The Definitive Guide to Plantar Fasciitis Treatment


Plantar Fasciitis is quickly becoming one of the most common foot and heel pain related conditions.

For many people, this means waking up in pain. For others, it means struggling to make it through a long day on your feet.

We've designed this guide to be a complete guide to everything you need to know about Plantar Fasciitis.

In this guide, we'll cover:

  • What Plantar Fasciitis is & What Causes it
  • How Plantar Fasciitis is Treated
  • The Best Products for Treatment Plantar Fasciitis
  • Common Questions & Treatment Myths
Plantar Fasciitis Treatment: The Definitive Recovery Guide

Chapters

 

Chapter 1

What is Plantar Fasciitis?

 

Chapter 2

How Do You Treat Plantar Fasciitis?


Chapter 3

The Best Plantar Fasciitis Treatment Products


Chapter 4

Frequently Asked Questions

Chapter 1

What is Plantar Fasciitis?


Plantar Fasciitis is an incredibly common condition that can affect anyone who spends an extended period of time on their feet, or puts significant stress on their feet regularly.

In this section, we'll break down what plantar fasciitis is and give you details on:

  • The Most Common Symptoms
  • Risk Factors of Plantar Fasciitis
  • What Causes Plantar Fasciitis
  • How It's Diagnosed
  • Similar Conditions
  • Recovery Time
What is Plantar Fasciitis

 

Plantar Fasciitis is one of the most common causes of heel pain and is characterized by pain on the bottom of the heel, usually on the inside aspect of the heel and foot. It is usually due to degeneration of the plantar fascia.

A study by the National Center for Complementary and Integrative Health found that nearly 1% of US adults are diagnosed with plantar fasciitis each year.

1% of US Adults Have Plantar Fasciitis

 

The plantar fascia is a fibrous tissue along the bottom of your foot that exists to support the arch of the foot. The plantar fascia is integral to the overall function of the foot and the connection of the hindfoot to the forefoot.

When strained, the plantar fascia may become weak or degenerated and causes the bottom of the foot to hurt when standing or walking.

Plantar fasciitis is common in runners, as well as those who spend extended periods of time on their feet.

It is also common in people who are overweight and people who wear shoes or boots without proper arch support. However, the condition can happen to anyone. Plantar fasciitis may occur in normal, flat or high-arched feet.  

Plantar fasciitis is known to cause stabbing pains that can often come and go throughout the day depending on a person’s level of activity.

The pain is usually the worst in the mornings or after sitting for a long period of time. Many refer to the pain as a ‘stone bruise’ because that is exactly what it feels like.


What are the symptoms of Plantar Fasciitis?

 

In most cases, plantar fasciitis causes stabbing,aching or throbbing pains in the bottom of the foot, usually near the inside part of the heel.

These symptoms can be present when taking your first steps of the day or after sitting for an extended period of time (for instance after driving).

In addition to these symptoms, people suffering from plantar fasciitis may experience:

  • Stiffness and pain after sleeping or resting which may come and go throughout the day. Sometimes, activity improves the pain.
  • Pain when standing for extended periods.
  • Pain while running or during exercise; pain after a cool-down period is also common.
  • Pain after prolonged activity.


What are the Risk Factors of Plantar Fasciitis?

 

There are many factors that can increase a person’s risk of experiencing plantar fasciitis. These risk factors include:

  • Age: Plantar fasciitis is most common in people 40 to 60 years old, but can be experienced by those younger or older.
  • Biomechanical Issues: People who have high arches or flat feet, or those who walk abnormally with an inward twisting or rolling of the foot. Prolonged immobilization or periods of non-weight bearing in the treatment of other injuries may also incite plantar fasciitis. A rapid change in alignment of the foot and arch will also contribute to the condition.
  • Weight: People who are overweight are at an increased risk for plantar fasciitis as excess weight increases stress and tension on the feet. More importantly, excessive weight actually produces inflammation that makes pain worse.  
  • Poor Arch Support: Wearing shoes with little or no arch support and/or cushioning can increase stress on the foot and arches. Those with a damaged heel fat pad from injections may also experience heel pain when massive cushioning is not present. Shoes should be well-made, strong and have some structure to them for foot health.
  • Working Conditions: Workers who spend a significant amount of time standing or walking during their work day are at an increased risk for plantar fasciitis as repetitive stress and activities may increase tearing of the fascia. The symptoms from a degenerative plantar fascia are also more noticeable during stance. Athletes are prone to the wear-and-tear cause as well.
  • Exercise & Activity: Military members, athletes, and those who spend their time doing physical activities that include running or jumping are at an increased risk due to the repetitive nature of physical activities/exercises. This is especially true if the heel cords (Achilles tendon) are tight. Doing exercises with poor form or in poorly made shoes put one at risk as well.


Who is at Risk of Plantar Fasciitis?

 

There are many risk factors for plantar fasciitis, but certain people are more likely to experience the condition than others based on their health, lifestyle, and activity levels.

These groups are more likely to experience plantar fasciitis at some point during their life:

  • Regular Runners
  • Cleated athletes (soccer, football, baseball)
  • Court athletes (basketball, volleyball, tennis)
  • Middle Aged People & Boomers
  • Overweight People
  • Heavy Lifters
  • Workers that stand (teachers, manual labor, nurses, servers, chefs, retail)

 

Regular Runners

 

The benefits of running normally far outweigh the cons. But it’s also true that long, frequent runs or significant and rapid changes in one’s normal running routine can lead to plantar fasciitis.

While pushing your limits is invigorating, it’s also true that plantar fasciitis has been the bane of many a runner.

