Medical Treatments

I do recommend going to see your doctor about Plantar Fasciitis. They will be able to confirm that that is what the problem is, and look at any obvious causes. They should be able to do this through a routine examination as PF is common.

 

Depending on the severity of your symptoms the doctor is mostly like to recommend an initial course of self-help treatments, like the ones mentioned over on our "Managing Plantar Fasciitis Yourself" page. However, if they are concerned that it may be something else, such as a broken bone or pinched nerve, then they might refer you straight to x-rays or other diagnostic tests. If the doctor is unsure of the diagnosis then it's a good idea to keep your home treatment fairly basic in the meantime - you don't want to spend money on products unnecessarily, and you don't want to exacerbate problem that isn't PF. So, best to stick to painkillers and heat/ice if this is the case (which is unusual if you symptoms fit the patterns described on the Symptoms page).

Initial recommendations

Most doctors in the first instance will recommend simple home treatments including most of the ones described in our comprehensive guide: "Managing Plantar Fasciitis Yourself".

 

The home treatments they might recommend may already be covered off in that section of our website.

Foot strengthening and stretching

Ice, heat and painkillers

Massage and rolling

Therapies and home treatments

Compression, support and insoles

Lifestyle and footwear

Painkillers - over-the-counter and prescription

paracetamol

ibuprofen

Unless you have a pre-existing medical condition that prevents it, your doctor will also potentially recommend using normal over-the-counter painkillers until the episode of Plantar Fasciitis has gone. The NHS website recommends that you don't take Ibuprofen for the first 48 hours as it can slow down healing for sprains and strains (reference).

 

Myself and most of my friends of PF found over the counter painkillers to be only moderately effective, and less effective the more severe the case of PF. That doesn't mean you shouldn't take them, but you should be aware that they are unlikely to be a significant or long term help.

Your doctor may prescribe a stronger painkiller that is prescription-only. If this is the case, be aware that it will be a short term prescription and you need to explore other options at the same time to bring the inflammation down (you will only get really strong painkillers if you are in a hospital and you won't go straight there for plantar fasciitis.) Ensure that you follow the directions on any painkillers that you buy over the counter or at home and don't exceed the dose even if they have not eliminated the pain completely.

Steroid injection

As the name suggests this is an injection of a steroid (Cortisone) which is done into the painful part of your foot to provide pain relief, lower inflammation and promote healing. Many people see good results from this and it is regarded to be an effective and straightforward treatment. There *are* risks because this is a medical procedure involving a steroid, but they are most commonly manageable and infrequent. Your doctor or the treatment team providing the injection will provide you with information about the possible risks and side-effects and you should read and understand these fully.

 

My GP recommended this after I had had PF for about 6 months without improvement. I was given a local anaesthetic at the same time as the injection: the treatment was very uncomfortable but not enormously painful . But then, I have a fairly good pain threshold and I don't have issue with needles. If you have issues with needles in particular you need to discuss this with your doctor before you have the procedure confirmed.

You will be given advice on the day about what to do afterwards - normally this is 48 hours of rest to avoid any damage to your plantar fascia following the procedure, and this includes stretching exercises. You will also be given instructions on what stretching exercises to do after 48 hours and it is important that you follow those. The pain relief for me was instant from the local anaesthetic, and I found continued to be effective for about 6-8 weeks before it returned. Many people I have spoken with have had longer pain relief than that or had it go away permanently.  You can have recurring injections with a maximum frequency of about 3x per year.

Referral to podiatrist or physiotherapist

Your doctor may make a referral to an NHS podiatrist or physiotherapist who can do a deeper exploration of your feet, legs and movement and make recommendations of what you can do. You can also do this privately but of course you will need to pay for that. 

Physiotherapist

A physiotherapist will do a full-body examination looking at how you generally move and stand, and where you might have tightness or lack of mobility in your legs and feet which are contributing to plantar fasciitis. If you haven't attended a physio before, note that you will often need to wear shorts or clothing that makes it easy for the physio to see how your legs move - they will generally provide shorts if you don't have them. They will look for things like poor alignment in your legs and body, muscular weaknesses or tightnesses, and pressure you may be putting on your plantar fascia. If you're a runner they will probably ask you to run on a treadmill briefly to see your running style, and if you do other exercise such as weightlifting they may want to see a demonstration of some basic lifts to see your form. They will then recommend a programme of exercises and massage and may also make recommendations for changes to your running or walking style, your weightlifting form, or anything they think is contributing. You should expect physiotherapy to involve a few appointments with a week or two in between.

Podiatrist

Podiatrists are focused on your feet more than your overall body form although they may still want to see how your foot operates in relation to your legs. They will make recommendations around footwear, so it can be beneficial to take in your regular shoes or sports shoes with you so they can see if those may be a factor. They will probably discuss foot orthotics (insoles) with you and will potentially recommend some, that could be either custom-made to fit you, or off-the-shelf ones. A good podiatrist will have a really detailed knowledge of what's available in terms of orthotics, splints and compression socks.

Surgery (plantar fasciitis release surgery)

It is very unlikely that you will have to go down the surgical route and you will have had to exhaust really all other options and be in significant pain before it is considered. I've had discussions with my GP about it but have no plans to have surgery while self management options are working. Plantar Fasciitis release surgery can be done as open surgery or as endoscopic (keyhole) surgery with the latter involving a much shorter recovery time.