Plantar fasciitis treatment

The plantar fascia is a thick band of tissue running along the sole of the foot from the heel bone to the base of the toes. It supports the arch and acts like a spring when you walk and run. Plantar fasciitis, sometimes called plantar fasciopathy, is pain and degeneration where this band attaches to the heel.

It is one of the most common causes of heel pain. Risk factors include long hours of standing or walking on hard floors, walking barefoot at home on tiled or marble floors, flat or unsupportive footwear, a sudden increase in walking or running, tight calf muscles, flat feet or high arches, and being overweight. A heel spur is often seen on X-ray, but the spur itself is rarely the cause of pain.

Most people improve with calf and plantar fascia stretching, supportive footwear indoors and out, cushioned heel cups or arch supports, night splints for some, weight management and reducing long periods of standing. Painkillers can help in flare-ups. Shockwave therapy is another option for persistent cases.

Steroid injections into the heel are often given and can ease pain for a while, but they carry a risk of thinning the heel fat pad and weakening or rupturing the fascia, so they are used cautiously. Surgery to partially release the fascia is reserved for a small number of persistent cases. When heel pain has lasted months despite good basic care, there is a reasonable middle option.