
Plantar Fasciitis, Heel Pain Therapies and Treatments
Plantar fasciitis is a common condition characterised by sharp heel pain due to inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot, connecting the heel bone to the toes.
This condition often results from overuse, repetitive strain, or excessive pressure on the feet. Plantar fasciitis is one of the leading causes of heel pain and affects people of all ages, but is especially common in athletes, runners, and those who spend a lot of time on their feet.
In Australia, plantar fasciitis is a prevalent cause of foot-related pain, with an estimated 1 in 10 Australians experiencing the condition at some point in their lives. Although the condition is typically self-limiting, meaning it can improve with time, various treatments can help relieve symptoms and speed up recovery.
What causes plantar fasciitis?
Plantar fasciitis develops when repetitive pressure is applied to the plantar fascia and is overloaded. This results in swelling, tearing or bruising of the plantar fascia. The following can cause plantar fasciitis:
- Tension and stress on plantar fascia.
- Repeated stretching and loading of the fascia.
- High impact activities such as running or dancing.
Source: The Foot Hub
Conventional Treatments for Plantar Fasciitis
Conventional treatments for plantar fasciitis focus on reducing inflammation, relieving pain, and supporting the foot to prevent further injury. These treatments are often the first step in managing the condition and are widely recommended by healthcare professionals.
1. Rest and Activity Modification
One of the most important treatments for plantar fasciitis is to reduce activities that put excessive strain on the plantar fascia. This includes avoiding prolonged standing, running, or walking on hard surfaces. Resting the foot allows the tissue to heal and prevents further injury.
Dr. Sarah Evans, a podiatrist in Sydney, advises,
"Rest is key in the early stages of plantar fasciitis. The goal is to avoid aggravating the condition while promoting healing. Gradual return to activity, combined with other treatments, is essential."
2. Footwear Modifications and Orthotics
Wearing supportive shoes with good arch support and cushioning can help alleviate the stress on the plantar fascia. Specially designed orthotic inserts are commonly used to provide additional support to the arch and reduce pressure on the heel.
Custom orthotics, prescribed by a podiatrist, are often more effective than over-the-counter inserts as they are tailored to the individual’s foot structure and walking pattern. In some cases, night splints are also recommended to stretch the plantar fascia and Achilles tendon during sleep.
3. Physical Therapy
Physiotherapy is a crucial component in treating plantar fasciitis. A physiotherapist can guide patients through exercises that stretch the plantar fascia and strengthen the surrounding muscles. Regular stretching of the Achilles tendon and calf muscles can reduce tension on the plantar fascia and promote healing.
Some common exercises include:
- Calf stretches to lengthen the Achilles tendon.
- Towel stretches to stretch the bottom of the foot.
- Toe curls and marble pickups to strengthen foot muscles.
4. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Over-the-counter NSAIDs, such as ibuprofen or aspirin, are often recommended to manage pain and inflammation associated with plantar fasciitis. While these medications do not treat the underlying cause, they can provide temporary relief from pain and discomfort.
5. Corticosteroid Injections
For more severe cases of plantar fasciitis that do not respond to conservative treatments, corticosteroid injections may be administered to reduce inflammation and pain. These injections provide temporary relief but should be used cautiously, as repeated injections can weaken the plantar fascia and increase the risk of rupture.
6. Extracorporeal Shockwave Therapy (ESWT)
Extracorporeal shockwave therapy is a non-invasive treatment that uses high-energy sound waves to stimulate healing in the plantar fascia. This therapy has been shown to be effective for chronic plantar fasciitis that does not respond to other treatments. ESWT is typically performed by podiatrists or orthopaedic specialists and has a success rate of 60-70% in treating plantar fasciitis.
According to Dr. Luke Henderson, an orthopaedic surgeon in Melbourne,
"Shockwave therapy is particularly effective for patients with chronic, persistent plantar fasciitis. It promotes blood flow and healing in areas where the plantar fascia is damaged."
Alternative and Holistic Treatments for Plantar Fasciitis
Many patients seek alternative or holistic treatments for plantar fasciitis, either to complement conventional treatments or as a standalone option. These therapies aim to promote natural healing, reduce inflammation, and relieve pain without the side effects of medications or invasive procedures.
1. Massage Therapy
Massage therapy can help relieve tension in the plantar fascia and surrounding muscles. A professional massage therapist may focus on the calf muscles, Achilles tendon, and foot arch to release tightness and improve circulation, promoting healing in the inflamed area.
