What to Look for in Plantar Fasciitis socks

The broad ligament running along the bottom of your foot is called the Plantar Fascia. When this tissue suffers damage beyond normal wear and tear, you’ve come down with a case of Plantar Fasciitis (PLAN-ter  fash-ee-EYE-tis). The pain is typically felt at the front of the heel, and it can be severe, even debilitating. The condition may also be called Heel Spur Syndrome, but heel spurs do not exist in all cases of Plantar Fasciitis.

Most people experience the worst pain early in the morning, after a night of rest.  This is because during the night, your plantar fascia has contracted since it’s not in use. When you take your first steps in the morning, the damaged ligament is pressed suddenly into service and stretches too far, too fast.

So the goal of any Plantar Fasciitis sock is to keep the plantar fascia from contracting, thereby sparing it this shock. In addition to reducing pain, this will also allow the tissue to heal faster instead of becoming re-injured day after day.

Of course, in addition to finding a sock that relieves pain and helps healing, you will need to address any risk factors that tend to lead to Plantar Fasciitis. Many, many people will encounter this painful condition at some point in their life, but you can reduce your chances by:

• Maintaining a healthy weight
• Avoiding footwear that does not provide adequate arch support and good toe flexion
• Always stretching thoroughly before exercise, even walking
• Avoiding excessively violent foot stress in your activities. Sports like basketball and tennis are particularly risky, especially if you don’t warm up properly

Treating and healing Plantar Fasciitis is usually a pretty long process. Even with Plantar Fasciitis socks, you can expect at least three months to pass before all your pain is gone and normal activity does not cause a recurrence. The recommended treatment is a conservative plan of icing, rest, anti-inflammatory medications, and benign devices like socks and splints. If pain remains severe or persists a year or more, it’s probably time to get more aggressive and seek more formal medical intervention.

When choosing a sock for Plantar Fasciitis, you’ll be faced with a couple of choices. Are you looking for a night-time treatment only, or something you can wear around the house during the day? Or will you want to slip shoes over this sock and wear it as a supportive device for normal activities, at work or shopping? For the most part, you’ll need a separate sock for each purpose:

Night-time Plantar Fasciitis socks have a strap to pull the toes up, so obviously they can’t be worn with shoes. Some of the support socks are too bulky to pair with other footwear, while others are designed to provide specialized arch support while wearing shoes. It’s up to you whether to try all types or just one, but most people with Plantar Fasciitis are encouraged to investigate as many treatments as possible, because there’s no one thing that works for every person.

If you have diabetes, open sores, circulation problems, or any type of skin irritation or rash on your foot or leg, you should consult your doctor before investing in any type of confining device like these socks. He or she might have specific recommendations for the use of these products that will enable you to make the best choice.

Suggestions for Plantar Fasciitis Socks

The Strassburg Sock is “the” sock for Plantar Fasciitis. Designed for night-time wear, it’s a comfortable alternative to bulky, hot splints that make it difficult to walk and interfere with sleep. This sock has two adjustable strap points to allow as much flexion as you desire, although you should never stretch the plantar fascia to an uncomfortable degree. The manufacturer claims that use of this sock reduces recovery time from Plantar Fasciitis by 60%. The sock is made of a knit material that is breathable and washable.

A similar product is Mueller Sports Medicine’s Adjustable Plantar Fasciitis Foot Night Support. Although not styled as a pull-on sock, it’s mechanism is essentially the same as the Strassburg sock, pulling the toes up to achieve the flexion desired.

And yet another sock-like night splint is one supplied by ThermoSkin. In addition to the gentle stretching provided by pulling the toes back toward the shin, the material keeps the foot warm which helps the plantar fascia to maintain the stretch more comfortably. Some people have reported that the warmth causes them discomfort or a “sweaty” feeling, but others feel it’s a small price to pay for the morning relief from pain.

Mueller also offers an arch-support product designed to wear with shoes. Consisting of a simple band that wraps around the arch of the foot and closes with velcro, it provides an upward compression for the arch that can reduce or eliminate pain while walking. These are a good option for people who like to walk barefoot or shoeless around the house, also, but could not because of Plantar Fasciitis pain.

ProTec Athletics also offers an arch support shipped in pairs, unlike the single support by Mueller. The nice thing about an arch support’s upward compression feature is that your plantar fascia is kept extended a tad even when your foot is not touching the ground. This helps promote healing even while you’re at work or performing normal activities around the house.

The Thermoskin Heel-Rite daytime splint uses heat therapy combined with a sock-like splint to both reduce inflammation and reduce pain during the day. A patented lining keeps feet dry and comfortable while maintaining skin at a temperature 2-3 degrees higher than surrounding tissue.

Another interesting entry in the arsenal of Plantar Fasciitis socks is the AirCast AirHeel. It uses air cells to provide support under the arch and behind the heel. The product works by “pulsating compression” every time you take a step, squishing the air back and forth between those two areas. You slip it on like a sock, and use a single strap to get a snug fit. Like other arch-support products, this one can be worn with shoes and even hiking boots (provided they’re roomy enough).

Thorlos socks for Plantar Fasciitis are actual socks that have additional cushioning features meant to provide better arch support for particular activities.  Not intended as therapeutic socks to help cure and heal pain, these socks are meant to provide better protection so you don’t develop Plantar Fasciitis in the first place. They offer different versions for running, walking, hiking and basketball. Some of these socks are bulkier than you’re probably used to, and may increase your shoe size. So if you invest in them, be prepared to buy new shoes as well.

Tuli’s Cheetah Heel Protector is not advertised as a Plantar Fasciitis treatment, but as a remedy for heel pain which is the hallmark of the condition. The heel cups absorb shock and are well regarded as an effective way to reduce the pain of Plantar Fasciitis. The ankle support is made of comfortable neoprene, and the heel cups are rubber.

Remember that if the first sock you try doesn’t reduce your foot pain, don’t compound the problem by buying a different version of the same sock. Any effective treatment for Plantar Fasciitis should make your foot feel better right away—it shouldn’t hurt more for a time until the sock is “broken in” or your foot somehow becomes accustomed to the new position. Anything that makes the pain worse is not going to help you heal.

There are so many different Plantar Fasciitis socks available, you’re almost certain to find something that will help you beat the pain of this miserable condition. And if socks don’t work, you can always move on to splints for more serious relief.

Plantar Fasciitis (also commonly known as Heel Spur Syndrome) results from straining the broad ligament that runs along the bottom of your foot from the heel bone to the base of the toes. This tissue, the plantar fascia,  is subject to great stressors and tension, and can normally handle everything we throw at it. But sometimes the dozens of little injuries it suffers are more than it can repair by natural regenerative processes—particularly when our lifestyle contributes to those injuries.

Some of the factors that contribute to the development of Plantar Fasciitis are easy to pinpoint, such as excess weight, intense exercise like marathon running or playing basketball, or that time last week when you ran for the bus and felt something “give”.

Others are more elusive—a sudden weight gain, as in pregnancy.  Tight calf muscles, whether due to lack of exercise or wearing high heels.  Long periods of standing or walking on hard surfaces, as many of us are required to do in our work.

That’s one of the reasons so many people develop Plantar Fasciitis at some point in their lives—there are nearly limitless “causes”, including getting older. For everyone, normal activities eventually start taking an abnormal toll on certain areas of the body.

Fortunately, there is an equally broad field of solutions for the pain, and one of those is Plantar Fasciitis splints. Doctors and therapists recommend a conservative approach to treat this condition, relying on things like ice and rest, gentle stretching, lifestyle changes, and healthy diets to maintain all your ligaments and muscles in their best condition.

Splints fall into the gentle stretching category. Since Plantar Fasciitis pain is often worst first thing in the morning, using a splint at night while you sleep makes a lot of sense. There’s no research that points to splints as a “cure” for the condition, but they’re definitely in the useful end of the spectrum of treatments that you can try.

There are many different splint designs (and price points), but all attempt to keep your plantar fascia extended while you sleep, so that it does not contract to the extent it would otherwise.  When you wake up, your foot will not be so tight, and theoretically you will not experience the pain of coaxing a stubborn tendon into normal operating position. Many people swear by them; some people find them not helpful at all. Every individual’s case is unique, so if you’re willing to spend from $20 to $80 for a splint to potentially ease your pain and speed healing, read on.

What to Look for in a Splint for Plantar Fasciitis

There are basically three types of splints to choose from.

The first type is a rather medieval-looking appliance whose purpose is obvious: to “pull” the toes up toward the shin. This is called dorsiflexion—the upward movement of the foot at the ankle joint. These splints provide two anchors—one on the top of the foot, the other somewhere above the ankle. A line is attached to each anchor, and this is the way the angle of the foot is controlled.

The optimum angle for night splints is 90 degrees, so that your foot is exactly perpendicular to your leg. When we sleep, the toes tend to point down to varying degrees, a relaxed pose. This shortens the plantar fascia. To reduce pain in the morning, it’s necessary to keep that ligament stretched out to prevent the sudden shock of your first step snapping it to attention.

