Plantar Fasciitis: Treatment Options

Plantar Fasciitis: Treatment Options

If you think you have plantar fasciitis, it is important to address it sooner rather than later. If nonsurgical treatments are initiated soon after the onset of symptoms, many patients can make a quick recovery within a few weeks. Even if the symptoms have been present for quite some time, nonsurgical treatments are still the first line. It just may take a bit longer for the heel pain to subside.

In fact, only 5% of patients who experience plantar fasciitis go on to have surgery. Let us review what these treatment options may look like. Protocols for nonsurgical management of plantar fasciitis will vary based on the healthcare provider's preferences, but may include the use of rest, iontophoresis, where a very low level of electrical current is used to deliver medications through the skin, night splints, heel inserts, ice, anti-inflammatory medications, and stretching routines.

Corticosteroid injections may be used but sparingly as there is a concern for potential rupture of the plantar fascia with injections. If symptoms persist after nonsurgical measures are exhausted, surgery may be considered.

Surgery for the treatment of plantar fasciitis is called a plantar fascia release. This involves cutting part of the fascia that attaches to the heel bone, the calcaneus, to relieve tension in the tissue. This procedure can be done through an open approach with an incision on the bottom of the foot or through a minimally invasive approach.

The minimally invasive approach is completed endoscopically, meaning a small camera and instruments are used through 2 smaller incisions more on the side of the foot called portals. The open approach allows for complete visualization of the plantar fascia that can often result in a tender scar on the bottom of the foot. Endoscopic surgery may be more technically demanding for the surgeon, but allows them to have complete visualization of the ligament without scars on the sole of the foot.

No matter how the release is performed, recovery is similar. Patients may start bearing weight on the affected foot as they feel comfortable. As the incision or incisions heal, physical therapy can begin, which will help patients gradually return to their daily activities.