Plantar fasciitis is a condition that can take six – 18 months to resolve. Treatment begins with conservative management such as weight reduction and avoiding activities that irritate the foot. Mechanical support for the foot can be achieved through arch supports, heel cups, night splints and orthotics that can relieve pressure off the plantar fascia. Stretching and strengthening are also important aspects of the treatment. Stretching the soleus and gastrocneumius muscles and the plantar fascia can be accomplished with the stair and ball-rolling stretches along with cross-friction massage. Strengthening exercises improve the muscles of the foot.
Ice and anti-inflammatory medications can help manage foot pain. Longer-lasting anti-inflammatory medication such as corticosteroid injections may be used for chronic heel pain. Multiple injections, however, can increase the risk of fascial weakness or rupturing, lead to fat pad atrophy and infection of the heel bone. Although these side effects can be prevented, steroid injections are reserved for persistent cases.
In the most severe cases, surgery may be an option to release the pressure off the fascia. Newer forms of therapy, such as sound wave therapy and botulinum toxin, may be more widely available in the future but currently there is limited evidence of efficacy.
Reviewed by health care specialists at UCSF Medical Center.