The second type of Plantar Fasciitis splint is more like a cast. It encases some or all of the foot and some or all of the lower leg. At the ankle, it may have a solid back, or work like a hinge to permit adjustment. These tend to be a bit bulkier, although there are many, many styles to choose from. Some are made out of hard materials on the outside, similar to athletic knee or shin pads; others are more soft and plush, at least next to the skin.

This type may be dorsal (covering the top of the foot and shin) or plantar (covering the bottom of the foot, heel and back of the lower leg). The distinction is important, because a dorsal type is obviously easier to walk in and a more appropriate choice if you want to wear the splint around the house during the day, or if you need to make frequent nighttime visits to the bathroom.

The third and last type of splint is little more than a suggestion of control, more like a  firm wrap that make it difficult for the foot to assume its natural sleeping position. These typically cover half the foot, the heel, and the ankle. These tend to be the sleekest-looking option, and appear to be most comfortable and “natural”, but they may not provide enough correction for severe cases. They are also the most versatile, since they are easier to walk in than the other two.

Look also for splints that go high enough on the leg to provide good stabilization/immobilization techniques. Some splints are made barely ankle-high for reasons of comfort. These may not be a good choice if you have a severe case of Plantar Fasciitis that needs a lot of strength to keep your foot in the desired position.

Plantar Fasciitis Splint Suggestions

The splint you ultimately decide to try will depend on a couple of things: how severe your morning pain is, how much you can afford to spend,  how long you’ve been suffering from the pain of Plantar Fasciitis, and any recommendations from your doctor or podiatrist.  Here are a few of the more popular splints on the market, from least expensive to most expensive. The type of splint varies within that cost category. Since many splints combine features of all three types, there is no attempt to classify them strictly by type.
Tuli Cheetah is a one-size-fits-all,  lightweight ankle wrap that can be used for walking or as a night splint. Velcro closures, heel cup and firm support are featured in this product billed as a “proven favorite of gymnasts and dancers.”

Bird & Cronin splints come in small, medium and large sizes. The lightweight design makes it a more comfortable nighttime option than some of this type. It has a non-slip sole for those late-night trips to the  bathroom, although no appliance of this design will be easy to walk in, especially for older people.

Swede-O Deluxe Padded Night Splint bills itself as one of the most comfortable sleep/rest splints on the market. A removable wedge allows the ability to increase dorsiflexion by 5 degrees. The soft padded cover protects skin from irritation, as do the wide bands around shin, ankle and foot.

Bird & Cronin NAP Night Splint is a latex-free product that leaves the heel free. Some users report that belly sleepers will find no benefit to this design, as the foot will not retain the desired position without a heel cup. For those who sleep on their back or side, however, the lack of bulk and confinement is appreciated.

AlphaBrace Night Splint is like a half-cast right-angle that cradles the back of the leg, heel and foot bottom. The front and top are left open with straps to keep the foot immobilized. The soft foam interior, along with the open front design, allows free circulation of air and prevents heat and moisture buildup.

Freedom Dorsal Night Splint offers a gel pad for the top of the foot and wide calf and toe straps for a thoroughly comfortable nighttime splint. This brand provides more room in the toe area for wider feet, and a flexible shell for easier nighttime walking.

Thermoskin Plantar FXT is a soft bootie made of a material that keeps skin warm. The manufacturer claims this helps the plantar fascia to stretch and heal, and the slim bootie design is a nice alternative to bulkier splints.

Final Word

Remember that most people (90%) find relief from Plantar Fasciitis pain within a year, and that it is very important to be active or even proactive in your own treatment. Even if your doctor recommends a Plantar Fasciitis splint to help speed the healing of your foot, don’t assume that that and that alone will cure your condition. Continue to modify your risk factors (activity level, weight, a variety of stretches during the day and before any exercise) and apply other appropriate treatments as you come across them and if they make your foot feel better. Shoe inserts, heel cups, applying ice and resting your foot as much as possible will all certainly not cause any harm and might be just the thing to complement any benefits you might realize from using night splints.

But most of us need to “dress up” at least a little for work, and want something fun and kicky to wear for the occasional wedding or stroll on the town. If that’s the kind of shoe you’re looking for, there are lots of choices in dress shoes for plantar fasciitis.

First Step

First, though, it’s important to understand what Plantar Fasciitis is, and how the shoes you wear affect healing and the potential for recurrence.

You probably already know that Plantar Fasciitis (PLAN-ter Fash-ee-EYE-tis) is a pain in the bottom of your foot, usually at the front of the heel or somewhere along the arch. People feel different levels or kinds of pain: a hot poker, or stabbing, or like walking on glass, or maybe just a dull ache. It’s generally worst or sharpest immediately upon getting out of bed, then might diminish a bit, then might return worse than ever after some period of inactivity during the day.

The pain is a result of small tears in the plantar fascia, the broad band of ligament-like tissue that runs along the bottom of your foot. The fascia may even have torn loose a little bit from your heel bone.  It’s a very common problem in this modern era of office work and city life: generally inactive lifestyles and lots of hard surfaces for walking and recreating. Fortunately, most cases are easily resolved within a few months of proper care.

What to Look for in a Shoe for Plantar Fasciitis

If you already know that you have this condition, you’ve probably looked into how to reduce the pain on your own, or maybe you’ve even visited your doctor.

Either way, you found out that wearing proper footwear is one of the highest-recommended “treatments” for most cases of Plantar Fasciitis. Maybe it should be the highest on the list, since aside from reducing inflammation with ice and pain relievers, all of the other conservative treatments are brought together in a well-suited shoe: stretching and massage, taping and orthotics.

A pair of good dress shoes for Plantar Fasciitis will:

• Facilitate a gentle, controlled stretch of the plantar fascia, Achilles tendons, and calf muscles with each step
• Provide soft support for the arch and heel, with lots of shock protection
• Fit snugly, keeping the heel in place and not allowing the foot to slip into an over-extended position as you rise up on the toe.

The features to look for to get those benefits are:

• Arch Support
• Lots of cushioning to absorb shock
• Flexible toe box, allowing toes to bend back easily
• A slightly raised heel

Plantar Fasciitis Dress Shoe Suggestions

Rubber-soled Mary Jane from Drew Shoes

A Mary Jane dresses up any suit and slacks combo.  This one is available in 8 colors and has all the features recommended above. The two padded insoles are removable, leaving plenty of room to add your own over-the-counter or custom orthotic if they don’t already conform perfectly to your feet.

The breathable lining has a microbe shield to keep your feet feeling fresh and your shoes clean.

Velcro closures ensure a snug fit, and the rocker bottom beneath layers of pampering soft material will help you walk comfortably with natural motion. The 1″ heel provides superior support, while the collar around the ankle is foam-backed for a comfortable, no-rub grip.

Merrell Heather Sandals

For a dressier choice, these open-heel sandals from Merrell will go as well with skirts and dresses as they will with slacks. Twelve colors make it easy to match them to your favorite outfits, whether for work or for walking on the beach.

Lightweight yet durable, these sandals have neoprene-lined leather uppers for a smooth, comfortable ride on the top of your foot, while the plush microfiber footbed pampers your sore spots.

The patented AirCushion in the heel absorbs shock and adds stability. Good arch support make these sandals an exception to the old rule that sleek-looking sandals are not good for problem feet.

Orthaheel Thong Sandals

This style, called Lori, has a cute flower embellishment that makes it perfect for garden parties, weddings, and casual picnic outings. Five spring-timey colors and a faux-straw footbed belie the seriously rehabilitative design of these sandals.

A podiatrist from Australia invented this brand for heel-pain sufferers, and that concern is reflected in the contoured arch support and deep heel cup of this model. Not only will this shoe take care not to worsen your Plantar Fasciitis, but it will encourage proper alignment of feet, ankles and legs for more efficient, effective mobility.

The wide strap has an elastic insert for comfortable flexibility, and the toe-post is carefully designed not to irritate or chafe.

You might want to look at our Orthaheel shoe review post for more information about this brand of shoe for plantar fasciitis treatment.

Sole Platinum Sandal

And finally, the infamous flip-flop. For years, doctors have been warning that people with foot problems (actually, all people) should avoid flips because they have zero arch support and your toes are always clutching.

But here’s a flip-flip in six colors that addresses those flaws. Over time, the continuous-contact sole molds to the shape of your foot providing just the right arch and heel support that you need to maintain sensible activity with comfort and style. Customers have reported that the sizes run large, so take the time to make sure you’ll get a good, snug fit.

Sealing the Deal

Now that you have some information and examples of good dress shoes for Plantar Fasciitis, it’s time to go shopping! A lot of people are buying online these days, both for the convenience and the lower prices, but if you have problem feet you don’t want to rush into anything. Take the time to search out the shoes you want in a store near you and actually try them on.

If that’s not possible, get all the information you can relating to a proper fit. Many people with Plantar Fasciitis have trouble finding shoes that “perform as advertised”, and a lot of the time it’s because they end up with the wrong size. Order from a site that offers free returns for the best chance of a satisfactory experience.

