Plantar fasciitis is a common cause of heel pain that is worse first thing in the morning. The plantar fascia is a band of tissue that traverses the length of the foot, connecting the heel to the toes. The band of tissue contracts and becomes inflamed; small tears may develop in the ligament. Plantar fasciitis develops for a number of reasons, including flat feet or feet that roll inward. Treatments decrease pain and help the fascia heal. Conservative treatments for two to three months give good results in 90 percent of people with plantar fasciitis, the Mayo Clinic reports.
Night Splints
Because the tissues contract during periods of immobility, pain is most severe in the morning and after periods of inactivity. A night splint that keeps the ligament stretched by bending the foot upward slightly prevents contracture and decreases pain in the morning from the sudden stretch of the fascia, the Richard Stockton Athletic College Training Department explains.
Non-Steroidal Anti-Inflammatory Medications
Non-steroidal anti-inflammatory medications (NSAIDS) such as ibuprofen and naproxen decrease inflammation in the foot caused by plantar fasciitis and ease pain. NSAIDS must be used in conjunction with other therapies to reduce the cause of the pain and not just treat the symptoms.
Orthotics
Orthotics are inserts that fit into shoes to change an improper gait that may be contributing to plantar fasciitis. Orthotics can be bought over the counter or custom designed for your particular foot problem. Custom orthotics are more effective but also considerably more costly.
Stretching Exercises
Stretching exercises help keep the plantar fascia and calf muscles from contracting. Strengthening muscles in these areas is also helpful. Exercises can be done at home or with the assistance of a physical therapist. Placing palms flat against a wall with knees slightly bent and your injured foot slightly behind the other also helps stretch the calf and foot muscles, the Ohio State University Medical Center illustrates. Picking up marbles or coins with your toes helps strengthen foot muscles, lead author Craig Young, M.D explains in the February 1, 2001 article in American Family Physician entitled "Treatment of Plantar Fasciitis."
Steroid Injections
Steroid injections into the area of inflammation in plantar fasciitis are sometimes used to treat severe pain and inflammation. Because steroid injections weaken the ligament, this treatment cannot be done more than a few times, because the plantar fascia could rupture, the Mayo Clinic states. Steroid injections also reduce the fat pads on the feet which are necessary to cushion the force of the foot striking the ground. Reduction of the fat pads can worsen plantar fasciitis.
Supportive Shoes
Supportive shoes with good arch support help maintain proper positioning of the plantar fascia. Walking barefoot should be avoided.
Surgery
In severe cases, surgical treatment of the plantar fascia may be necessary. A small cut is made in the plantar fascia to relieve the contraction of the fascia. Surgical treatment should be done only when severe pain is unrelieved by any other treatment, since the treatment weakens the arch of the foot, according to the Mayo Clinic.
