Traditional methods of treatment
• Reducing tensile stress on the attachment site of the plantar fascia is one of the first treatments for plantar fasciitis. When tensile stress is reduced, the site of irritation and collagen degeneration in the fascial tissue will have a chance to heal. The best way to reduce tensile stress is to have the client rest from any offending activities.

• Orthotics may also help change faulty biomechanical patterns in the foot and may take pressure off the plantar fascia and allow time for healing. Orthotics are most useful if the patient has either a flat foot or excessively high arch that is contributing to the irritation of the plantar fascia.

• Corticosteroid injections into the plantar fascia are sometimes used to address inflammatory effects. However, there is evidence that steroid injections into the plantar fascia may have detrimental effects. Steroids have been shown to leak into the fat pad - that layer of fatty tissue directly underneath the calcaneus designed to help absorb shock - and cause the fat pad's degeneration, as well as rupture of the plantar fascia. There is also a question as to the reason for corticosteroid (anti-inflammatory) injections if the primary problem is not an inflammatory condition.

• Ice applications are also commonly used as an anti-inflammatory treatment. Methods include placing a bag of frozen corn or peas on the foot because these mold well to the contour of the foot. Rolling the foot over a frozen plastic bottle of water also works as a type of ice application. One might question why these methods get beneficial results if the condition is not an inflammatory problem. Quite possibly, the beneficial result occurs from some of the other physiological effects of ice application, such as pain reduction.

• A device that has been used extensively to treat plantar fasciitis with very good results is the tension night splint. This brace is worn on the foot to maintain a position of dorsiflexion during the night. Prolonged dorsiflexion will condition the plantar fascia to tensile stress and prevent the aggravation of tensile forces on the attachment site at the calcaneus.

• Shock-wave therapy is another treatment method that is receiving frequent mention in the rehabilitation literature. This procedure is similar to that used to break up kidney stones. The reason for its use in plantar fasciitis is that it may help reduce the development of extra calcification, as with a bone spur, and therefore reduce pain in the region. However, there are differing opinions on the effectiveness of this approach.

References