But don’t jump to conclusions. Bone spurs in the heel (more often called heel spurs) are actually a symptom of a different condition called Plantar Fasciitis, which is the true culprit. Fortunately, treatments to reduce the pain of this condition and eventually cure it are easy, inexpensive, and will help 90% of sufferers find relief within a year. And for most of those people, with proper care and treatment, the condition will resolve even quicker, in three to six months.

What Causes the Pain?

The type of bone spurs that may develop in response to Plantar Fasciitis (PLAN-ter Fash-ee-EYE-tis) are called enthesophytes. This type forms at the attachment point for a tendon or ligament, unlike osteophytes which form in the spaces of a joint.

The ligament involved is called the plantar fascia. “Plantar” just refers to the bottom of the foot, while “fascia” is a type of connective tissue. The plantar fascia is the broad band of tendon-like tissue along the bottom of your foot, connecting your heel bone to the base of your toes. It is an important part of the structure called the “arch” of your foot.

This arch is what allows you to walk with a typical gait, where you come down on your heel, and then propel yourself forward onto your toes.  Actually, the entire system involves your calf muscles and Achilles tendon in addition to the plantar fascia. All three, when kept limber and healthy, work together to keep a spring in our step.

But when the plantar fascia is subjected to excessive stress and strain, the normal little rips and tears of daily life get ahead of the body’s healing processes. The small tears become bigger, the tissue can start to pull away from the bone, and inflammation occurs. The pain you feel first thing in the morning is the plantar fascia’s response to its first little stretch of the day with all those injuries still waiting for proper treatment.

Bone spurs, or heel spurs, may occur at the point where the plantar fascia attaches to the heel bone. When the ligament repeatedly pulls on this attachment to an abnormal degree, or actually begins to separate, the normal response is for more bone to grow to correct the problem. That’s the heel spur—just a tiny little piece of calcification that is an attempt to correct the problem of Plantar Fasciitis.

Risk Factors

Our modern lifestyle works against us sometimes, especially when it comes to taking care of our feet and legs. Instead of regular physical exercise in fields and forests, we spend most of our time walking on cement and hard floors, or sitting behind a desk. This leads to a cascade of factors that put us at risk for damaging the plantar fascia and resulting bone spurs in the heel:

• Weight: we all know there’s an obesity crisis in America, and that it’s spawning an epidemic of diabetes and other health issues. One of those issues is Plantar Fasciitis. With the arch of the foot under the strain of excess weight, it’s much more likely to develop rips and tears that can’t heal fast enough to recover.
• Tight calf muscles: without enough exercise or due to wearing inappropriate shoes, our calf muscles can become so short that they interfere with the proper motion of walking. The arch of the foot takes a disproportionate share of the load while walking or running in this situation.
• Bad footwear: it’s not just women’s high heels that are considered unhealthy footwear. If you don’t have a long history of walking barefoot over uneven, soft surfaces, your plantar fascia is not “trained’ to absorb shock as efficiently as it was meant to. To compensate, today’s urbanized population needs to pay attention to shoes that provide extra cushioning, adequate arch support, and good toe flexibility. When you go from wearing stiff, flat shoes at work all week to flip-flops or bare feet on the weekends or vacations, you’re setting yourself up for an unpleasant episode of Plantar Fasciitis and potentially bone spurs on your heel.
• Extreme activity: professional athletes subject their feet to enormous shocks and loads, but the weekend warrior can easily make the same mistake in a pickup game of basketball. If you lead a basically sedentary life with spurts of sports or other exercise, it’s very important to stretch carefully and thoroughly every time you undertake an activity.

Treatment

Whether your doctor says you have heel spurs or Plantar Fasciitis, or is unable to make a diagnosis right away, he or she will probably recommend the following treatments to start. This condition is usually always treated conservatively for a number of months before even considering more invasive remedies like injections or surgery.

In addition to the treatments suggested here, it’s important to make the lifestyle changes that will prevent further damage to your plantar fascia. Losing weight, exercise, and always stretching before any exercise will go a long ways toward keeping your feet pain free after you’ve cured the agony of bone spurs in your heel.

Ice and Rest

Plantar Fasciitis begins as a “soft-tissue” injury, and these two treatments can work wonders. But most people can’t just sit around holding ice on their foot all day. As a compromise, try to refrain from any activity that causes the pain to flare, or that you can feel is extending the bottom of your foot—climb stairs slowly, and crab-wise if possible; no running or jumping; if you must stand, sit frequently and gently massage your feet, ankles, calves. If in doubt—don’t do it.

When using ice on your foot, remember to always add a barrier between it and your flesh. It’s easier than you think to freeze your skin and tissue, and that will only compound your problems. A lot of people find the best success with a frozen can of vegetables that they roll under their foot for 5 or 8 minutes at a time, a few times a day. Look online for special wraps that are designed to be unobtrusive at work, with a cold gelpack inside to reduce the pain and inflammation in your foot.

Stretching

Stretching the calf muscles and Achilles tendons can be a very effective cure for Plantar Fasciitis, as well as help prevent a relapse. The reason is that taking a step with tight calf muscles translates into an excessive snapping force on the bottom of your foot. You may not feel it with each step, but over time the tissue in your plantar fascia will start to become degenerative and weak.

Because most sufferers report their greatest pain in the morning upon getting out of bed, night splints are a way to provide a gentle stretch while you sleep. They hold your foot in a gently extended position overnight to prevent the plantar fascia from retracting during this long period of inactivity. There are many styles of splints to choose from—consult with your doctor or podiatrist about which one to try first.

Inflammation Relief

Anti-inflammatory medication like Aleve, Ibuprofen and plain old aspirin will help relieve some of the pain and inflammation that causes it. A few products deliver this relief directly at the source of the pain in the form of medicated creams.

Other ways to reduce inflammation are to elevate the foot, or to compress it by standing on the edge of a thick book.

Tape and Inserts

Athletic tape  is often used as a sort of home-made orthotic by isolating, immobilizing and supporting different areas of the foot. You can  figure out a taping regimen yourself, as long as it relieves the pain, but you can also find detailed instructions online or ask your doctor for help in coming up with a pattern.

There are also many types of shoe inserts available in stores or online to help your shoes deliver the kind of support that will relieve pain and prevent injury. Heel cups are one of the most effective remedies of this sort.

Custom Orthotics

For a certain percentage of people, the above treatments will not cure the pain caused by their Plantar Fasciitis and bone spurs in the heel. But there is still a chance that custom orthotics.

Get a referral from your primary care physician to see a podiatrist for a more thorough exam of your problem. Whether the podiatrist fashions orthotics (shoe inserts) for you, or sends your prescription to a laboratory for manufacture, the quality and effectiveness of the devices will be vastly greater than anything your doctor can supply. It is not unheard of for an over-the-counter or mass-produced orthotic to hurt more than help a Plantar Fasciitis case, so if you’ve moved on to this step, invest in a quality product. Again, if the orthotic causes you more pain or does not relieve your pain, let the podiatrist know as soon as possible for another evaluation.

Chances are, your pain will respond to these less aggressive treatments and you’ll never even have to worry about acupuncture for Plantar Fasciitis or any of the other scarier (and more expensive) options.

Are You Sure It’s Plantar Fasciitis?

The first thing to do is to become as informed as possible about your condition. If you have pain in the forward bottom part of the heel when you take a step, Plantar Fasciitis is the usual suspect. Most sufferers find this pain to be worst when they take their first steps of the morning. As their foot loosens up (Plantar Fasciitis normally affects one foot), they will experience less pain, but may find it returns later in the day, possibly in different areas, but still affecting the underside of the foot.

This condition is most common in:

• overweight people (particularly women)
• athletes, especially those in running games on hard surfaces
• people whose job involves a lot of standing or walking on hard floors
• people with inactive lifestyles suddenly engaging in stressful physical activities
• mature people, usually over 40 or 50

If you fit any of those profiles, or have recently experienced some facet of one of them (gaining weight suddenly, as with pregnancy; pushing a heavy object and straining your calves and feet; switching from wearing high heels to flats), then Plantar Fasciitis is a very likely diagnosis.

But if you’ve actually received an injury to your foot, or you can think of no risk factor that applies to you, you might want to see a doctor to rule out other sources of similar pain:

• stress fracture
• arthritis
• atrophy of fat pads in the feet
• tarsal tunnel syndrome
• some antibiotics having a risk of tendon damage

The good news is that for most of these, the same common-sense home treatments that help Plantar Fasciitis are also recommended as a first step.

Try These First

If the onset of your symptoms is recent, you will probably find the following to be very helpful in reducing pain. In a majority of cases, they will be the only treatment required to “cure” Plantar Fasciitis. So before you try one of the other therapies like acupuncture for Plantar Fasciitis, try these first.

Ice and Rest

These are the first line of defense against a soft-tissue injury like Plantar Fasciitis. If in doubt about whether any activity will further stress your feet, don’t do it.

Stretching

Gentle stretches to limber and loosen the calf muscles, Achilles tendons, and bottoms of the feet should be incorporated into your daily routine. Massage sore areas carefully.