The overuse of the plantar fascia can cause tiny tears in the ligament that cause plantar fasciitis to form. Not allowing a good recovery period prevents the body from performing normal repair functions after a workout.

 
What to Do If You’re a Runner

 

Don’t fret; here’s what you can do to keep running while preventing plantar fasciitis:

  • Check your shoes. Don’t be cheap with your feet; make sure your running shoes are up to snuff. Running shoes should be replaced every three months. Have your physician evaluate your foot and make recommendations; people that work at running stores are not doctors usually.
  • Correct your insoles. Know your feet; are you flat-footed? High-arched? Consider having a doctor help you choose an insole for your particular anatomy. Insoles change alignment; decide with your physician if alignment changes are needed.
  • Stay extra limber. Incorporate calf and foot stretches into your pre-run routine and several times throughout the day. Also, don’t forget to stretch your hamstrings and hip flexors. Hips play a very large role in the function of the foot and ankle.  

 

Middle-Aged Boomers

 

When you approach roughly 45 years of age, you’ll likely start noticing some unpleasant changes that may include plantar fasciitis.

This is likely the result of decades of wear and tear. For this reason, women are especially prone to plantar fasciitis since they wear high heels or flat-bottom sandals more often.

Also, menopause can be a factor because as it causes a thinning of the fat layer of the sole. Indeed, hormonal changes are a source of a lot of musculoskeletal pain in women and men.

 
What to Do If You’re a Boomer

 

Unfortunately, you can’t stop growing up. But here’s what you can do to help your plantar fasciitis when you’re middle-aged:

  • Wear more comfortable shoes. This is your excuse to ditch the fancy footwear for something with a little more support. Shoe that can bend in half are not recommended. Structure and quality are important.
  • Take extra care. Avoid long treks if your feet aren’t supported through orthotics, insoles, and thoughtfully padded shoes. However, exercise is important so avoiding it entirely is also bad for feet.
  • Don’t avoid exercise. Your pain may make you want to stay immobile: don’t do it. Exercise your legs, feet, and calves instead. Stretch and strengthen your legs and core. This and aerobic exercise can reduce overall pain in the body and prolong life.

 

Overweight People

Foot-pain studies show that many individuals who report heel pain are overweight.

Further, obesity often results in pronation, which is usually a result of fallen arches. This is due to a complex bio mechanical reaction that occurs in some individuals.

According to a recent study in the US National Library of Medicine, obesity is present in up to 70% of patients with plantar fasciitis.

Plantar Fasciitis Caused by Weight

 

Excess weight places additional stress on the plantar fascia. Over time, the strain will cause small tears in the ligament and plantar fasciitis symptoms will develop.

The other response of the fascia is to thicken with increased loads; this, too, can cause pain.

Finally, to make matters worse, the extra weight may be wearing out your shoes faster, diminishing the support you get with each step.

It is also known that extra fat tissue actually produces inflammation; this can increase pain everywhere.

 

What to Do If You’re Overweight

 

In addition to losing weight, here’s some extra steps you can take to help your feet:

  • Change shoes/insoles more frequently. If you’ve gained a lot of weight somewhat recently, make sure you’ve adjusted your shoe-buying habits; you may need new pairs more often.
  • Get insoles that account for pronation. Fallen arches might be a problem if not supported. (Make sure you actually have midfoot pronation before doing this.) Remember to stretch the Achilles tendon as this is a source of this as well.    
  • Consider working out in a pool. Water can reduce the overall load on your feet while allowing you to experience resistance during an aerobic work. Chest high water reduces body weight by about 75% and waist high water reduces it about 50%; this removes a lot of stress from the plantar fascia yet allows movement and exercise.  

 

Heavy Lifters

 

Like runners, weightlifters put a lot of wear and tear on their feet. If your muscle bulk is making you heavier than the average person, you may be at risk for plantar fasciitis.

In particular, lifters that go heavy on leg day are the most prone to problems. Squats and deadlifts can exacerbate existing foot conditions, such as pronation.

Also, those weight lifters that neglect the lower limbs in favor of bulking the upper limbs and chest also place a great deal of strain on the fascia day to day.

 

What to Do If You’re a Lifter

 

You don’t need to sacrifice progress for pain; here’s how to get whole again.

  • Focus on your upper body while you heal. Unfortunately, your squats may be delaying the healing process. Try giving your lower body a break for a week. Or, if you still work out the lower limbs, use body weight only and don’t add extra weight.
  • Get comfortable with arches. Some competitive lifters may shun soles that aren’t flat, but artificial arches may be necessary to correct foot pain. We recommend that you seek a professional evaluation of your foot shape in order to craft the best insert for your sport. Orthotics essentially redistribute weight about the foot and can lessen the impact on the fascia itself.
  • Make sure you have good lifting mechanics. This goes without sayin


What Causes Plantar Fasciitis?

 

The exact cause of plantar fasciitis is not completely known, but is attributed to stress and repeated tearing of the plantar fascia. Overall, most believe that this is a degenerative condition.

However, we are now learning there is a component of chronic inflammation that may play a role. This is much different from acute inflammation of injury.  

Under normal circumstances, the plantar fascia acts as a shock absorbing support for the arch of your foot and helps you to walk, run, and jump.

When tension and stress build on the plantar fascia, you can develop small tears over time. The body must be allowed the ability to heal itself over time or the condition will persist and worsen.  

Repeated overstretching and tearing can cause the fascia to become irritated and inflamed, causing the sharp, stabbing pain with which patients with plantar fasciitis are all too familiar.

While doctors aren’t 100 percent sure what causes plantar fasciitis, there are some commonly accepted theories.

