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COLUMBIA ORTHOPEDICS SERVICES

Diagnosis & Treatment

Plantar Fasciitis

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How is Plantar Fasciitis Diagnosed?

Diagnosis

To diagnose plantar fasciitis, your doctor will ask about your medical history and your routine physical activities. They will perform a physical examination, search the foot for tender areas, and ask you about your symptoms and what time of day they occur. 

Your doctor may order imaging tests to rule out other problems, such as a stress fracture or bone spurs. But typically, MRIs and X-rays are not necessary to diagnose plantar fasciitis.

How is Plantar Fasciitis Treated?

Treatments

Methods of treating plantar fasciitis vary based on the severity of the case. In most instances, people recover with simple treatments such as icing, stretching, and adjusting their exercise routines and activities. Over-the-counter pain relievers such as ibuprofen (Advil, Motrin) or naproxen (Aleve) can minimize pain and inflammation. 

Most plantar fasciitis patients improve over time with conservative healing methods. But, if necessary, your doctor may recommend an alternative plantar fasciitis treatment, such as physical therapy, utilizing special devices, or in extreme cases, surgery.

Therapy

When icing and ibuprofen aren't enough, alternative therapies and the use of special devices can help relieve plantar fasciitis pain. These can include:

  • Physical therapy - A physical therapist works with you to stretch your plantar fascia and calf muscles. They may tape up your foot for support and provide therapeutic massage and tips for strengthening your lower legs.
  • Orthotics - Prescription inserts or heel pads that are worn inside the shoe, providing arch support and alleviating pressure on the foot
  • Night splints - Worn overnight to secure the plantar fascia and Achilles tendon in an extended position, providing a gentle stretch while you sleep
  • Canes or walking boots - A temporary solution to take some weight and pressure off your foot
  • Cortisone shots - A powerful anti-inflammatory, cortisone is injected into the plantar fascia to reduce pain and swelling

Surgery

After six to 12 months, if all other treatment options don't provide relief from your foot pain, doctors may recommend plantar fasciitis surgery or other medical procedures. 

  • Gastrocnemius recession - Tight calf muscles can exacerbate plantar fasciitis. This procedure lengthens the calf muscle to improve mobility of the ankle and reduce stress on the plantar fascia.
  • Plantar fascia release - A partial incision is made in the plantar fascia ligament to relieve pressure in the tissue. This procedure can be done with an open incision or endoscopically.
  • Extracorporeal shockwave therapy (ESWT). High-energy sound waves are aimed at the plantar fascia tissue and heel area to stimulate healing.
  • Ultrasonic tissue repair. A small incision is made in the foot. A probe is inserted, emitting ultrasonic energy which breaks down damaged plantar fascia tissue and suctions it away.

FAQs

FAQs

It varies. With treatment, plantar fascia pain could subside after a few weeks, but in some cases could last from six months to a year. Commitment to your treatment is essential, and the sooner you start, the better.

How should I tape my foot for plantar fasciitis? 

  1. On a flexed foot, wrap a piece of athletic tape horizontally around the ball of the foot.
  2. Wrap another long strip around the side of the foot in a U shape, from the side metatarsal (bunion) near the big toe, down around back of the heel, and up to the side of the metatarsal near the baby toe.
  3. With two strips of tape, make an X shape, crossing the bottom of your foot, attaching the tape to the U-shaped strip from step two.
  4. Finish with three or more strips placed horizontally across the foot over the X shape, from the ball of the foot to just above the heel, so most of the bottom is covered.

Common causes include prolonged standing or walking, tight calf muscles, unsupportive or worn-out footwear, and exercise involving running or jumping.

Applying moderate to firm pressure, massage the length of your arch vertically, from the base of the toes to the heel. Then massage horizontally across the width of the arch. Spend two minutes on each foot.

Select a shoe with good heel and arch support. Avoid cheap flip-flops and high heels.

Get Care

Trust NewYork-Presbyterian for Plantar Fasciitis Treatment

The foot and ankle experts at NewYork-Presbyterian understand how disruptive pain from plantar fasciitis can be. Our team of professionals will help you identify the symptoms and causes and recommend a course of treatment.

Reach out for an appointment today, and we'll help you get back on your feet.