Inflammation Relief

Cream formulations of Ibuprofen, aspirin and Aleve, applied directly to the foot, will give the quickest relief. But tablets or capsules will also help.

Tape

Specialty athletic tape can be used to isolate and immobilize areas of the foot where you feel the most stress.

Arch Support

Buying an over-the-counter shoe insert (orthotic) may give some people the same or better results as taping—and it’s less trouble. But if the insert does not relieve pain—and especially if it becomes worse—it is doing more damage, so stop using it immediately.

Next Up: Acupuncture For Plantar Fasciitis

Keep in mind that most people will not be completely pain-free for several months or even longer—but a successful course of treatment will gradually reduce the severity and/or frequency of pain. If you’re not noticing that at all, you might want to consider acupuncture.

Although very little research exists to show that acupuncture for Plantar Fasciitis is effective, anecdotal evidence  suggests it might be beneficial for some patients. Considering the major expense and risks of other treatments for stubborn cases, acupuncture seems like a worthwhile bridge between self-treatment and more full-fledged medical care.

Acupuncture may be performed with or without accompanying electrical stimulation. There are several theories about why acupuncture relieves pain, mainly involving the release of endorphins—the body’s natural pain-killers.

In one study, which unfortunately included only 11 patients, 9 of those treated reported pain reduction of 50% or more. Two patients said their pain was completely resolved. To give acupuncture the best chance of success, you should plan on one or two treatments per week for at least a couple of months.

As long as you’re spending money on acupuncture, you may as well take the time to be sure you’re visiting a qualified, competent and compatible practitioner. There is a certification process for these professionals—a three-year training program administered by an accredited institution such as the National Commission for the Certification of Acupuncturists (NCCAOM).

Your foot pain is important and wide-reaching. It can even become debilitating, so make sure the acupuncturist you select has enough experience to give you the very best treatment. There’s nothing wrong with a newly-certified practitioner getting their foot in the door, but you’ll have the most success with someone who has seen a wide range of conditions and clients, and has enough insight to help you discover potential triggers for your foot injury. In addition to the acupuncture itself, your acupuncturist should prescribe (and demonstrate) stretches and massage that will help you eliminate or reduce pain between visits.

And certainly avoid any professional who promises to cure your problem. Plantar Fasciitis is unpredictable in its response to any treatment, whether it’s acupuncture, splints, pain relievers or surgery. An acupuncturist can no more guarantee a good result than a podiatrist can guarantee a new pair of shoes will cure you.

And finally, if acupuncture for Plantar Fasciitis does not seem to be reducing the pain to a manageable level, it’s probably time to see your doctor.  There are still other avenues to relief before you consider anything as radical as surgery, and a referral to a qualified podiatrist or pedorthist can help you explore those options.

Whatever your own experience with heel spurs, it’s definitely an inconvenient condition. Whether foot pain makes mobility unpleasant, painful, or impossible, it’s important to find heel spur treatments that will subdue the pain so you can lead a more normal life.

What Are Heel Spurs

A heel spur is an extra area of growth in the heel bone. It is simply a calcium deposit, more like cartilage than hard bone. On X-rays it will look like a very obvious cause of pain, like a spike that digs into the soft tissue of the heel.

This is misleading. Half of patients with heel spurs, in fact, experience no pain at all. “Heel spurs”, in association with foot pain, is simply another way to say you have Plantar Fasciitis (PLAN-ter Fash-ee-EYE-tis).

On the bottom of your foot a large, firm ligament forms a bridge between your toes and your heel. This is the plantar fascia. You can feel an edge of this broad band of tissue if you press your fingers along the bottom inside edge of your flexed foot. Most people are basically aware of this assembly of ligament and muscle, because we all feel a twinge from time to time when we over-extend a foot, as when running, or pushing a heavy object, or climbing stairs.

As strong as this tissue is, it is actually the weak point in a larger system involving the calves, Achilles tendon, and structures of the feet. It is strained repeatedly through our daily movements. The forces supported by our feet day in and day out are enormous, and mostly underestimated by the majority of people. Modern life has done us no favors by putting us at desks for eight hours a day, or forcing us to walk on hard, unyielding surfaces most of the time. Our feet, essentially, have not yet adapted to the rigors of modern life.

We are constantly subjecting this tissue to small tears and other abuse, but normally it can recover in time to fight the next day’s battle. When it can’t (due to more severe injury, degeneration from aging, or other factors), the tears grow, cause inflammation, and lead to the pain normally classified as Plantar Fasciitis.

By now, you’re probably wondering where heel spurs come in. When a ligament like the plantar fascia repetitively yanks or tears or causes trauma at the bone connection point, the body responds by trying to grow more bone at the point of weakness. In the case of trauma where the plantar fascia connects to the heel bone, a heel spur is the end result.

But not all people with Plantar Fasciitis have a heel spur, and not all people with heel spurs have Plantar Fasciitis. The exact relationship between the two is not well understood, but the briefest way to explain current understanding is to say that if you have pain consistent with Plantar Fasciitis, and you also have a heel spur, the spur is a response to the condition—not the source of pain. About 70% of people with Plantar Fasciitis also have heel spurs.

Symptoms of Heel Spurs

You might have been given a diagnosis of “heel spur” because many doctors believe this is easier to understand from the patient’s point of view, when an actual heel spur exists. Since there’s no point confusing the issue by using the two terms interchangeably, this article will continue to refer to Heel Spurs. But remember that if you have pain that sounds like Plantar Fasciitis, that condition is more likely the cause of your discomfort—not any heel spurs that may or may not have developed because of it.

This is not to say your doctor is wrong, and in almost all cases he or she will recommend the correct course of treatment, which is the same whether you are diagnosed with a heel spur or with Plantar Fasciitis. But if a person believes that an apparently sharp piece of misplaced bone is causing their pain, they may be more likely to consider surgery as a corrective action, when there is no evidence that such a risky, expensive procedure will fix the problem.

Symptoms of heel spurs are hard to miss. Most people report that they feel a sharp pain immediately upon getting out of bed, which then diminishes as they slowly perform their daily activities. At some point during the day, whether your job is sedentary or active, the pain might return, even stronger than earlier. This usually happens after a short period of inactivity (such as a lunch break, or a couple hours at your desk), followed by normal activity like walking or climbing stairs.

The injury itself may have been caused by any number of factors. The most common are:

Weight

This is probably the greatest single risk factor leading to Plantar Fasciitis. In some rare cases (such as pregnancy), your weight gain cannot be avoided. But in general, overweight people—particularly women—are much more likely to have persistent pain from the condition.

Inflexible Calf Muscles

This probably ranks equal with weight as a risk factor, but overweight people tend to be inactive physically. And an inactive lifestyle is likely to contribute to calf muscles that are tight or too short. There are also some people who simply have short calves.

Sudden Change In Activity

This risk factor can apply both to inactive people and active people. If you’re inactive, your calf muscles and plantar fascia are probably not conditioned for the additional stretching that occurs when you suddenly begin to perform activities, even relatively mild ones like walking.

Sports and Hard Activity

Sports that require lunging, jumping, or repetitive hard steps are particularly hard on the plantar fascia, especially when they take place on hard surfaces. Tennis, basketball, running, step aerobics, and volleyball are all examples. There is a real possibility of tearing the fascia away from the heel in activities like this, especially in competitive situations.

Occupation

People in some occupations are more likely to develop Plantar Fasciitis. Waitresses, nurses, mail carriers, and teachers are all people who spend too much time on their feet each day.

Bad Shoes

What makes a “bad shoe”? One that is stiff, inflexible, and with too little arch support. Look for shoes where the toe bends back easily, and with plenty of cushioning inside.

Biomechanical/Gait Abnormalities

Some people are subject to overpronation, where the ankle rolls inward slightly when walking or standing. This puts more weight on the insides of the feet, and may contribute to the development of Plantar Fasciitis. People with flat feet may experience overpronation more often.

The opposite is underpronation, and can also cause problems by rolling the feet outward. This occurs more often in people with high arches.

Medications

Some medications have a side effect or risk of weakening ligamentous tissue. Whether or not these medications actually cause Plantar Fasciitis is not proven, but there is some support for the possibility that quinolone antibiotics are a contributing factor.

Age

This is a risk factor that obviously can’t be controlled, but if you simply can’t think of how you might have injured your foot, realize that older tendons and tissues are more susceptible to rips and tears.

Heel Spur Treatments

As mentioned earlier, a conservative approach to treatment is recommended. This means starting with the easiest, least expensive remedies, and advancing through them alone and in combination to realize pain reduction and eventual healing.

Remember that treatments for heel spurs are identical to treatments for Plantar Fasciitis—just because you have been given a diagnosis of “heel spurs” is no reason to jump ahead to surgery, which should be the very last option for any patient.

Ninety percent of patients will be “cured” of heel pain within a year of following the treatments described below—assuming they also make the lifestyle or activity adjustments that prevent further damage to the plantar fascia.

Ice and Rest

Heel spurs and the associated pain are considered a soft-tissue problem, and the first line of defense for these types of injuries is always ice (to reduce inflammation) and rest (to allow damaged tissue to heal).

