Plantar fasciitis – a painful inflammation of the tendon-like tissue that runs from the heel bone to the ball of the foot – is the most common cause of heel pain. It affects between 1 to 2 million Americans a year.
Luckily, simple, noninvasive treatments are usually “very successful,” said Dr. Jim Christina, director of scientific affairs for the American Podiatric Medical Association.
For starters, it often helps to put ice on the bottom of the foot several times a day for not more than 20 minutes each time. Over-the-counter anti-inflammatory drugs such as ibuprofen, aspirin, and naproxen can also help. Stretching calf muscles may also reduce heel pain, as does stretching the bottom of the foot. (You can do this by resting the affected foot on top of the opposite knee and using one hand to flex the toes upward while the other hand massages the bottom of the foot near the heel.)
If that doesn’t help enough, you can try physical therapy using ultrasound and electrical stimulation of fascia tissue to stimulate blood flow. You can also buy over-the-counter insoles or custom-made orthotic devices, which support proper foot function. Shoes with good arch support, such as athletic shoes, are important, too. If none of that helps, you can try cortisone injections into the painful area of the foot, although this can weaken tendons and muscles in the foot, said Dr. Joseph S. Fox, a podiatric surgeon at the Gramercy Surgery Center in New York.
Roughly 90 percent of patients get better with these low-tech approaches. For those who don’t, shockwave therapy, which uses high-energy sound waves to increase blood flow around fascia tissue, may help. So may a new technique called coblation therapy in which a doctor makes a small incision near the heel and uses low-temperature radiofrequency waves to destroy nerve fibers in the inflamed area.
Finally, there’s surgery, often done through tiny incisions, to cut a portion of the fascia tissue, a procedure that can “release” tight fascia tissue by lessening tension from the fascia to the heel bone. While surgery is generally covered by insurance, the other procedures often are not.
But the best bet is to prevent plantar fasciitis by wearing supportive shoes, warming up before athletic activities, and stretching the feet and calves before and afterward.