AUTHOR: Marc Mitnick DPM
REVIEWED BY: Podiatric Medical Review Board
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HOME TREATMENTS FOR PLANTAR FASCIITIS
There are many treatments that people can try at home in an effort to reduce the pain of plantar fasciitis. The important point here is whether or not you actually have this condition.
It is important to point out that not all heel pain is from plantar fasciitis. As explained elsewhere in this section, there are other conditions that may cause heel pain. If you have not been diagnosed by a doctor, but feel you may have this type of heel pain and you are not in severe pain, then you can certainly try a few of the following suggestions with this cautionary note.
If your pain does not improve and in fact seems to be worsening, then you should seek medical care as there is a good chance you may have another problem.
night splints for plantar fasciitis
If your pain seems to be most evident when you first get out of bed in the morning, which by the way, seems to be the most common complaint I hear from patients, then using a night splint may prove to be very helpful, at least in controlling the morning pain.
Most patients will tell me that when they first get out of bed, those first steps are extremely painful, but as they continue to walk, the pain does ease up somewhat.
The reason for this is due to the plantar fascial ligament tightening up during the night, so when you take those first initial steps, the stretching of the ligament is very painful.
A night splint works by keeping the plantar fascial ligament "stretched" during the night, making those first initial steps in the morning less painful.
The key here is the type of night splint you purchase as there are different types. My recommendation is what is known as a low profile night splint. The less bulky the night splint, the less problem with trying to sleep with this device on your foot. Patients have told me, over the years, that they have trouble sleeping with the bulkier splints as they are just too annoying.
plantar fasciitis shoes
In this instance it is not so much what shoes you wear, but rather what shoes to avoid. Since plantar fasciitis in many instances is caused by over-stretching the ligament, wearing flimsy shoes or even walking around bare foot for prolonged periods will aggravate the problem. Poorly supportive shoes like flip-flops, ballerina shoes, flat sandals and any other shoes with poor support will slow down the healing process and actually, in many cases, be the cause of your heel pain.
On the flip side, wearing shoes with a good arch support will reduce the pain and reduce the over-stretching. There are many different shoes on the market that advertise they help plantar fasciitis, but in reality, I feel the best shoes are nothing more then a good laced walking shoe with a good arch support.
If you are going to try "shoe therapy", then the key here is that you must wear your shoes essentially from the time you wake up in the morning, until you go to bed. Coming home from work at six o'clock, kicking off your shoes and walking around barefoot for the next five hours is counter productive in relieving your heel pain.
Most of the shoes on the market that are advertised as a walking shoe, exhibit a good rigid shank meaning the shoe is built stiff so your foot cannot flatten out from the shoe. In addition, there is usually an arch support of some type. The only problem here is that if you happen to have a relatively high arch, or a very rigid flat foot, the built in arch support may not help. Overweight individuals may also experience problems with the built in arch support.
medical grade orthotics
If you happen to be overweight or have a job where you are on your feet all day, particularly on cement surfaces, then a store bought arch support is probably not going to do it for you. The problem with most store bought devices is that they attempt to "cushion" the problem away rather then support the plantar fascial ligament and keep it from continually over-stretching.The solution is to try a medical grade orthotic. These orthotics actually support the plantar fascial ligament and do not allow for over-stretching. A medical grade orthotic can be quite effective at permanently controlling the strain on the plantar fascial ligament and thus reduce or eliminate heel pain.
plantar fasciitis exercise
A lot of physical therapists, in treating heel pain will perform deep tissue massage. By massaging the painful heel, two things are accomplished. 1. The plantar fascial ligament loosens up, thus reducing pain and 2. The stimulation increases blood flow to the area which helps the healing process.
Stretching exercises may also help especially in an effort to relieve the pain experienced when you take your first steps in the morning. By stretching the foot, prior to getting out of bed, the foot tends to be less painful.
oral and topical medication for plantar fasciitis
Taking a controlled round of oral anti-inflammatory medication for perhaps upwards to ten days can be very helpful in reducing pain. There are a few caveats here.
- Take the medication (Aleve, Advil, Motrin, etc.) according to the manufacturer's recommendations, taking the medication on a regular basis helps to maintain continuous blood levels of the medication, which allows it to work better.
- Do not take the medication in a haphazard manner, taking it one day, not the next, etc. as this decreases the effectiveness of the medication
- Do not take this type of medication for prolonged periods as there are side effects. Yes, even over the counter medication has side effects.
- Do not take this medication if you suffer from hypertension, have a history of liver or kidney disease, or suffer from blood abnormailities. Do not take this medication if you are on blood thinners. Check with your physician.
- Elderly people should avoid this type of medication altogether.
Topical medications such as those that make the area feel hot or cold are harmless enough to try and if they reduce the pain, that's even better. Just remember, these types of medications are "skin irritants" which give off a feeling of hot or cold and essentially mask the heel pain, making the heel appear to feel better.
There are also prescription topical anti-inflammatory medication which can be rubbed into the painful heel. I have never had much success with them, but there is little harm in trying them.
ice or heat for plantar fasciitis
If your heel is very painful, then icing it can reduce the symptoms, but ice does nothing to heal the area, it just reduces pain. Apply an ice pack for fifteen minutes on, ten minutes off, then repeat
Heat on the other hand, particularly moist heat is used to help heal the area. Heat brings increased blood flow to the area which carries the nutrients needed to help resolve the problem. Heat can be applied continuously, until the heat pack cools down, ten re-heat and repeat.
REFERENCES
American Podiatric Medical Association
continue....posterior heel pain
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Specific Recommendations For This Condition
KLM ORTHOTICS
In my opinion, the best pre-made orthotic available. Offers the best combination of support and cushioning. Will work in the greatest percentage of people who try a pre-made orthotic. (keep in mind, everyone's foot structure is different and so unlike a prescription orthotic, pre-made devices can be hit or miss) Click the link below for a full description.
REDITHOTICS
Many of you are forced to wear dress shoes on a daily basis and it can be difficult to get an orthotic into a dress shoe since there is limited space. Redithotics are a pre-made orthotic designed specifically for this purpose. Click the link below for a full description.
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