However, most feel that it’s a degenerative condition with no known cause. Plantar fasciitis can be caused be certain conditions of the feet or by activities that create tension or strain on the plantar fascia.

Individual patient factors such as anatomy, inflammatory load, medications, activities, genetics and others play a large role as well.

It will likely be proven that mitochondrial dysfunction of the fascia itself from chronic toxicity may be the source.  


How is Plantar Fasciitis Diagnosed?

 

In order to properly diagnose plantar fasciitis, your doctor will perform a brief targeted exam to check for pain points and tenderness in your foot.

In addition, they will ask questions about the symptoms you’re experiencing and the activities you were doing during the time that the symptoms presented.

In most cases, the doctor will make a diagnosis based on your history of symptoms and a physical examination alone.

There may be some cases where an X-ray or MRI is recommended to ensure that the pain you’re experiencing isn’t the result of a different condition. Ultrasound is an excellent imaging technique to diagnose plantar fasciitis as well.  

An X-ray is not required to diagnose plantar fasciitis as it will not show the ligaments clearly. However, it will demonstrate the architecture of the foot clearly and will also allow your doctor to see a ‘spur’ if you have one.

An MRI can very easily show the fascia. Spur size is associated with pain level and is often a helpful finding in the diagnostic process.


How Long Does it Take to Recover from Plantar Fasciitis?


Everyone experiences plantar fasciitis differently. Your healing time depends on the severity of your condition. The normal course and progression of pain from plantar fasciitis can last up to 24 months.

The length of time that someone experiences plantar fasciitis can vary from person to person. In most circumstances, pain can last a couple of months while severe cases can last for two years.

Find the best methods to treat the level of severity of your plantar fasciitis – the longer it goes untreated, the longer and more painful your condition can become. In addition, pain that persists after treatment may not be plantar fasciitis, and a reevaluation may be in order.

The worst thing you could do for plantar fasciitis is to neglect your symptoms. Avoiding treatment can make plantar fasciitis symptoms last longer.

How Long Does it Take to Recover from Plantar Fasciits


What Conditions are Similar to Plantar Fasciitis?

 

Plantar fasciitis can often be confused with other conditions as many share some of the same symptoms. These conditions include:

  • Heel Spurs/Bone Spurs
  • Baxter’s neuritis
  • Arthritis
  • Bursitis
  • Stress fracture of the calcaneus

 

Heel Spurs & Bone Spurs

 

Heel spurs are excess calcium deposits that extend from the bottom of the heel bone. They can be caused by muscle and ligament strains or overstretching in the feet, making this a common condition in athletes.

Pain associated with heel spurs is often described as a sharp pain in the bottoms of their feet and can be relieved with stretching, wearing supportive footwear, or rarely through the surgical removal of the heel spur.

 

Baxter’s Neuritis

 

Baxter’s neuritis is a painful condition involving a sensory nerve that runs between the spur and the heel bone. The compression of this nerve may be caused by trauma through physical activity, wearing poorly constructed or ill-fitting shoes, or from other foot conditions such as flat feet or high-arched feel.

Baxter’s neuritis can feel like a tingling, burning, or shooting sensation in the heel of the foot. Footwear with balanced cushion and support or surgical intervention are common methods of treatment.

 

Arthritis

 

Arthritis is the time-dependent destruction of joints. Arthritic joints become stiff, painful, swollen, and even unstable as the condition progresses. As there are many joints in the foot, there are many places that arthritis may strike, including the heel, ankle, and even the big toe.

Physical therapy, footwear with a supportive arch, and anti-inflammatory medication can help to relieve pain.

 

Bursitis

 

Bursitis is caused by inflammation of the bursa, or the small, fluid-filled sacs that protect the joints, bones, or tendons from the friction of motion. Bursitis of the feet most often affects the heels and the toes.

Bursitis can cause the affected area to be swollen and painful at the heel and can be made worse with walking, direct pressure or physical activity. Resting the feet, stretching, wearing cushioned and supportive footwear, and taking anti-inflammatory medications are effective methods of relieving symptoms.

Ice and basic anti-inflammatory modalities may help as well.

 

Stress Fracture of the Calcaneus

 

Stress fractures are hairline cracks or breaks in a bone. These usually occur with over-training and/or poor bone quality. Bone quality is dependent on hormones, nutrition and calcium/D3 intake.  

Stress fractures happen in people that begin training after long periods of inactivity or in those over-training for events such as marathons. These typically occur in the calcaneus (heel bone) very close to the area where plantar fasciitis is felt.

Your physician should suspect this based on history and examination; X-rays are often not sensitive enough to detect these and MRI may be necessary.

Chapter 2

How Do You Treat Plantar Fasciitis?


Plantar fasciitis treatment has several goals including relieving inflammation and pain in the heel, allowing microscopic tears in the plantar fascia to heal, and improving the strength and flexibility of the foot to prevent further damage.

There are a number of different treatments to help relieve symptoms of plantar fasciitis, including:

  • Exercise & Stretching
  • Night Splints & Boots
  • Orthopedic Shoes & Insoles
  • Over the Counter Medication
  • Physical Therapy & Massage
  • Weight Loss
  • Injections
  • Surgery
  • Taping
How to Treat Plantar Fasciitis

Plantar fasciitis treatment has several goals including relieving inflammation and pain in the heel, allowing microscopic tears in the plantar fascia to heal, and improving the strength and flexibility of the foot to prevent further damage.

 

Plantar Fasciitis Improves in 10 Months with Treatment

 

According to the American Academy of Orthopaedic Surgeons, more than 90% of patients suffering from plantar fasciitis find improvement within 10 months treatment.