Self-massage using a tennis ball or a frozen water bottle can also be effective in reducing pain. Rolling the foot over a ball or bottle helps stretch the plantar fascia and break up adhesions, providing relief from pain and stiffness.
2. Acupuncture
Acupuncture, a traditional Chinese medicine practice, involves inserting thin needles into specific points on the body to relieve pain and promote healing. Acupuncture has been shown to reduce pain and inflammation in people with plantar fasciitis, though more research is needed to confirm its effectiveness.
Dr. Emily Nguyen, an acupuncturist in Brisbane, says,
"Acupuncture can provide significant relief for plantar fasciitis by targeting pain points and encouraging the body’s natural healing mechanisms. Many of my patients report reduced pain and improved mobility after several sessions."
3. Nutritional Supplements
Certain nutritional supplements are believed to support tissue healing and reduce inflammation in plantar fasciitis. These include:
- Omega-3 fatty acids: Found in fish oil, omega-3s have anti-inflammatory properties and may help reduce pain.
- Vitamin C: Essential for collagen production, which is important for tissue repair in the plantar fascia.
- Curcumin: The active ingredient in turmeric, curcumin has strong anti-inflammatory effects and may reduce inflammation associated with plantar fasciitis.
While evidence on the effectiveness of these supplements is limited, some patients find them helpful when used alongside conventional treatments.
4. Essential Oils
Some people use essential oils with anti-inflammatory and analgesic properties to relieve pain from plantar fasciitis. Oils such as peppermint, lavender, and eucalyptus can be diluted with a carrier oil and massaged into the affected area to reduce pain and swelling. Although the evidence for essential oils in treating plantar fasciitis is mostly anecdotal, many individuals find them soothing.
5. Cold Therapy (Cryotherapy)
Cold therapy is a simple and effective treatment for plantar fasciitis. Applying an ice pack or rolling a frozen water bottle under the foot can help reduce inflammation and numb the pain. Icing is particularly beneficial after physical activity or prolonged standing.
6. Alternative Medicine
Alternative medicine has emerged as a potential treatment option for managing the pain and inflammation associated with plantar fasciitis. While traditional treatments like physical therapy, rest, and orthotics remain the primary approach, some patients have explored natural-based therapies for relief, especially when conventional treatments don’t provide adequate pain management.
You are not alone
In Australia, plantar fasciitis is one of the most common causes of heel pain, especially among active individuals and those with occupations that require long periods of standing or walking. According to Sports Medicine Australia, up to 10% of Australians will experience plantar fasciitis in their lifetime. The condition is most prevalent in adults aged 40-60, though it can affect younger individuals who engage in repetitive high-impact activities.
The economic impact of plantar fasciitis in Australia is significant. Podiatry Australia reports that the condition is a leading cause of missed workdays and reduced productivity, particularly in industries that require prolonged standing or physical labour. With increasing awareness of the condition and more effective treatments, Australians are seeking earlier intervention to avoid long-term disability.
Expert Insights on Managing Plantar Fasciitis
Dr. Peter Manning, a leading podiatrist in Melbourne, stresses the importance of early intervention:
"Plantar fasciitis can become chronic if not treated early. The key is addressing the underlying biomechanical issues, such as poor foot structure or overuse, while managing pain with a combination of rest, physiotherapy, and footwear changes."
Dr. Lisa Connors, a sports medicine physician in Perth,
"Active individuals, particularly runners, need to be mindful of their training patterns. Overtraining or failing to wear the proper footwear can exacerbate plantar fasciitis. Prevention through strength training and stretching is crucial in these populations."
Summary
Plantar fasciitis can be a painful and frustrating condition, but with the right combination of conventional and alternative treatments, most patients can find relief and return to their normal activities. Whether it’s through physiotherapy, custom orthotics, acupuncture, or massage therapy, a tailored approach that addresses both the symptoms and the root causes of plantar fasciitis is essential for long-term recovery.
For Australians suffering from plantar fasciitis, seeking early treatment and making lifestyle changes, such as wearing supportive footwear and incorporating regular stretching, can significantly reduce the risk of chronic pain and long-term disability.
Sources
- Sports Medicine Australia
- Podiatry Australia
- Arthritis Australia
- Dr. Sarah Evans, Podiatrist, Sydney
- Dr. Luke Henderson, Orthopaedic Surgeon, Melbourne
- Dr. Emily Nguyen, Acupuncturist, Brisbane