It’s up to your schedule to determine when and how long to apply cold to the source of pain. If your work allows it, bring a gelpack to work in a cooler and use it whenever you have a few minutes off your feet. If you can’t manage that, then reserve a couple of slots after the day’s activities to apply ice for 5-8 minutes at a time. Remember that you just want to chill the bottom of your foot, not freeze it. Always use some kind of barrier between your skin and the ice.

Stretching

Simple stretches can work wonders as far as limbering up the muscles and tendons that make your lets and feet work together smoothly. Of course, you’ll have to take care to stretch very slowly and gingerly at first, because energetic stretches will only damage your foot further.

But incorporate a few simple exercises into your daily routine:

• Balance on your toes at the edge of a stair or ledge. Slowly lower your heels until you can feel a pull. Repeat 10 or 12 times.
• Extend your legs each morning before getting out of bed, first with your feet pointed straight ahead, then with the toes pulled up toward the shin as much as is not painful. Gently hold for a few counts, and repeat until your feet feel “loosened”.

There are several products designed to help you massage and stretch your foot. In addition to making it easier to perform these actions, they feel great. A couple to look at are:

• A massage ball based on acupuncture techniques. Easy to use at home or at the office under your desk.
• The tried-and-true wooden foot roller.

Inflammation Relief

Ibuprofen, aspirin and Aleve will give you some relief during periods of sharpest pain and will also reduce some of the inflammation that arises from Plantar Fasciitis.

If you can find this kind of medication in cream form, you can apply it directly to the site of pain for fastest, most effective action. One such anti-inflammatory ointment is called Traumeel; another is called Pentrex.

Mechanical Supports

You’ll find lots of choices when it comes to products that isolate or immobilize at-risk areas of your foot. These items aim to reduce pain and further injury by keeping the plantar fascia safe from overextension. Some are meant to be used in your footwear to increase comfort while performing normal activities, while others are therapeutic.

• Pedifix’s Arch Bandage is a soft elastic bandage that gently squeezes the arch of your foot to provide support and extra stability.
• Dr. Leonard’s Plantar Fasciitis supports does double duty, with a night splint and also a daytime arch support. The night splint holds your foot in a gently extended position while you sleep, with the goal of keeping the plantar fascia from tightening up overnight and causing pain in the morning. Night splints in general seem to help a lot of people, and there are more specialized units available, such as the Bird & Cronin splint. You can find many more models online with different features to address your unique problems.
• Pro-Tec Athletics Arch Supports offers support in a more compact package, basically just a strap that wraps around the middle of the foot to relieve pain and stabilize the arch while you’re walking.
• Heel cups can provide great relief for the pain of heel spurs. There are many varieties and materials available—check out the HTP Heel Seats, shoe inserts that apply accupressure to the tender heel area.
• Mass-produced shoe inserts can be a helpful component for people seeking to alleviate pain and prevent further injury. These can be found at any drugstore, or look online for products like the Powerstep Pinnacle insert.

Another option is to use specialty athletic tape to achieve some of the same benefits as the products above. You can find detailed taping instructions online, or your doctor or physical therapist can help you find the best taping regimen for your individual problem.

Custom Orthotics

Get a referral from your primary care physician to see a podiatrist for a more thorough exam of your problem. Whether the podiatrist fashions orthotics (shoe inserts) for you, or sends your prescription to a laboratory for manufacture, the quality and effectiveness of the devices will be vastly greater than anything your doctor can supply. It is not unheard of for an over-the-counter or mass-produced orthotic to hurt more than help a case of heel spurs, so if you’ve moved on to this step, invest in a quality product. Again, if the orthotic causes you more pain or does not relieve your pain, let the podiatrist know as soon as possible for another evaluation.

Cortisone injections

Although it may provide relief from pain, if you are still exploring less aggressive options to cure heel spurs this treatment might be ill-advised. If you totally mask your pain you will not be as able to tell whether other treatments are working.

Discuss this option thoroughly with your physician, therapist, and any other professionals you are consulting. Long-term use of steroids can actually start to have a weakening effect on tendons and cartilage—an effect that can exacerbate the heel spur syndrome you already have, and lead to more extensive problems.

Acupuncture

There is not much research showing acupuncture to be a cure for heel spur pain, but some people have found relief using the method—similar to the cortisone injections, but less likely to cause additional problems.

Several points on the foot, ankle and leg may be selected for stimulation, some of it supplemented with tiny electrical pulses. The idea is that the acupuncture needles, inserted in specific areas of the body, release endorphins as anti-inflammatory agents. Most acupuncturists treating heel spurs will also include a massage of the calf and foot, and provide instruction on beneficial stretches to use between treatments.

Extracorporeal Shock Wave Therapy (ESWT)

Moving on to one of the more expensive options for treatment, ESWT should not be considered until the therapies above have been exhausted. The FDA requires that the condition be chronically painful for at least six months with less aggressive treatment before ESWT can be attempted.

The therapy sends shock waves into the foot using a device similar to an ultrasound. Perhaps it stimulates new blood flow to the injured area, promoting healing; perhaps it “reminds” the brain that there’s something wrong there and healing activities should begin again. Either way, for patients who have found no solutions thus far, and are not willing to take the extreme and most dangerous step to surgery, this might be an attractive option.

Surgery

There are countless surgeries that an orthopedic specialist might perform in an effort to relieve the pain of chronic heel spurs. Very careful consideration of the risks should be taken before resorting to this step. Many patients have found that surgery cured their heel spur pain—but many have also found no relief or, in some cases, worse pain and more problems following surgery.

If you’re like most sufferers, the burning, aching, or stabbing pain might ruin your morning as soon as you step out of bed. You might get a reprieve as your foot warms up and you gingerly start your daily activities. But eventually you’ll climb stairs a little too energetically, or step just wrong getting off the bus, and the pain will flare up again even worse than before. You definitely need to find out how to cure Plantar Fasciitis.

But even if you have what you consider a mild case of this condition, it’s very important to start treating it before it gets worse. It’s not common for Plantar Fasciitis to “go away” on its own. Even if the pain subsides for a time, you need to find out what triggered it and make adjustments so it doesn’t have a chance to return.

There are myriad treatments for Plantar Fasciitis. The reason is because there are many causes for this type of foot pain, and each person responds differently to each therapy. One important thing to remember is that, even if you find a successful treatment, if you don’t address the root cause of the problem it will almost certainly return.

What Is Plantar Fasciitis?

The Plantar Fascia is a broad band of fibrous tissue running along the bottom of the foot. It attaches at the heel and then fans out at the base of the toes. It is, essentially, the  working “arch” of your foot.

This large, important ligament is a bit like a rubber band. At a certain point in your stride, it is absorbing up to two times your body weight, depending on what activity you’re engaged in—walking, running, making a fast turn on the basketball court. If this “rubber band” is stretched too tight, it can tear a little bit, either in the band itself or at the connection points by the heel. This leads to inflammation and pain in some or all of the entire Plantar Fascia. Without intervention the damage will get worse: tearing more and more, hurting more and more.

So treatment is very important, and in most cases involves pretty common-sense remedies. But even if you cure your Plantar Fasciitis, it can easily return if you don’t pay some attention to the conditions or activities that caused it.

What Causes Plantar Fasciitis?

Let’s look at some of the risk factors and activities that can lead to Plantar Fasciitis first. If a specific preventive action is recommended for that risk factor, it will be listed as well:

• Weight: One of the biggest factors in the development of Plantar Fasciitis is weight. A sudden weight gain can also be responsible, as for a pregnant woman. Obviously, if you are overweight, you will gain many other health benefits in addition to curing Plantar Fasciitis by slimming down as much as possible.

• Achilles tendon and calf muscles: Some people are prone to shorter Achilles tendons or more inflexible calf muscles. Others simply do not exercise enough to keep these connectors limber and supple. Consequently, each step has a more forceful effect on the Plantar Fascia involved in the condition, repeatedly “jerking” that ligament and leading to the damage that causes the painful inflammation. Stretching and exercises designed to lengthen and loosen these tendons and muscles should be incorporated into the daily routines of such people.

• Standing: Many people have jobs requiring them to stand or wealk much of the day, often on hard surfaces. Footwear appropriate to this unnatural surface is recommended to keep Plantar Fasciitis at bay, perhaps including inserts or other orthotics.

• Gait: Hip, leg and ankle configurations give each of us a different gait. People who pronate—whose weight is distributed more to the inside of their foot, rather than balanced or tending outward—have more pressure put on the Plantar Fascia with each step. Either over-the-counter or specialty orthotics can help with this.

• Repetitive Stress: Sports are a major risk factor in the development of Plantar Fasciitis, especially the hard-driving ones with frequent jumping, turning and stopping/starting activities. Here again, stretching is of utmost importance to prevent a recurrence. People with jobs that require them to step up or down repeatedly (such as delivery drivers) are also at risk and should take similar precautions to keep the tendons and ligaments in good working order.

• Some medications: there is some evidence for the possibility that quinolone antibiotics can contribute to Plantar Fasciitis. If you suspect this, you should definitely see your doctor at once.