There are a number of different treatments to help relieve symptoms of plantar fasciitis, including:

When traditional and conservative methods aren’t getting results, your doctor may recommend further medical treatments to help reduce pain and correct problems.

Such treatments may include steroid injections, shock wave therapy, and, in rare cases, surgery. Some doctors also offer newer regenerative techniques for the treatment of plantar fasciitis.


Injections

 

Many people think injections may be the right solution for them to treat their pain, but it may in fact not be the best method of relief. Here are a few things to consider before you treat your plantar fasciitis with injections.

 

How Plantar Fasciitis Injections Work

 

Before receiving injections, most patients meet with their doctor to ensure that they have first tried other forms of treatment.

Injections are serious procedures that require patients to be sure that a simple method of treatment won’t help them instead. Doctors then check for any skin problems or allergies at the site of injections.

The medication solution is injected where the pain is most prominent. This mixture can be made up of steroids, numbing medicines, and other chemicals. After the injection is complete, the area is covered.

 

What Happens after Injections?

 

A numbing sensation persists for a few hours after injection. After the numbing goes away, heel pain will persist for some time. The medication will work to relieve heel pain, though results vary among patients.

Depending on your condition and body, you can expect relief in days, weeks, or even months.

Most doctors ask that patients remain mostly inactive for several days after the injection. Some doctors even recommend a walking boot to reduce pain and inflammation as healing continues.

 

The Painful Side Effects

 

Injections will not cure plantar fasciitis; they only act as relief and may last for three to six months. They may also not work at all. There are a number of risks associated with the procedure.

Patients can see a thinning of the fat pad and bleaching of the skin near the injection site. Damage to the plantar fascia is also a common side effect.

Tearing or rupturing of the plantar fascia can also occur. Studies show that some injections can result in deterioration of tendons and cartilage in the foot.


Surgery

 

About 5% of plantar fasciitis sufferers, especially those with severe pain, resort to surgery to heal their pain. In some cases, surgery can be the most viable treatment option, though the outcomes of surgery are not ideal for everyone.

How do you know if surgery is right for you? Consider the following options before you commit to surgery.

 

When is Surgery Necessary?

 

In most cases, you can effectively reduce plantar fasciitis pain without surgery. Studies show about 95 out of 100 people who live with plantar fasciitis reduce pain without surgical intervention.

A procedure should only be considered once several non-surgical options are fully explored. Your doctor shouldn't consider surgery unless you've tried nonsurgical treatments for at least six months.

Operational methods increase in success every year; however, the success rate is still only estimated to be about 70-80%. These outcomes encourage doctors to recommend patients try treating their plantar fasciitis through conservative methods such as inserts, better shoes and therapy.

For most, non-surgical treatments produce more powerful, safer and lasting results.

 

Plantar Fasciitis Release Surgery

 

Plantar Fasciitis Release surgery is an operation doctors traditionally use to treat plantar fasciitis pain. The surgery requires the surgeon to cut a section of the plantar fascia ligament with the goal of releasing tension and reducing inflammation.

To begin, the surgeon makes a small incision above the heel pad, specifically where thick sole skin meets the thinner skin at the side of the heel. The doctor may also choose to make the incision at the bottom of the foot. For endoscopic procedures, the surgeon makes a small incision on one side of the heel, directly below the ankle bone.

Next, the surgeon will detach the plantar fascia from the heel bone, or create an incision on one side of the heel to release tension. The doctor may also remove or smooth the surface of the bone to help the plantar fascia heal with less strain. In some cases, a small wedge of damaged tissue may be removed.

For about two to three weeks following surgery, patients wear a non-weight-bearing cast to decrease tension and allow the tissues to heal. Some surgeons extend this period of time to 6 weeks. After endoscopic surgery, patients can begin limited weight-bearing almost immediately in some cases. Most return to normal footwear immediately and to regular activities within three to six weeks.

Doctors prescribe every patient a strength and flexibility program to rehabilitate the muscles gradually. Some doctors hope the patients can manage this themselves and some use the skills of a physical therapist to assist. Most patients are recommended to refrain from running or jumping for at least three months after surgery.


Exercises & Stretches

 

Probably the most important at-home treatments are plantar fasciitis exercises and stretches which are a great way to relieve pain and strengthen your feet. This should always be the first treatment tried.

There are a variety of different stretches and exercises that are not only easy to do at home but can help to provide immediate relief.

Since plantar fasciitis pain is often at its worst when first waking up, it’s recommended that you start your morning out with a few of these exercises to stop the pain before it starts.

 

Exercises

  • Tennis Ball Massage
  • Towel Grab
  • Toe Curls
  • Marble PIckups
  • Foam Rolling

Stretches

  • Heel Raise & Heel Stretch
  • Standing Wall Stretch
  • Towel Stretch
  • Foam Roller Stretch
  • Toe Stretch.
Exercises & STretches for Plantar Fasciitis

 

For a more in depth look at the various plantar fasciitis exercises and stretches, check out our complete guide (including instructional videos) here.


Night Splints & Boots

 

Many people use night splints (or boots) to lessen plantar fasciitis pain everyday. The device is designed to put the foot in the best position for recovery during the night.

We’ll explain exactly how it works and why night splints are one of the best devices to have in your arsenal for pain relief.

 

How Do Night Splints Work?

 

Night splints work by stretching the calf and plantar fascia as you sleep. This helps to minimize stress on the areas of the foot that are painful.

Many users find that the morning pain they experience in their feet is reduced drastically by stretching the heel cord overnight. Night splints also help provide the supportive stretching a person may need throughout the day while they are on their feet.

This can potentially aid work, exercise, and many other everyday routines.

