musculoskeletal and connective tissue disorders
Plantar Fasciitis
Treatment of Plantar Fasciitis
Splinting, stretching, and cushioning or orthotics To alleviate the stress and pain on the fascia, the person can take shorter steps and avoid walking barefoot. Activities that involve foot impact, such as jogging, should be avoided. The most effective plantar fasciitis treatments include the use of in-shoe heel cushioning and arch supports with Achilles tendon-stretching exercises and night splints that stretch the Achilles tendon and plantar fascia while the patient sleeps. Prefabricated or custom-made foot orthotics may also alleviate fascial tension and symptoms while the patient is ambulatory. Other treatments may include activity modifications, nonsteroidal anti-inflammatory drugs (NSAIDs), weight loss in patients with obesity, cold and ice massage therapy, and occasional corticosteroid injections. However, because corticosteroid injections can predispose to plantar fascial rupture, many clinicians limit these injections (see Considerations for Using Corticosteroid Injections ). For recalcitrant cases, physical therapy and cast immobilization should be used before surgical intervention is considered. For recalcitrant types of plantar fasciitis, extracorporeal pulse activation therapy (EPAT), in which low-frequency pulse waves are delivered locally using a handheld applicator, may be tried. The pulsed pressure wave is a safe, noninvasive technique that is thought to stimulate metabolism and enhance blood circulation, which in turn may help regenerate damaged tissue and accelerate healing ( Treatment reference ). 1.Auersperg V, Trieb K: Extracorporeal shock wave therapy: an update. EFORT Open Rev. 5(10):584-592, 2020. doi: 10.1302/2058-5241.5.190067 