• Improper footwear: confining, inflexible shoes and boots that hold the foot at an unnatural angle are likely to lead over time to a tight, shortened Plantar Fascia that is more susceptible to damage. Don’t wear such things habitually—your most frequently-worn footwear should be flexible and have plenty of arch support.

• Age: It’s to be expected that as we get older, our muscles, ligaments and tendons start to lose flexibility and degenerate a bit. Also, most people tend to put on some weight with age. Although there’s no preventive measure for aging, we can help ourselves avoid Plantar Fasciitis by continuing to get good, gentle exercise with plenty of stretching each day. Yoga or something similar is an excellent way to keep the body strong well into advanced ages.

How To Cure Plantar Fasciitis

As mentioned earlier, many people find success in curing their Plantar Fasciitis using simple, inexpensive home remedies. It’s very important to remain flexible in your outlook, willing to move on to the next treatment if you don’t find relief within a week or so. Sticking with something that’s not working just allows the condition to worsen.

In conjunction with the treatments below, of course, it’s imperative to control any risk factors that might impede your progress toward a cure.

Ice and Rest

Plantar Fasciitis begins as a “soft-tissue” injury, and these two treatments can work wonders. The problem is that many people can’t just sit around holding ice on their foot all day. As a compromise, try to refrain from any activity that causes the pain to flare, or that you can feel is extending the bottom of your foot—climb stairs slowly, and crab-wise if possible; no running or jumping; if you must stand, sit frequently and gently massage your feet, ankles, calves.  Since it can take up to three days for this type of injury to reach maximum tenderness, it’s often hard to tell what activity caused it. If in doubt—don’t do it.

A word of warning when using ice: you want to chill the bottom of your foot, not freeze it. If you’re using an actual frozen item (such as a frozen can, or a Ziploc with ice in it), place some kind of barrier between the item and your skin. Apply the cold therapy for just 5-8 minutes at a time. Five times a day is ideal, but if you can only manage it after your daily activities are finished that’s better than nothing. There are also specialty wraps with cold gelpacks inside that are ideal for this purpose—portable, unobtrusive, convenient.

Stretching

It may not be immediately apparent, but stretching the calf muscles can be a very effective cure for Plantar Fasciitis, as well as help prevent a relapse. This is because if there is too much tension on the back of the heel—as when the calf muscles are tight or short—then the sudden force of taking a step translates into excessive, snapping action on the Plantar Fascia.

You should, of course, stretch very slowly and gently, otherwise you’re basically duplicating the injurious action. It’s also necessary to always stretch before walking—missing just once can lead to injury that might take a week to heal, and then you’re back at square one. Lean against a wall, or walk slowly up a slight incline for a good, gentle stretch; or try some of the aerobic stretches you see on the fitness club wall.

Inflammation Relief

Ibuprofen, aspirin and Aleve will give you some relief during periods of sharpest pain and will also reduce some of the inflammation that arises from Plantar Fasciitis. If you can find this kind of medication in cream form, you can apply it directly to the site of pain for fastest, most effective action.

Other ways to reduce inflammation are to elevate the foot, or to compress it by standing on the edge of a thick book.

Tape

Specialty athletic tape can be used as a sort of home-made orthotic by isolating and immobilizing certain areas of the foot. You probably won’t do harm by figuring out a taping regimen yourself, as long as it relieves the pain, but you can also find detailed instructions online, or by asking your doctor.

For a certain percentage of people, the above treatments will not cure their Plantar Fasciitis. But there is still a chance that the next level of therapies will help. Whether or not they are covered by your insurance depends on your policy, but if the condition prevents you from working you’ll probably be able to get some help from your benefits coordinator.

Orthotics

Get a referral from your primary care physician to see a podiatrist for a more thorough exam of your problem. Whether the podiatrist fashions orthotics (shoe inserts) for you, or sends your prescription to a laboratory for manufacture, the quality and effectiveness of the devices will be vastly greater than anything your doctor can supply. It is not unheard of for an over-the-counter or mass-produced orthotic to hurt more than help a Plantar Fasciitis case, so if you’ve moved on to this step, invest in a quality product. Again, if the orthotic causes you more pain or does not relieve your pain, let the podiatrist know as soon as possible for another evaluation.

Night Splints

These products hold your foot in a gently extended position overnight. The hope is that preventing the Plantar Fascia from tightening up during the sleeping hours will lessen foot pain in the morning. At the same time, it may gradually contribute to lengthening the tendon for long-term relief.  There are several styles of splints—consult with your doctor or podiatrist about which one to try first.

Cortisone injections

Although it may provide relief from pain, if you are still exploring less aggressive options to cure Plantar Fasciitis this treatment might be ill-advised. If you totally mask your pain you will not be as able to tell whether other treatments are working.

Cortisone shots are a synthetic version of a steroid your own adrenal gland produces. When people talk about “not noticing” the pain of some kinds of trauma, it’s because the adrenalin their body produced during the time of stress masked or suppressed the normal pain response. An injection of cortisone achieves the same effect, except it is applied directly into tissue to reduce inflammation, and it lasts for periods of days or weeks.

Discuss this option thoroughly with your physician, therapist, and any other professionals you are consulting. Long-term use of steroids can actually start to have a weakening effect on tendons and cartilage—an effect that can exacerbate the Plantar Fasciitis you already have, and lead to more extensive problems.

Acupuncture

There is not much research showing acupuncture to be a cure for Plantar Fasciitis, but some people have found relief using the method—similar to the cortisone injections, but less likely to cause additional problems.

Several points on the foot, ankle and leg may be selected for stimulation, some of it supplemented with tiny electrical pulses. The idea is that the acupuncture needles, inserted in specific areas of the body, release endorphins as anti-inflammatory agents. Most acupuncturists treating Plantar Fasciitis will also include a massage of the calf and foot, and provide instruction on beneficial stretches to use between treatments.

Extracorporeal Shock Wave Therapy (ESWT)

Moving on to one of the more expensive options for treatment, ESWT should not be considered until the therapies above have been exhausted. The FDA requires that the condition be chronically painful for at least six months with less aggressive treatment before ESWT can be attempted.

The therapy sends shock waves into the foot using a device similar to an ultrasound. Perhaps it stimulates new blood flow to the injured area, promoting healing; perhaps it “reminds” the brain that there’s something wrong there and healing activities should begin again. Either way, for patients who have found no solutions thus far, and are not willing to take the extreme and most dangerous step to surgery, this might be an attractive option.

Surgery

There are countless surgeries that an orthopedic specialist might perform in an effort to relieve the pain of chronic sufferers. Very careful consideration of the risks should be taken before resorting to this step. Many patients have found that surgery cured their Plantar Fasciitis—but many have also  found no relief or, in some cases, worse pain and more problems following surgery.

But it’s helpful to know about the differences between Plantar Fasciitis versus Heel Spur Syndrome, if only for the reason that the two are closely related. Even many professionals use the terms interchangeably. It’s easy to become confused when terminology is not exact and there is little agreement about what constitutes which condition. You are researching your foot pain in an attempt to find relief—the last thing you need is a lot of mixed-up information that’s frustrating and confusing.

What is a Heel Spur?

A heel spur is simply a calcium deposit—not a hard, bony structure, but more like cartilage. On X-rays it will look “spikey” and painful, but in reality the shape is more like a shelf seen from the side. One reason medical professionals might attribute heel pain to a spur is because patients can see the spur in an X-ray, and it looks like something that would be stabbing the soft tissue of their heel. It’s easy to picture the pain, in other words.

But if a heel spur exists, it almost certainly is not the cause of your heel pain. Rather, it’s a symptom of the true cause, which is Plantar Fasciitis.

So What Is Plantar Fasciitis?

If you flex your foot and press with your fingers under the ball of your big toe, you will feel a large, firm ligament that stretches toward your heel. This is the inside edge of the Plantar Fascia. It is a broad band of fibrous tissue attached to the heel, which then fans out at the base of the toes. The whole assembly supports the arch of your foot.

When this tissue is strained (similar to a strained muscle), it can become inflamed and sore. Tiny tears in the ligament can also occur, particularly at the heel bone attachment point. This makes walking or standing painful, as the full weight of the body puts a load on the swollen, tender, ligament.This medical condition is called Plantar Fasciitis (PLAN-tar Fash-ee-EYE-tis). The name breaks down like this:

• Plantar means bottom of the foot
• Fascia is the type of connective tissue it is made of
• -itis is a suffix meaning inflammation

This inflammation of the Plantar Fascia can cause pain at the heel attachment point, or anywhere along the ligament up to the base of your big toe. The pain can be pinpoint sharp, or it can involve a major portion of the tissue. It can also move around throughout the day.

Where’s The Confusion?

When the Plantar Fascia pulls or yanks repeatedly on its attachment at the heel bone, the body responds by trying to grow more bone. Voilá! There’s your heel spur! Heel spurs exist in about 70% of Plantar Fasciitis cases.  Some doctors look at the heel spur—when it exists in conjunction with the pain of Plantar Fasciitis—as an indication of how long the condition has been causing a problem. In other words, if you have Plantar Fasciitis and do not treat it, eventually you will develop a heel spur.