 

Benefits of Wearing Night Splints

 

The most exciting thing about night splints is that they gently stretch the fascia! The user doesn’t feel overwhelming discomfort while wearing them.

Once stretched out, the plantar fascia will be less tense. This means the user will experience less pain!

For some people wearing the splints overnight works best. However, many other users report feeling more benefits after wearing the splints for a longer period of time. Some can only tolerate these a few hours each evening.

When first starting to use night splints, you should try to only wear them for about one hour. Gradually extend the amount of time you spend in the splints each night.


Shoes

 

When discussing treatment options for your plantar fasciitis with your doctor, one of the first things they’ll mention is changing your shoes. Footwear can have a lot to do with foot-related pain, especially when it comes to plantar fasciitis.

While there are other treatments for the condition, changing your footwear can have a huge impact on your pain level and recovery.

What you wear on your feet matters, and arch support is key.

 

The right shoes for plantar fasciitis will:

  • Provide adequate arch support for your foot type
  • Provide heel support if necessary or cushioning
  • Include a thick, stiff (or slightly flexible) sole
  • Provide mid-sole cushioning to lessen shock
  • Be comfortable enough to wear all day, without increasing heel pain
  • Be properly fitted to your foot
Shoes for Plantar Fasciitis


Orthotic Insoles & Inserts

 

Orthotic devices built specifically for feet can relieve stress and reduce plantar fasciitis pain! Orthotics stretch your plantar fascia as you stand or walk. You can purchase these devices without a prescription or doctor referral, so it's easy to turn to them when you're looking for quick pain relief.

Below, we’ve outlined how custom orthotics work and why they're helpful for treating plantar fasciitis pain.

Orthotics are typically made out of material that is supportive and malleable. Orthotics with soft arch supports and heel cups can help decrease pain.

These types of orthotics spread and absorb shock as you walk. Pressure is equally distributed throughout the heel which makes for a more comfortable environment for your feet. Heel pain is commonly related to abnormal inward twisting of the feet.

Orthotic devices help with arch support and cushions your feet in a way that would be helpful for support.

 

Custom Orthotic Inserts

 

You can get custom orthotics created for your feet, but these require a prescription. They are usually more costly than non-prescription orthotics but provide extra support.

Custom orthotics are usually designed to accommodate all the issues of your particular problem and anatomy.  

Custom orthotics have traditionally been made by taking a mold of the foot with plaster. However, advanced practices now utilize digital 3D scanning and modeling technology.

The doctor will then use the impression to create an orthotic that controls and redirects specific mechanical problems.

Before you buy a custom orthotic, you may wish to try to take advantage of non-prescription orthotics. They can be purchased at almost any drugstore, supermarket, or athletic store.

Many physicians offer their preferred OTC orthotics right in the office as well.


Medication

 

Over the counter anti-inflammatory medications can be used to help temporarily relieve the inflammation and pain associated with plantar fasciitis, but they are generally only effective for a short period of time.

Acetaminophen is another OTC medication that provides excellent pain relief.

Other medications can be used during treatment to help relieve symptoms but may require a prescription from your doctor.

The most common medications recommended for plantar fasciitis include:

  • Ibuprofen (Advil, Motrin IB, etc.)
  • Naproxen Sodium (Aleve)
  • Diclofenac
  • Prednisone and Prednisolone (Oral Cortisone)
  • Cortisone Injections (Kenalog, Depomedrol, Celestone, etc.)


Physical Therapy

 

In many cases, your doctor may recommend physical therapy to help treat your plantar fasciitis pain. You’ll want to find a physical therapist that is experienced in evaluating and treating plantar fasciitis so that they can work with you to develop a program to help alleviate your symptoms.

 

How Will Physical Therapy Help Plantar Fasciitis?

 

The physical therapy approach to treatment will likely include a combination of various exercises, stretches, and other conservative treatments.

You’ll likely experience many of the same recommendations we’ve discussed in other areas of this treatment guide, including:

  • Stretching exercises to improve flexibility and strengthen your foot
  • Night splints or taping to help correct foot and ankle positioning
  • Recommendations of more supportive footwear or inserts to reduce stress on the plantar fascia
  • Taping techniques used to provide short term relief

 

Do I Need a Specific Type of Physical Therapist?

 

Most, if not all, physical therapists should have experience working with plantar fasciitis as it is an incredibly common condition. When looking for an expert, you should consider:

  • Experience with orthopedic injuries and sports injuries, specifically the foot and ankle
  • A deep understanding of the connections of the entire leg/pelvis/spinal complex
  • A board-certified specialist or a therapist who completed a program in either orthopedic or sports injury physical therapy. These specialties will help you ensure you’re working with an expert.
  • Doctor recommendations will play a major factor with whom you work. Your physician should have previous experience with various physical therapists and can make recommendations based on your specific condition.


Shock Wave Therapy

 

Probably not for the faint of heart (or light of wallet), this procedure uses either pressurized air or electromagnetic pulses to deliver shock waves to the foot.

It’s a fairly painful treatment method, but a 2017 study found that the practice is effective. Multiple treatments are usually required, and anesthesia is recommended.

This procedure is not covered by insurance, and each visit may cost upwards of $600.


Tenex Procedure

 

The Tenex Procedure is a less common, minimally-invasive method for treating plantar fasciitis that is occasionally used when other treatment options for plantar fasciitis have failed.

The procedure is designed to break apart and remove scar tissue using ultrasonic energy.


Taping

 

Plantar fasciitis taping is designed to help you remain active and reduce pain.

There are many plantar fasciitis treatments available to help relieve pain and reduce the stress placed on your foot, and one of the more frequently recommended methods is plantar fasciitis taping.

