Icing
Ice should be used as an adjunct therapy, as it is known to decrease pain, swelling, and inflammation of tissues. Ice can be applied to the sore area for 15 to 20 minutes, four times daily, to relieve the pain. You may also roll the bottom of your foot on a frozen cylinder for five minutes after periods of activity and before sleeping. Ice cylinders are made by freezing water in plastic bottles or cups. You may also massage the heel of the foot by applying water frozen in Styrofoam cups in circular motions for five to ten minutes.
Non-steroidal Anti-Inflammatory Medications and Corticosteroid Injections
During the acute phase of plantar fasciitis, oral intake of non-steroidal medications in conjunction with stretching exercises may be useful to reduce inflammation. Ibuprofen, ketoprofen, or fluribiprofen are prescribed to relieve mild to moderate pain. These drugs are known to inhibit the synthesis of prostaglandins, which activate the inflammatory and pain responses in the body.
Steroid injections are administered if the pain occurring due to plantar fasciitis fails to respond to customary conservative measures. Corticosteroids are successful in controlling the pain, but it is recommended that a patient must not have more than three steroid injections within a year. Repeated steroid use can cause fat pad atrophy and plantar facial rupture.
Shoe Modification
Footwear plays a critical role in preventing and treating plantar fasciitis. It is best to use shoes with excellent shock-absorbing qualities. The shoes must feel comfortable and should foster good foot postures.
Orthotics
Overpronation, a condition in which the foot arches roll excessively inward, can cause excessive plantar fascia tension – a significant factor in plantar fasciitis development. Orthoses are mainly used to control and reduce this dysfunction by maintaining the foot in its neutral position. In addition to the reduction of plantar fascia tension, over-the-counter and custom-made orthoses increase stability in stance and gait and provide passive plantar fascia stretch.
Night Splints
Use of dorsiflexion (Top of the foot towards the shin.) night splints during sleep maintains the ankle joint in neutral position, keeping the plantar fascia and Achilles tendon constantly stretched throughout the night. This is helpful in decreasing the plantar fascia pain and microtrauma during weight bearing in the morning.
Rick Kaselj, MS
.