The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis.

Wearing nonsupportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when oneʼs job requires long hours on the feet. Obesity and overuse may also contribute to plantar fasciitis.

Nonsurgical Treatment

Treatment of plantar fasciitis begins with first-line strategies, which you can begin at home:

• Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery.
• Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia.
• Ice. Putting an ice pack on your heel for 20 minutes several times a day helps reduce inflammation. Place a thin towel between the ice and your heel; do not apply ice directly to the skin.
• Limit activities. Cut down on extended physical activities to give your heel a rest.
• Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia.
• Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.

If you still have pain after several weeks, see your foot and ankle surgeon, who may add one or more of these treatment approaches:

• Padding, taping and strapping. Placing pads in the shoe soens the impact of walking. Taping and strapping help support the foot and reduce strain on the fascia.
• Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis.
• Injection therapy. In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain.
• Removable walking cast. A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal.
• Night splint. Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients.
• Physical therapy. Exercises and other physical therapy measures may be used to help provide relief.

When Is Surgery Needed?

Although most patients with plantar fasciitis respond to nonsurgical treatment, a small percentage of patients may require surgery. If, aer several months of nonsurgical treatment, you continue to have heel pain, surgery will be considered. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial for you.