Plantar fasciitis taping helps to reduce strain placed on the plantar fascia while walking which helps to reduce the painful symptoms associated with the condition.

 

Does Plantar Fasciitis Taping Work?

 

Your personal success with taping of the plantar fascia may vary as everyone experiences different symptoms, and some may be more severe than others.  

Depending on the severity of your case, taping may not be enough to provide the relief you need, and a doctor visit may be necessary.  

In most cases, however, taping can aid in reducing pain levels but is not enough on its own to completely eliminate plantar fasciitis. Taping is a supplemental treatment for plantar fasciitis and is usually recommended in conjunction with other treatments like custom orthotics, physical therapy, and often pain medication.

 

When Should Taping Be Used?

 

Taping is usually recommended for reducing pain levels and can be applied in the early morning hours after waking when plantar fasciitis symptoms are generally the worst.  

Taping allows you to go about your day with added support, hopefully reducing pain levels throughout the day.

Your doctor will provide you with specific instructions based on your needs, but in general it is not commonly recommended that tape be worn all day or while sleeping as it may cause skin irritation.

Taping is a great way to reduce pain during athletic endeavors.


Check out our complete guide to plantar fasciitis taping (including instructional videos) here.


Weight Loss

 

Plantar fasciitis is a very common condition, and this is even more so in patients that are either overweight (BMI=27-30) or obese (BMI=30+).

Being overweight increases the amount of stress placed on your feet, resulting in added stress on the plantar fascia.

Because of this, weight loss can be one of the most effective ways to alleviate plantar fasciitis pain. Unfortunately, losing weight and becoming more active while dealing with heel pain can create a unique challenge for patients.

 

How to Treat Plantar Fasciitis with Weight Loss

 

Losing weight with plantar fasciitis can be challenging, but it is a great way to find relief and prevent plantar fasciitis from recurring.

  • Find Low Impact Ways to Get Active:  Look for low impact activities like yoga, swimming, bike riding, or using rowing machines. These types of activities will help you burn calories while reducing the amount of stress put on your feet.
  • Invest in Supportive, Comfortable Shoes:  Find a solid pair of shoes that will feel comfortable but also provide the right amount of support for your arches and heels. If you can find a pair of shoes with a fascia bar insert, even better.
  • Work on Your Diet: When it comes to losing weight, increasing activity and managing your diet go hand in hand. Try to increase your water intake while better managing your calorie intake. One of the easiest ways to reduce your calorie intake is to cut out sugary beverages. Staying away from highly processed foods is a must.


Massage

 

Massage therapy is one of the most popular forms of healing, even for plantar fasciitis! The body’s soft tissue areas are composed of muscles, connective tissues, and tendons.

Massage therapy can help loosen tight muscles and encourage relaxation. Plantar fascia massage is a great alternative treatment method for plantar fasciitis that:

  • Promotes muscle relaxation
  • Reduces stress on your feet
  • Improves circulation

 

Promotes Muscle Relaxation

 

A deep, plantar fascia massage directly targets the source of pain, ultimately eliminating tension and inducing relaxation.

Massages stimulate circulation to injured areas of the plantar fascia, increasing nutrient and oxygen uptake in the muscles. The boost of activity to the affected sites reduce stiffness and swelling, as well as increases flexibility.

Massage therapy also releases endorphins (or pain-killing natural substances) and boosts dopamine and serotonin levels throughout the body.

All the hormones released during the process help the body physically and emotionally, promoting healing, pain management, and relief.

 

Improve Circulation

 

A regular plantar fascia massage is known to boost circulation in the feet! A massage can help promote increased circulation due to the hands-on pressure which moves blood through damaged and congested areas of the foot.

Squeezing, pulling, and twisting removes lactic acid from the muscle tissues. The practice improves the lymph fluid circulation, which removes any metabolic waste produced.

Adding a massage to your daily routine can deliver the rich blood supply your feet need to promote healing.

 

Stress-Relieving

 

Stressed out after a long day on your feet? Massage therapy can reduce mental and physical stress. When you’re stressed out, the body is tense and filled with cortisol.

High levels of cortisol in the body can contribute to weight gain, digestive problems, headaches, and sleeplessness.

Studies show that cortisol levels drop dramatically after a massage. As cortisol declines, the body enters recovery mode, triggering feelings of relaxation and pleasure.

Chapter 3

The Best Products for Plantar Fasciitis Treatment


Since plantar fasciitis is such a common condition, it should be no surprise that there are dozens of treatment methods available.

Some treatments are proven, others are complete gimmicks.

In this section, we'll discuss the most commonly used treatments for plantar fasciitis and whether or not they're effective.

  • Compression Socks
  • Inserts & Insoles
  • Orthotic Shoes
  • Medicine
  • Pain Relief Cream
  • Heel Cups


Compression Socks

 

Compression socks are often recommended for people suffering from plantar fasciitis as they can help to reduce inflammation and to decrease swelling in the foot.

The idea behind compression socks is relatively simple: provide additional support to the foot through compression, hopefully reducing discomfort in the arch of the foot as inflammation and swelling decrease.

 

The potential benefits of compression socks for plantar fasciitis include:

  • Reduced inflammation
  • Decreased swelling
  • Increased arch support
  • Lessened soreness and cramping
  • Improved circulation
  • More efficient muscles in the foot and leg

 

Their versatility and relatively low cost make them a good option, but the constant compression can get uncomfortable. The socks rarely heal plantar fasciitis on their own.

Compression on the fascial tissue works along with the same principle as low dye taping and other techniques of treatment. It is thought that the compression assists the fascia in maintaining the arch.

