Houston Methodist. Leading Medicine

Foot FAQ

Question:

Okay so add me to the list of women who suffer from plantar fasciitis now. I thought I had escaped but not so. What's out there for treatment that works? I don't want to end up like my friends hobbling around for years with foot pain.

Answer:

Many people suffer from foot pain attributed to plantar fasciitis. The plantar fascia is a thick band of connective tissue along the bottom of the foot. It goes from the calcaneus (heel bone) to the metatarsal bones (toes). It supports the arch of the foot and helps carry the load of body weight during standing and walking activities. The term fasciitis suggests an inflammatory response. Early on, that might be the case but if symptoms persist for months and even years, then there has been a failed healing response. Biopsy studies of tissue samples from people with chronic plantar fasciitis show no signs of inflammatory cells. The term fasciopathy might be a better descriptor -- it just means something's wrong with the fascia but we don't know what. Usually treatment of musculoskeletal conditions depends on the cause of the problem. But with plantar fasciopathy, the cause remains unknown. Or rather, we should say, the cause is poorly understood. For some people (like runners), overuse, training errors, and poor footwear may be contributing factors. Older adults who are overweight or who have problems with foot alignment may be at increased risk for plantar fasciopathy. So, where does that leave you? Well, if indeed, the symptoms are new and there is active inflammation, then treatment can focus on the standard treatment of antiinflammatory medications, support (perhaps a heel pad in the shoe), and stretching. Many people find this combination curative. A physical therapist can show you how to apply some manual (hands-on) stretching designed for the plantar fascia. The therapist can apply some additional manual techniques to release tension in the tissues. The therapist can also assess you for posture and shoewear changes that might help. Getting started early is a good idea. If these conservative measures don't help, then you might be a candidate for other treatment ideas such as shock-wave therapy to the foot, a special splint to wear at night, or special inserts for inside your shoes. Jan D. Rompe, MD, et al. Plantar Fascia-Specific Stretching Versus Radial Shock-Wave Therapy as Initial Treatment of Plantar Fasciopathy. In The Journal of Bone & Joint Surgery. November 3, 2010. Vol. 92. No. 15. Pp. 2514-2522.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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