Plantar Fasciitis & Heel Pain Treatment
How can it be treated?
The vast majority of the time non-operative treatment measures used alone or in combination control things well. These include-
- Rest, ice, compression and elevation (RICE) during an acute flare up.
- Simple pain killers may be prescribed by your doctor.
- Comfortable shoes.
- Avoid aggravating activities such as running- try cycling or swimming for a while.
- Physiotherapy.
- Insoles and soft heel pads.
- Taping.
The simple measures above do not help - what next?
- Extracorporeal Shockwave Therapy - this is a promising new treatment that has seen a significant increase in interest in its use recently. In tough to treat cases this treatment can be very useful and has very few potential side effects.
- Steroid injections- if other therapies are unsuccessful you may be considered for a steroid injection. This was a very common treatment in the past but is falling out of favor due to the small risks of plantar fascia rupture, heel fat pad damage and infection.
- Surgery is only considered as a last resort here. Surgical release of the plantar fascia is only effective in approximately 50%-60% of cases and a proportion of people can actually be left worse off after surgery. In select patients with definite plantar fasciitis and a tight gastrocnemius (calf muscle) that does not stretch out after physiotherapy a surgical lengthening of the calf muscle thru a small incision can be very effective in treating the condition- perhaps somewhat surprisingly.
Plantar fascia release and gastrocnemius (calf muscle) release are small procedures and only take approximately 30 minutes to perform. They can be undertaken as a day case under regional anaesthetic block making the foot or leg numb for six to twelve hours. You will be seen by an Anaesthetist and can be awake, sedated or have a general anaesthetic during surgery. For a plantar fascia release it is advised to use crutches for two to four weeks after surgery. For a gastrocnemius (calf muscle) release you can walk straight away. There is no need for a cast or prolonged immobility with modern surgical techniques for either procedure.
Mr. Al-Nammari undertakes the majority of his private operating at The Nuffield Hospital in Ipswich. Using the latest techniques in local anaesthetic blocks means that most people having surgery are comfortable enough to get home on the day of surgery should they so wish. For those who need to or just feel more comfortable spending the night in hospital after surgery this is of course possible. The choice of anaesthetic is based upon your own preferences and the opinion of the Consultant Anaesthetist who you will meet before any surgery. Many people prefer to be asleep during surgery and have the local anaesthetic block performed while asleep to control any post-operative pain.