In addition, some compression socks can make the muscles function better by improving efficiency.

Pros:

  • Can be combined with other solutions and worn under shoes
  • Relatively inexpensive, $15-50 dollars per pair and may be re-used
  • Can be worn overnight

Cons:

  • Must often be used in conjunction with other treatment tools to achieve healing
  • Constant compression can get uncomfortable
  • May not always result in success

 

The primary reason that many people will turn to compression socks first is that they’re a relatively inexpensive option when it comes to temporary pain relief from plantar fasciitis.

The unfortunate downside to compression socks is that they’re primarily a temporary solution and won’t actually treat the causes of plantar fasciitis.

However, they may assist the body during its natural healing process.


Arch Support Inserts & Insoles

 

There are many forms of treatment available for relieving plantar fasciitis pain with supportive insoles being one of the easiest non-surgical methods available – but even within the world of insoles, there are several factors to keep in mind when finding the right ones for you.

Know the benefits of proper insoles and what to look for when purchasing to ensure that you find the best insoles to alleviate your pain.

 

How Can Insoles Help Relieve Foot Pain?

 

While insoles are easily available at just about any drug store, not every pair you find is created equal. Soft insoles may be comforting for the feet, but supportive insoles with added arch support will be your best friend when it comes to alleviating plantar fasciitis pain.

 

Tips For Purchasing Insoles

 

How can you be sure that you are purchasing the right insoles that will help to relieve the stabbing sensations of plantar fasciitis? Keep these points in mind during your search:

  • Look for insoles with arch support:Whether you have flat feet or a defined arch, additional arch support in your insoles will help to engage and strengthen the muscles of your arches as you walk. This support provides stability to the heel as well as distributing the pressure evenly across the foot to help offload stress.
  • Choose the proper insole volume. Insoles are available in high, medium, and low volumes. These volumes indicate how much space they take up within your shoe. Low-volume insoles take up the least amount of shoe space. They are ideal for those with low arches and for use with cycling shoes. Medium-volume insoles are your middle-ground option. These fit well in your everyday casual and athletic shoes. People with high arches and those with low arches can find relief with this volume of insole. High-volume insoles are great options for those with high arches and are most often added into hiking boots and running shoes. Bear in mind, you may not actually need an orthotic and physician advice is recommended.
  • Try your insoles both in and out of your shoes. When deciding which insole is the right choice for you, make sure to test them both in and out of the shoe you plan on inserting them into. Outside of the shoe, gauge your comfort, balance, and overall feel of the insole. This will allow you to identify the level of support they impart as well as any areas of the foot that may still experience pressure. Then, test your insoles inside of your shoe of choice. This is the best way to ensure that you are choosing the correct size and insole volume to work within your shoes.
  • Remove the existing insole of the shoe prior to placing the orthotic into the shoe

 

The Best Insoles for Plantar Fasciitis

 

Now that you know what to look for when choosing the right insoles for you, here are just a few of our top recommendations:

  1. Dr. Scholl’s Plantar Fasciitis Insoles: Dr. Scholl’s is an affordable, easily obtainable option for supportive, comfortable insoles. However, these plantar fasciitis insoles are only available in a men’s and women’s option rather than in a range of sizes. A physician’s eye and expertise is often more accurate at choosing the proper insole than the kiosk here; however, this is a good low-cost option.
  2. Powerstep Pinnacle Insoles: These flexible insoles feature a cushioned, supportive, and stable version with several size options available. The material wicks away moisture, repels odor, and is shock-absorbing which makes these insoles especially great for runners.
  3. Vivesole Plantar Fasciitis Insoles: The Vivesole insoles are made of lightweight foam and fit easily into your everyday boots and athletic shoes. These insoles are podiatrist-designed and provide support, added comfort, and relief from foot, leg, and back pain.
  4. Protalus M100: These insoles are the most expensive recommendation on our list, but they certainly live up to their cost. The Protalus M100 insoles are made of high-quality materials that absorb shock, relieve pain and pressure on the feet, and help to improve balance and alignment.


The Best Shoes for Plantar Fasciitis

 

Choosing the right pair of shoes can be what makes or breaks your treatment plan for plantar fasciitis. Often, your shoes could be one of the reasons you’re dealing with heel pain in the first place.

 

When looking for the best shoes for plantar fasciitis, there are a few features that you want to look out for to make sure you’re getting a quality pair of shoes:

  • Arch Support:  The right pair of shoes will offer great arch support which will limit over-pronation and ultimately reduce stress on the plantar fascia.
  • Contoured Footbeds: The right footbed will evenly distribute weight across the foot and eliminate stress points
  • Heel Cup:  A deeper heel cup will help keep the heel in place and provide extra padding where you need it most.
  • Shock Absorption:  Shoes that work best for plantar fasciitis will feature some sort of shock absorption which helps to limit the strain and impact on your feet when walking or running.


For a more in depth guide, check out our guide on the best shoes for plantar fasciitis.


Over-the-Counter Medicine

 

Over-the-counter medications like Ibuprofen or Naproxen can provide temporary pain relief from plantar fasciitis but unfortunately do nothing to actually treat the causes.

For people dealing with plantar fasciitis, they are a must-have when as they help to reduce pain and inflammation. However, this often needs to be combined with other treatment methods to be effective.

Acetaminophen is one of the most effective OTC pain relievers and is another good option.


Pain Relief Creams

 

Pain relief creams are often used during treatment of plantar fasciitis as a topical pain relief option that can be applied directly to the areas that hurt the most. While they can be extremely effective for temporary pain relief, they share a very similar situation with over-the-counter medicines.

