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New Treatments for Plantar Fasciitis Offer Hope

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Diagnosing a Child’s Foot Pain
We see patients each week, at our clinics in Sunnyvale, Dallas and DeSoto, for the condition known as plantar fasciitis, an inflammation of the plantar fascia.

The plantar fascia are a tough band of connective tissue that runs along the bottom of the foot. It is responsible for the arch in the foot, and absorbs the shock of running. For this reason, it is a common complaint among runners, although any older person whose shock-absorbing pads on the bottom of the feet are thinning, can also develop the injury.

There are an estimated 15 million visits each year to foot and ankle doctors for this condition, which lasts an average of five months. About one million of these visits concern chronic plantar fasciitis, whereby the condition persists for a year or more.

Because plantar fasciitis interferes with an active lifestyle and because it sometimes fails to respond to the usual treatments, any news about a possible breakthrough is greeted joyfully. Two recent reports— one concerning an exercise that was developed in Scandinavia and the other about treating chronic plantar fasciitis with ultrasound— seem promising. Only time will tell if they will deliver relief across a broad spectrum of cases.

Exercise the Feet to Relieve Plantar Fasciitis

Feet respond well to exercises that are specifically designed to stretch and strengthen the ligaments and tendons. One exercise developed by Danish researchers involves standing barefoot with the sore foot on a stair or a box. The unaffected leg should be hanging free, bent slightly. Place a rolled-up towel beneath the toes and leave the heel hanging over the edge of the stair or box.

Slowly raise and lower the sore heel, counting to three on the way up, holding for a count of two at the top of the rise, and counting to three on the way down. Try to work up to 12 repetitions. Once this goal is reached, you can wear a backpack filled with books to increase the weight. Perform this exercise 8-12 times every other day (giving the heel a day’s rest in between).

In the Danish study, 65 patients with chronic plantar fasciitis were divided into two groups. One group followed the exercise protocol described above. The other group did a simple stretching exercise (pulling their toes towards their shins 10 times, three times daily). After three months, the group in the box/stair exercise group reported the greatest improvement. Patients in the other group eventually recovered, but only after nine months.

While this sounds exciting, some researchers warn that time is needed to show whether the effects are lasting. Still others point out that ultrasound surgery has been tried before but failed to deliver long-term relief. In addition, a study showing benefits for 65 patients is not the same as large-scale clinical trials.

Time-tested Therapies for Plantar Fasciitis

In the meantime, we have tools for plantar fasciitis that offer relief for the great majority of patients. Anti-inflammatory medications (NSAIDs), cortisone injections, ice and/or heat depending on the duration and nature of the inflammation, massage, arch supports and physical therapy are just a handful of options to counter the effects of plantar fasciitis. Radiofrequency treatments, using electrical current, are helpful for some cases. Night splints allow the patient to stretch the plantar fascia during sleep. This alleviates some of the dreaded morning pain when patients take their first steps of the day.

The patient is also asked to avoid walking barefoot, to limit activities that impose a pounding on the soles of the feet, and to wear good shoes with a strong arch support.

If none of these treatments work, we may consider surgery. Call one of our clinics (DeSoto, Dallas, or Sunnyvale) if you are plagued with plantar fasciitis. Let’s discuss how we might be able to help you resume walking without pain.

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