Plantar fasciitis, or heel pain, can be debilitating. It starts as pain with the first few steps in the morning or after periods of sitting. It can take away the joy of walking and running if left ignored. Early diagnosis and treatment has the best outcome. Here is the regimen I provide to all my patients in caring for their heel pain. For the best results, a multi-modal approach is necessary to help your heel pain.
- Home stretching exercises focused on stretching the Achilles tendon and plantar fascia is an important part of treatment. Exercises should be performed daily, spending 10 minutes to warm up the fascia and tendon before going about your day.
- Orthotics can provide long term benefits by decreasing the load on the plantar fascia, and thus relieving inflammation and pain.
- Shockwave therapy is a mainstay in conservative treatment that is well accepted in Europe but has not yet fully caught on in America and therefore not paid by insurances. It is a noninvasive treatment aimed to help you heal by restarting the inflammation cycle. Many athletes already use this modality for various muscle aches. Shockwave therapy has demonstrated up to 80% effectiveness in treating heel pain.
- Proper shoes – high heels, flat canvases and thongs are shoes that work against your heel pain. Select shoes that do not fold in half and has cushion within the insole for shock absorption. A silicone heel cup can help those with decreased fat pad, such as our elderly population.
- Pain medication as needed, both topically and orally. NSAIDS like ibuprofen will help the inflammation. A high grade CBD topical will also be helpful. Caution with products that claim to have CBD in it since this ingredient is not regulated by the FDA. Use a product that is tested by a third party for purity and quality. It should state so on the label.
With early diagnosis and treatment, the majority of plantar fasciitis can be resolved with the above regimen. For more advanced heel pain, steroid injections, further imaging and minimally invasive surgery can be discussed with your foot and ankle specialist.