But many people have heel spurs with no accompanying pain. There’s no real explanation for why this is so. It could just be that the normal stimulation of the Plantar Fascia (not overextension, just extension) triggers the formation of extra bone in these people. Some professionals believe that heel spurs inevitably develop as we age—they are most common in people age 50 or more.

Whatever the reason, it’s clear that when you have foot pain along the Plantar Fascia—including at the site of a heel spur—it is due to irritation and inflammation of the Plantar Fascia itself.  When a heel spur exists and the pain presents at the front of the heel, doctors are likely to attribute it to the heel spur. When a heel spur exists, but the pain is forward of the heel anywhere along the Plantar Fascia, it’s more likely to be called Plantar Fasciitis.

What’s The Treatment?

Whether or not pain along the inside bottom of your foot is diagnosed as Heels Spurs or Plantar Fasciitis, treatment is the same. Patients are advised to be active in both the research and selection of their treatments, because no one remedy works all the time for everybody.

A conservative-progressive approach is recommended. In most cases, pain can be reduced and healing facilitated without invasive procedures or complicated regimens. A typical  therapy would be:

• Applying ice
• Resting the affected foot
• Stretching feet and calves before getting out of bed in the morning
• Modifying activities that might have led to the injury

One of the main causes of Plantar Fasciitis is a sudden increase in weight. If this applies to you, be sure to start losing weight once you’re mobile enough to exercise.

Further “self-treatment” can include takng ibuprofin and using pharmacy shoe inserts to provide more arch or heel support.

If the above remedies do not help, do not delay seeking medical help. The longer pain persists, the more chance that damage increases, necessitating more stringent measures. If treating the symptoms by yourself, at home, do not work, see your doctor and ask about night splints–to keep the ligament extended while you sleep—and physical therapy options.

If pain persists after these options are exhausted, or if your physican sees a need for more aggressive treatment, you may need to resort to:

• corticosteroid injections: deliver pain relief medicine directly into the injured Plantar Fascia. However, this treatment may weaken the ligament and lead to further damage.
• extracorporeal shock wave therapy (ESWT): sound waves are transmitted through damaged tissue in an attempt to stimulate them toward healing. This is a relatively new therapy.
• Surgery: direct manipulation of the ligament in an attempt to relieve the painful pressure. This would be the most extreme and expensive option, not only because of the surgery but because of the recovery period.

Are there other shoes for plantar fasciitis? Quite a few actually. One company that makes a good set of shoes, sandals, and slippers designed specifically for people with plantar fasciitis is Orthaheel. This means the shoes have solid arch support while providing a lot of comfort. They are not half bad looking either!

How to Determine If Your Shoes are Suitable Plantar Fasciitis Shoes

You’ll find a lot of people tell you what to look for in a pair of shoes if you have plantar fasciitis and it can get pretty darn confusing putting all that information together. Here’s my real of thumb when looking for a shoe to treat heel conditions like plantar fasciitis:

Pick the shoe up with both hands and bend it. If the shoes bends in any place other where the ball of your foot would be located in the shoe, it’s NOT a good shoe to wear with plantar fasciitis. Obviously, there is some leeway to this “rule of thumb” guide for plantar fasciitis shoes. But I’ve found in my own case, it’s worked pretty well.

This rule applies to general shoes NOT designed specifically for people with plantar fasciitis. The key to finding the perfect shoe for you is to try different brands. What works best for Joe’s plantar fasciitis condition may NOT work best for Sam’s condition. So be prepared to try a few shoe brands before you find a pair of shoes that you find comfortable to wear with your plantar fasciitis condition.

We’ve found a few shoe brands are particularly good for plantar fasciitis: New Balance, Orthaheel, and Birkenstock. Personally, I find New Balance have the best running shoes for plantar fasciitis, while Birkenstock offer some of the best heel support but are just flat out ugly. A nice compromise between the two shoe brands are Orthaheel shoes. Orthaheel make particularly good women’s sandals and slippers. So let’s look at some of the Orthaheel shoe models.

Orthaheel Shoe Reviews/Recommendations for Plantar Fasciitis

Orthaheel Men’s Action Walker Shoes

Features

Why We  Recommend Them

These shoes offer the same features as the women’s version, but are shaped from men’s feet. These are a good option if you are looking for some straight up waking shoes for plantar fasciitis. I’ve had a pair of these for a while and they are a good alternative to the New Balance walking shoes. Keep in mind these are best for men looking for casual walking shoes (work, shopping, weight lifting, casual activities that don’t require heavy running). But don’t buy these thinking you can run marathon’s in them – they are a bit too heavy for that.

On the plus side, the Orthaheel Men’s Action Walkers have really sturdy heels; if you have a severe case of plantar fasciitis and you need some shoes with maximum support, these shoes will deliver what you need. The price too is pretty reasonable (you can get them for about $100 on amazon) as shoes go.

So here’s the breakdown: if you want running shoes for plantar fasciitis, we’ve yet to find better than New Balance running shoes. But if you want walking shoes or casual shoes, the Orthaheel Men’s Action walkers are a great pair of shoes that offer more heel support build in than the New Balance shoes.

Orthaheel Wave Slippers

Features
•    I Orthotic footbed realigns your foot and ankle to a natural position.
•    EVA midsole absorbs shock, reducing stress on your feet.
•    Flexible rubber outsole provides extra grip, keeping you steady as you walk.
•    Mesh webbing upper, neoprene upper lining, EVA insole, rubber outsole.

Why We  Recommend Them

Normally, wearing any sort of sandals or flip flops  is a bad bad idea when you have plantar fasciitis. The reason is because sandals and flip flops don’t have sturdy support and can easily bend pretty much anywhere. This means that extra stress is placed on your plantar fascia which can cause more micro tears in your ligament, making your condition worse.

The solution is to wear sandals/flip flops/sippers that are designed for people with such foot conditions. The Orthaheel brand some of the best sandals for plantar fasciitis that we’ve come across.

This Orthotic Flip Flops will help to control overpronation of the foot and reduce the pain. There are a tone of great reviews about these specific flip flops and a lot of people with plantar fasciitis recommend them.

As a bonus, they are reasonably priced when compared to other brands such as Mephistos or Birkenstocks.
The one con I’ll point out is that these sandals ARE a bit heavier than your usual sandal, but since they are designed for people with plantar fasciitis problems, they are built a bit heavier. If you want a lighter sandal, go with the Orthaheel Tide model. The Orthaheel Wave are better if you need more support.

Not only does this slipper relieve plantar fasciitis pain, it feels soft with a stretch cable knit upper. The removable EVA orthotic footbed helps realign your feet and ankles. Indoor / outdoor thermoplastic rubber outsole.

Womens Orthaheel Tide

Features

• Convenient- pain-free “natural healing” solution to many of the common aches and pains associated with poor lower limb alignment
• Orthaheel technology is clinically proven to reduce excess pronation- a contributing factor to “flat feet.” & plantar fasciitisPodiatrist-designed- biomechanical Tri-planar Motion Control footbed with a deep heel cup helps stabilize- support and realign the feet back to their natural position.

Why We  Recommend Them

By far, the most popular Orthaheel sandal would be the Women’s Orthaheel Tide. Why? It looks great with a classic flip flop style and it features Orthaheel’s patiented biomechanical support system. Normally, plantar fasciitis sandals are quite heavy (and clunky looking!). Any girl I know wouldn’t want to be caught dead wearing the usual plantar fasciitis sandal. But the Orthaheel Tide actually looks pretty good. It’s also quite light as these type of sandals go. So for style and comfort in a plantar fasciitis sandal, you can’t get better then the Orthaheel Tide. As a note I’ve recommended this specific model to a couple fashion conscious female friends and the feedback has been VERY positive. So I can recommend these sandals to women without hesitation. The sandals also come in a bunch of different colors which is a bonus.

Orthaheel Walker Women’s Plantar Fasciitis Shoe

Features

• Very comfortable
  Has a motion controlling contoured arch support with very deep seated heel cups that help to control the motion of your feet as you walk.
• Breathable moisture absorbing mesh liner with friction reducing PA foam base.

Why We  Recommend Them

The Orthaheel Walker Women’s plantar fasciitis shoe is pretty darn comfortable. Now as I’m a guy, I’m not an expert when it comes to wearing women’s shoes, but I have tried the Orthaheel Men’s Action Walkers and they are comfortable as anything I’ve tried.

These shoes are specifically designed for active women, so if you find yourself out and about a lot, then give these shoes a shot (I’ve heard they are great for going to the gym). If you plan to do a lot of running,  however,I would recommend New Balance shoes over these. I’ve yet to find a better running shoe for plantar fasciitis than New Balance shoes. But for walking shoes, Orthaheel are a good alternative (and in some cases cheaper).

Orthaheel – Gelly Brown Plantar Fasciitis Slipper

Features

• Convenient- pain-free “natural healing” solution to many of the common aches and pains associated with poor lower limb alignment.
• Active removable orthotic footbed with Tri-planar Motion Control supports the foot and helps realign lower legs- improving posture and balance.

