In one study, patients who underwent endoscopic plantar fasciitis surgery reported less pain and returned to daily activities five weeks sooner than those who did not undergo the procedure (7). In general, conservative treatment is recommended before considering surgical intervention.
Maintaining a healthy weight, wearing shoes that fit well and providing proper arch support, and utilizing over-the-counter orthotics can help prevent or reduce plantar fasciitis pain. If these treatments fail to improve your symptoms, consult a physician.
Nonsurgical Treatment
Your doctor may recommend nonsurgical treatments to help reduce pain and swelling. These include resting, icing, stretching, and taking nonsteroidal anti-inflammatory drugs (NSAIDs). You might also try using special shoe inserts, called orthotics, that are shaped to fit your feet. These may reposition your big toe or provide extra padding and support. Splints can also be helpful.
Your healthcare provider may use a tool called an ultrasound to check for a knot or tightness in your plantar fascia. He or she might then massage the area and apply a moist compressive pad to your foot to ease your symptoms.
Our specialists at NYU Langone offer a wide range of nonsurgical treatment options to treat your plantar fasciitis. If your pain and swelling don’t improve with these methods, we may recommend surgery. Our surgeons are experts in minimally invasive procedures for the foot and ankle. They will use a local anesthesia to numb your heel and a mild sedative to keep you calm during the procedure.
Physical Therapy
A podiatrist or orthopedic specialist can perform a series of conservative treatments to ease the pain and inflammation. These include icing, stretching exercises and support devices like night splints, orthotics and walking boots. They can also recommend anti-inflammatory medications, a plantar fasciitis massage technique called heel immersion and extracorporeal shock wave therapy (ESWT).
A physical therapist can provide instruction on eccentric, calf-descent exercises to loosen the tightened plantar fascia ligaments. They can teach you to roll your foot on a frozen water bottle, to use an ergonomically designed rolling pad or to do calf-stretches while standing or sitting.
Your physician may also recommend a treatment involving platelet-rich plasma (PRP). This involves drawing a small sample of your blood, processing it in a centrifuge to separate the healing platelets and injecting them directly into the affected area of the plantar fascia. This has shown optimal results when used in combination with physical therapy. If the nonsurgical methods do not relieve your symptoms, you might require surgery.
Over-the-Counter Medication
Taking over-the-counter pain relievers can help with plantar fasciitis. These include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).
Your doctor may suggest a walking boot or cane to keep you from moving too much or placing too much stress on your heel. Over-the-counter or custom arch supports called orthotics can help distribute pressure more evenly on your foot and reduce heel pain. Studies show that calf-specific stretching exercises three times a day can reduce heel pain. Wearing night splints that stretch the calf and Achilles tendon while you sleep can also decrease pain.
Many people with plantar fasciitis get better after a few months of treatment. But if your symptoms have not improved, or you are experiencing severe pain and discomfort, surgery may be an option for you. This procedure involves releasing the plantar fascia from where it attaches to your heel bone. It can be performed in an outpatient setting. Surgery to tighten or lengthen the gastrocnemius muscle is also an option for some patients with plantar fasciitis.
Shock Wave Therapy
During this noninvasive treatment, your NYU Langone provider will apply concentrated acoustic sound waves to your foot or heel that stimulate tissue regeneration and break down scar tissue. Your provider may recommend this procedure in addition to physical therapy or other treatments.
Your doctor uses a handheld probe to move across the base of your heel and arch or Achilles tendon at the back of your heel. This ultrasound treatment may also help reduce pain and inflammation.부산무지외반증
A study by Rompe and colleagues showed that shock wave therapy in combination with stretching improved the effects of radial pressure pulses on plantar fasciitis compared to radial pressure pulses alone. This is because combining these two techniques allows you to stretch out your tight calf muscles, which puts less stress on the plantar fascia.
If you’re experiencing debilitating heel pain that doesn’t improve after six to 12 months of nonsurgical treatments, your doctor might recommend a surgical procedure. One such option is a fasciotomy. This surgery unhooks the plantar fascia ligament from your heel bone.부산족부정형외과