) you can start using in your recovery process.
Normally, a combination of home remedies and medical treatment options is a good place to start. Don’t despair if after a few weeks your pain is still there, most of the times it takes between 6 and 18 months for the tears to your fascia to heal and the inflammation to disappear.
And once your Plantar Fasciitis is healed, that’s not a good enough reason to forget about it. You can still wear shoes and footwear made for people with Plantar Fasciitis, stretch your feet and work on your muscles’ strength, maintain a healthy body weight and do whatever else it takes (and you know works for you) to make sure you won’t have to deal with this painful condition ever again.
Brandon R. Katz is a registered professional nurse who has been instrumental in providing us with an informed opinion on the medical aspects of footwear. He graduated from NYU Rory Meyers College of Nursing with a Bachelor of Science in Nursing (BSN) and currently provides his services at a non-federal long-term care hospital in Brooklyn, NY.
Brandon proves to be the champion in the group of expert writers with his in-depth knowledge in foot health, how to take care of it adequately, and what shoes, socks, or insoles will be supreme for you. He has previously worked with hospitals where he has foreseen both inpatient and outpatient departments and has been a practicing nurse since 2009.
Brandon hails from Jersey City, NY, and has a loving family of four with a small popper called Rozo. His decision to become a nurse arises from the desire to be in the position of helping and rehabilitating people.
