I expect we all suffer from foot pains or aches now and again.
Our modern lifestyle, whether you are standing or sitting all day can cause problems with your feet.
Plantar fasciitis is one of the most common foot pain symptoms that doctors and podiatrists see, and it is usually curable with the right shoes and exercises.
But what if you get acute plantar fasciitis and your heel pain refuses to go away – what then?
Before we start, you might want to read my article, what is plantar fasciitis?, and see how you get it and how it can be treated.
When does it become acute plantar fasciitis?
Standard plantar fasciitis is treated using ice, rest, massage, stretches or changes in footwear and the use of orthotic insoles.
If all of these conventional methods fail and if you have any of the following:
- You are in constant pain.
- You have persistent problems walking or being on your feet.
- You have issues with your mobility.
- You have difficulty walking for longer than a few minutes due to plantar fasciitis pain.
- It is stopping you from doing your job.
If the pain comes on suddenly, as a result of a sports injury or accident, you will also be suffering from the symptoms of an acute plantar fascia injury.
Treatment for acute plantar fascia pain.
Initial treatment of acute or severe PF will follow the methods I outlined above. However, there will be more rest involved, where keeping the weight off of your feet will be paramount in your recovery.
It is also essential that you seek advice and treatment from a podiatrist as soon as possible.
The podiatrist will examine you and arrange a course of treatment or suggest some products that can help manage or reduce your pain.
It is possible that the podiatrist may suggest that you undertake a course of Extracorporeal or Focussed Shockwave therapy (ESWT or FSW), where sound waves are directed into the tissue surrounding the damaged plantar fascia.
“There is evidence that F-ESWT is effective in the treatment of plantar fasciitis, calcific tendinitis, and that RPT is effective in plantar fasciitis.”Source: British Journal of Sports Medicene
These sound waves help to over-stimulate the nerves which numbs the area and reduces sensitivity and pain but only for a temporary period.
Unfortunately, the benefits of Shockwave therapy only last for a short period (usually only a few months, but regular treatment can improve the effectiveness over time).
However, despite the short-term benefit, ESWT is considered to be the most effective, least invasive and appropriate treatment for acute plantar fasciitis. The improvements can be instant, and there are short recovery times and minimal side-effects.
What are the other treatment options?
For the treatment of severe or reoccurring plantar fasciitis or heel pain, your podiatrist may recommend a Corticosteroid injection.
Injections are another temporary solution to foot pain which is also used to treat problems such as tennis-elbow or knee pain.
Your podiatrist will inject into the side of the heel, not directly into the sole and the steroid is directed to the area where you feel the pain the most. After an initial numbing of the pain, the steroid works over the next weeks to help relieve pain, allowing you to walk and even run again.
It is not a permanent fix though, and there is no chance this treatment will fix your acute plantar fasciitis. It is just direct pain relief, and you will need to repeat the procedure after it wears off.
“A single ultrasound guided dexamethasone injection is a safe and effective short term treatment for plantar fasciitis. It provides greater pain relief than placebo at four weeks and reduces abnormal swelling of the plantar fascia for up to three months.”Source: BMJ.com
Plantar fasciitis surgery.
If all else fails, there is the option to have surgery to help release tension in the fascia ligament.
After the required scans have been done to pinpoint the location, the podiatrist makes a small hole in your heel, and the fascia is cut, releasing tension.
Because of the way plantar fasciitis occurs, where the ligament is stretched and torn at the heel, the loss in tension can help stop it from happening again.
Surgery can be painful, and the recovery can take up to 3 to 4 weeks, and you will have to wear a weight-bearing cast and rest as much as possible.
After you remove your cast, you can walk immediately, but anything more rigorous will have to wait for up to 8 weeks.
However, please bear in mind that having plantar fasciitis release surgery is not a minor operation and does come with risks and may not be that effective. Read my article written by Dr Meredith Warner on why it might not be a great idea.
Curing plantar fasciitis can be easy, provided you get treatment early. It is often as simple as a few visits and procedures from your podiatrist and some exercises at home.
But if you leave it too long, you could end up with severe damage and acute plantar fasciitis, which will need more expensive and painful treatments.
So if you have heel pain in the mornings, problems with foot pain after walking or standing for a long time or discomfort when walking, get to your podiatrist straight away – or prepare for ongoing pain!