Plantar fasciitis is the irritation and swelling of the thick tissue on the bottom of your foot, or your plantar fascia, states Medline Plus. The purpose of the plantar fascia is to connect your heel bone to the other bones of your foot. When this tissue becomes inflamed, it can cause pain and make walking difficult. According to Medline Plus, risk factors include flat foot and high arches, obesity, running and Achilles tendon tightness (the tissue that connects your calf muscle to your heel). Most cases of plantar fasciitis respond to conservative treatment; however, more invasive treatment may be necessary.
Corticosteroid Injection
Corticosteroids are a type of medication that are used to decrease inflammation. They are more powerful than nonsteroidal anti-inflammatory drugs (NSAIDs) and can be injected directly into the plantar fascia. First, your doctor will identify the area of your plantar fascia that is causing you the most pain. Then, he will numb the area before injecting the corticosteroid medication, possibly under fluoroscopic (live x-ray) guidance. You may notice an immediate improvement because there is also an anesthetic medication that is mixed in with the corticosteroid. The corticosteroid usually takes a few days to fully kick in, and may or may not relieve your symptoms, depending on how your body responds to it. Be cautious that too many injections can weaken your plantar fascia and cause it to tear.
Extracorporeal Shock Wave Therapy
Extracorporeal shock wave therapy is a procedure in which sound waves are directed at the area of heel pain to stimulate heeling. This option if for those who do not experience relief with more conservative types of treatments. The Mayo Clinic warns that this procedure is not consistently effective and may cause bruises, swelling, pain, numbness and tingling around your heel. Therefore, consider this option if conservative treatments do not improve your symptoms. If this procedure has worked for you in the past, chances are it will work for you during your current episode of plantar fasciitis.
Surgery
A last resort is surgical treatment of your plantar fascia. According to the Mayo Clinic, this procedure involves the detachment of your plantar fascia from your heel bone. Because this tissue attaches your heel to your toes to maintain your arch, you will notice a weakening of your arch after this procedure. This can be managed by wearing proper shoes. Your doctor may also prescribe orthotics for your weak arch after surgery.
