When you’ve been diagnosed with Plantar Fasciitis, you know that relief can’t come soon enough.
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.
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.
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.
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.
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.
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.
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.
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.
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.