There are a number of treatment options that you can use for plantar heel pain. As we’ve already touched on the main four are: education around the condition; doing stretches for first step pain; using radial shockwave therapy, or extra corporal shockwave therapy to help stimulate healing and the tissue; and using orthotics and footwear.
There are a number of different stages that plantar fasciitis will go through and some of these modalities will be more appropriate for the different stages. For example, in the acute stages, we tend to use the education, we tend to use the strapping, and we tend to use footwear modifications, and those sorts of things. Later on, we will start to move to things like the use of orthotics.
Now, people will often ask us, why do I need an orthotic for my plantar fasciitis? Well, what we’re trying to do is we’re trying to decompress the painful area underneath the heel, and we’re trying to support the arch so that it helps to reduce some of the tension and strain from the plantar fascia.
What I’ve found over the last 20 years of treating this condition is that it’s usually a multitude of different things that we need to do to get an optimal outcome. One of the modalities that I’ve started to use or that we are using at Waikato, Podiatry is radial pressure wave, or shockwave treatment. It sounds quite nasty but really, it’s a very safe modality, much safer than injecting cortisone into the heel.
The thing that I like about it as well is that it’s trying to initiate healing within the body, so it’s using the natural inflammatory mediators and your body’s own mechanisms of healing to really kickstart or reboot the healing response within the tissue. There are different stages like we’ve talked about, and I think really to be optimal, we need to make sure that you start with the basics, do those properly and regularly, and then we work through to the different treatment options.
An orthotic is only as good as the footwear that it goes into, so it’s essential that we have a shoe that’s going to work well with the orthotic. And it’s also really important to make sure that you fully understand what is expected for your contribution towards helping with this condition.
Just remember, there are things that you can do to help reduce your pain and allow you to become active quicker when you’re suffering from plantar heel pain.