What is the plantar fascia?
The plantar fascia is a band of tissue that runs along the sole of the foot from the calcaneus (heel bone) to the toes. It acts as a shock absorber, in part responsible for supporting the arch of the foot.
What is plantar fasciitis?
With excessive load and repetitive microtrauma, the plantar fascia becomes less elastic, developing small tears or splits. The body is unable to fully heal these and with ongoing activity plantar fasciitis and pain can develop. Plantar fasciitis is a common condition occurring in up to 10% of the population. It may occur both sides in 30% of patients.
Is my heel spur responsible?
Heel spurs are not the usual cause of plantar fasciitis. They are seen in 60% of patients who have no symptoms of plantar fasciitis.
Will I get better?
80-85% of patients will have resolution over 12 months with a combination of non-operative treatments
What is non-operative treatment?
The first line treatments you are recommended to try:
- Massage- for 5-10 minutes with a golf ball or ice. A frozen water bottle can be used to massage beneath the foot.
- Physiotherapy- for an individualised stretching and strengthening program.
- Taping – techniques can be used in the short term that may mimic the way an orthotic can help.
- Orthotics- wearing a soft arch support with a cushioned heel cup has been shown to be beneficial.
- Activity modification – will help minimise discomfort
- Anti-inflammatories- these can be useful in short courses when symptoms are acute.
Second line treatments include:
- A night splint (Strassburg sock)- This stretches the plantar fascia, minimizing the shortening that occurs overnight. This helps reduce pain with the first steps in the morning.
- Steroid injections- used as an addition. Often no long term benefit and associated with small risks.
- Blood or PRP injection
- Shock wave therapy
When is surgery considered?
Surgery is an option for those patients who have failed a compliant and appropriate course of non-operative treatment for 9-12 months and whose symptoms have persisted.