Why We  Recommend Them

It’s a big no no to wear bare feet around the house if you have plantar fasciitis – this can make the condition worse. It can be cumbersome wearing a clunky pair of plantar fasciitis shoes in the house too. And while you can wear a night splint around the house, it’s not a practical solution. What I suggest is to get a pair of slippers for plantar fasciitis, specifically Orthaheel’s Gelly Plantar Fasciitis Slipper. These are specifically designed for plantar fasciitis and you’ll notice it. Trust me, these are not just a pair of cheap slippers marketed for plantar fasciitis – there is a lot under the “hood” of these heels as it is. There’s a solid rubber sole that provides more support than regular slippers. These offer you the benefits of solid heel and arch support in a lightweight and breathable slipper.

If you want an alternative to plantar fasciitis shoes, consider a good pair of orthotics. We have a nice long post about the best orthotics for plantar fasciitis should you need some help finding some!

Heel Pads and Cushions for Plantar Fasciitis

Heel Pads are one of the more common treatment solutions. These are basically inserts that you put in your shoe that help to absorb the shock of impact on your heel when you walk. You have a couple options: Heel Pads made from silicone, leather, polyethylene foams, thermoplastics, and polyvinlye chloride. Silcone Heel Pads are pretty common off-the shelf products you can find in most drugstores.

There are a couple “main types”: Fat Pad Soft Heel Cups and Hard Plastic Heel Cups.

When to Use Fat Pad Soft Heel Cups

Not all plantar fasciitis conditions are the same (i.e. you could be suffering pain in different areas of the heel because the tear ligaments are in different locations). If you have plantar calcaneal bursitis or plantar heel spur syndrome, then use of Fat Pad Soft Heel cups is recommended.

If you are looking for specific product recommendations for soft heel cups, here’s our take:

Tuli’s Heavy Duty Heel Cups

These are very well reviewed online and MANY people who suffer from plantar fasciitis swear by Tuli cups. You can get Tuli cups for specific weights which is great since the cups are then not a one-size-fits-all. If you have bone spur discomfort, Achilles tendonitis, or plantar fasciitis, Tuli is a good bet. What’s great is that these are only about 9 dollars each – pretty cheap.


HTP Heel Seats

These are the best Heel cup inserts we’ve yet found online. They also have the best ratings and most reviews on Amazon.com They are more expensive than some of the other alternatives, but they are formatted specifically for plantar fasciitis and are comfortable and very effective. I myself have used a pair of these for a few months and would hands down recommend these as probably the most cost effective treatment for plantar fasciitis on the market (plantar shoes are ‘better’ in some ways, but they can be expensive).


Anti-Shox Silicone Heel Cradles

These are recommended by a variety of health professionals. I’ve never used them, but I’ve had other people say they are pretty good for treating plantar fasciitis. The key feature these have over some of the other brands is that they offer particularly good shock absorption. If you want to do heavy activities like running or jumping when your plantar fascia is inflamed, the Anti-Shox Silicone Heel cradles are a good bet.

When to Use Hard Plastic Heel Cups

In some cases, you may suffer from Fat Pad atrophy. This is basically a condition where the ball of the foot that helps to cushion the bones in your feet gets reduced or degraded in some way. This contributes to intense pain when walking. To use Hard Plastic Heel cups, you should position them under the Calcaneus (see picture).

Orthotics for Plantar Fasciitis

You can find a huge variety of orthotics (also called Orthosis) that will act as shock absorption and foot support. These include heel cushions, custom foot orthotics, dynamic foot insoles.

Shoe Inserts for Plantar Fasciitis (Pre-Made Orthotics)

These are basically special shoe inserts that can provide foot support. Many are constructed from special neoprene.

There are a few tips to keep in mind before choose a good pair of shoe inserts

• Expensive Doesn’t Always Equal the Best Shoe Inserts — There are a lot of shoe insert companies out there and many of them charge overinflated prices for cheap shoe inserts. Don’t base your choice of shoe inserts just on price alone. You may find that a 20 dollar shoe insert does just as good a job as say a 70 dollar shoe insert

• Buy A Reputable Brand – I’ve noticed a lot of no-name companies offering shoe inserts for sale online. However, many of these companies don’t have any sort of reputation. Chances are, their products are made from cheap material and won’t live up to the advertisements. I recommend you look at shoe inserts that have good reviews AND are manufactured by a reputable business.
• Comfort is Important – One thing that must be said: there is no point in wearing shoe inserts if they are not comfortable. Don’t just buy a pair of inserts and wear them if they are uncomfortable. Make sure they fit correctly (some inserts target specific weights — if you are a 200lbs man, you would get a different insert than a 100lbs woman, say)

Recommended Shoe Inserts

These are our recommended shoe inserts for plantar fasciitis. The recommendations come my own research into what inserts people are finding the most effective for plantar fasciitis and the positive feedback left on this site. There are a lot of bogus products on the market and we have tried to recommend inserts that come from reputable companies with a solid history behind them.

Powerstep Pinnacle Orthotic Insert

Feature list from the manufacturer:

• Heel cradle and platform guards heel on impact
• Strong springy supports calibrated for comfort
• EVA casing for long life from heel to toe
• Heat and slip reducing fabric for dryness

These inserts have a stellar reputation and over 71 customer reviews on Amazon with a 4.5/5 rating. Powerstep Pinnacle Orthotics are probably the most popular, well received shoe inserts on the market. Quite a few individuals who suffer from plantar fasciitis say these shoe inserts do the best job. These inserts are not only effective at reducing plantar fascia pain, but are also comfortable too (something that you don’t always get). At $22+ dollars a pair, they can be more expensive than some of the other options you find, but we recommend these as the best shoe inserts for plantar fasciitis in terms of price, effectiveness and quality.

Spenco

Spenco shoe insoles offer great shock absorption and a good deal of comfortability. The Spenco brand has a great reputation online and plenty of positive reviews on Amazon (over 60 reviews with a 4.5/5 rating across the board). They are also CHEAP at around $11 dollars.

Spenco insoles are geared for athletes or people who do sports often. Because they are formulated for heavy foot activity, they are probably the best buy if you have plantar fasciitis and want to do something foot intensive such as running. If budget is of concern, then go with the Spenco insoles.

Superfeet Premium Insoles

Feature list from the manufacturer:

• Recommended footwear: Ski and snowboard boots, running and trail running shoes, hiking boots, work boots and walking shoes- all with removable insoles.
• Provides maximum support, stability and shock absorption, and is ideal for feet with medium to high arches.
• Extra deep cup cradles your heel’s fat pad for natural shock absorption, while the bio-mechanically correct arch shape provides comfortable support.
• Friction control top cover with AgION® antimicrobial treatment helps reduce odor-causing bacteria.
• Durable lightweight ¾ external polypropylene stabilizer cap provides optimum rear foot control and flexibility.
• Supports and aligns the bones of the foot, helping prevent heel pain, Plantar Fasciitis and other common foot problems.
• Each pair includes a User’s Guide with information on sizing and trimming your new insoles, and the package is recyclable.

Superfeet Premium insoles are more expensive than some of the other popular insole brands, but they offer the most features bar none. I’ve used a pair and love them. They offer maximum support, great stability, and a good deal of shock absorption. One feature I really like is that they have an antimicrobial material that reduced foot smells. Some of the other shoe insoles I’ve tried really leave your feet smelling bad after a long day of walking around. If you can afford these and you suffer from plantar fasciits, then buy them. They are the “best” in everything but price. Note that these are best for people with HIGH arched feet and not low arches!

Lynco

Lynco orthotics have a good reputation online. They claim over 1 million people use their products. They are a good option for people with plantar fasciitis. However, they are twice the price of the Powerstep Pinnacle inserts and offer about the same functionality/features. Many health professionals do recommend these if you have plantar fasciitis.

Custom Orthotics

If you have a  serious foot injury or some special foot condition that make pre-made orthotics unusable, then custom-made foot orthosis is an option.

Custom Orthotics are (usually) made from:

• Leather – usually more comfortable and can absorb up to 30% of the weight before it feels wet
• Plastic – usually cheaper than leather

For plantar fasciitis, most people find that deep heel seat leather orthotics work well. Custom orthotics tend to be much more expensive than the shoe insert/shoe option. You should consult a foot specialist for your condition BEFORE you spend the money getting Custom foot orthotics made.

Plantar Fasciitis Night Splints (also known as Posterior Night Splints)

These are large splints (either plastic or some fabric) that fit over the leg and foot. They help to keep the plantar fascia stretched out. Wearing these can help prevent the stretching and contraction of the plantar fascia ligament, which allow the affected area to heal. Wearing a night splint to bed can help prevent the spikes of pain you first get upon waking up and first putting pressure on your foot when you get out of bed. It’s definitely worth having one if you suffer from foot pain around the heel area.

Plantar Fasciitis Night Splint Recommendations:

As for specific recommendations, we have a couple.

Swede-O Deluxe Padded Plantar Fasciitis Night Splint

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