Pain relief creams are an effective method of reducing pain but usually do not treat the actual causes of plantar fasciitis. In order to be effective, they need to be combined with other treatment options that target the cause of the pain.

There are natural remedies and herbal-based creams that actually can impart healing substances to the foot.


Heel Cups

 

Heel cups are often used to treat plantar fasciitis. They are designed to raise your heel to help relieve stress and tension while providing extra cushioning where the pain is the worst.

While not nearly as effective as inserts or orthopedic shoes, they can be a cost effective option for minor pain relief.

Chapter 4


The Most Commonly Asked Questions About Plantar Fasciitis

When you get the internet involved with anything, especially medical conditions, it can be hard to find the right answers to your questions.

We've compiled some of the most common questions we get asked regarding plantar fasciitis to help you find the answers you're looking for.

Have a question that hasn't been answered yet? Let us know and we'll add it to the list!


How Do You Treat Plantar Fasciitis at Home?

 

Your doctor will likely recommend several treatments that can be performed at home to relieve pain. These treatments may be done in combination to achieve desired results. These at-home treatments can include:

  • Weight loss to reduce stress on foot
  • Purchasing supportive shoes to improve foot and arch support
  • Increasing foot rest and limiting stressful activities to reduce stress on the foot
  • Icing the foot and heel to reduce inflammation and reduce pain
  • Stretching and splinting (or taping) of the foot to increase flexibility of the foot and leg muscles
  • Rolling the foot over a tennis ball to provide tissue massage


What Does Plantar Fasciitis Feel Like?

 

Plantar fasciitis is most often described as a burning, stabbing sensation when standing or walking after prolonged stretches of time off your feet. Terms such as ‘throbbing’ or ‘aching’ are often used.

The phrase “stone bruise” adequately describes what this feels like. While this pain can decrease as you move, it often returns after periods of rest. This pain is experienced on the bottom of the foot at various points around the heel bone.

Plantar fasciitis is caused by damage to the plantar fascia, the shock absorbing band of tissue that spans the sole of the foot. This is sometimes caused by wearing unsupportive shoes or through direct trauma to the fascial band and can result in moderate to severe pain with every step.

Most sufferers of plantar fasciitis report the pain to be the most intense as they take their first steps in the morning.


How Long Does Plantar Fasciitis Last?

 

Every individual with plantar fasciitis experiences the symptoms differently. Pain can be short-lived, though on average plantar fasciitis can last for a few months. In severe cases, symptoms can last for multiple years.

Wearing unsupportive shoes and damaging the fascia through exercise, especially running, can prolong your symptoms.


How Long Does Plantar Fasciitis Take to Go Away?

 

The faster that plantar fasciitis is treated, the easier it is to alleviate your symptoms. This is also influenced by how severe your condition is.

Changes to your lifestyle may help you to find relief. Maintaining a healthy weight, wearing supportive footwear, and altering your physical activity to avoid further damage to the plantar fascia may help to ease symptoms and make them less frequent.

At-home stretches, pain medication, and surgical intervention may help to make symptoms more bearable, but this still may not guarantee a full recovery.


How Long Does Plantar Fasciitis Take to Go Away?

 

The faster that plantar fasciitis is treated, the easier it is to alleviate your symptoms. This is also influenced by how severe your condition is.

Changes to your lifestyle may help you to find relief. Maintaining a healthy weight, wearing supportive footwear, and altering your physical activity to avoid further damage to the plantar fascia may help to ease symptoms and make them less frequent.

At-home stretches, pain medication, and surgical intervention may help to make symptoms more bearable, but this still may not guarantee a full recovery.


Can Plantar Fasciitis Come Back?

 

Symptoms of plantar fasciitis can be managed, and in some circumstances they may even go away on their own. However, many factors can cause this condition to return. Physical trauma to the plantar fascia, wearing unsupportive shoes, and even the changing weather can encourage a plantar fasciitis flare-up.

Stretching and wearing adequate arch support in your footwear can help keep pain under control, and surgical intervention may provide you with relief. However, this does not guarantee that your plantar fasciitis won’t return.


Why Does Plantar Fasciitis Hurt in the Morning?

 

The fascia and connective tissue of the foot and calf naturally contract as you sleep which, when suddenly stretched with the first morning steps, can result in intense pain.

These first steps taken after waking are often described as having a burning or stabbing pain. Long stretches of rest or sleep can cause this pain and sensitivity to return.

There are a few methods you can try to help relieve this foot pain while lying in bed:

  • Stretching the arch of your foot while lying flat in bed can directly stretch the plantar fascia as well as the muscles of the calf. Wrap a towel around the front of your foot and gently pull on the towel while stretching the ball of your foot upward.
  • Curling your toes downward tightly or pretending to write words by using your big toe as a pointer are both methods of stretching the muscles deep within the arch of the foot. This can loosen the foot structures and increase blood flow as well.
  • Roll your foot on a soft ball (tennis) prior to taking a step

ABOUT THE AUTHOR

Meredith Warner, MD


Dr. Meredith Warner is a board certified orthopedic surgeon who is fellowship trained and has extensive experience with complex foot and ankle reconstruction.

Dr. Warner founded her private practice, Warner Orthopedics & Wellness in Baton Rouge, LA in 2013 and is an expert in general orthopedic medicine. She specializes in treating injured workers, treatment for complex foot and ankle injuries and non-operative treatment of the spine.

Dr. Meredith Warner’s Major Milestones

  • Founded private practice in 2013
  • Invented The Healing Sole flip flop to treat plantar fasciitis
  • Served in two wars with the U.S. Air Force
  • Leader of Journal Club for Surgeons
  • Earned a Master of Business Administration, MBA