Mon10202014

Your Health

Healing the heel: Treating plantar fasciitis


courtesy of Ted Ray
The red area in the illustration shows an inflamed ligament in the heel, known as plantar fasciitis.

Plantar fasciitis is the term used to describe foot pain that occurs in the heel or the arch of the foot. Typically brought on by overuse, such as running or walking long distances, plantar fasciitis can be difficult to treat because the inflammation is in the fascia, or ligamentous tissue, on the bottom of the foot.

Typical approaches to treatment include cortisone shots to reduce inflammation, orthotics to support the foot and protective boots worn at night to prevent the foot from contracting. But no one treatment works for everyone.

So what can you do if arch and heel pain affect you? I spoke with Dr. Lawrence Oloff of SOAR Medical Group, the team podiatrist for the San Francisco Giants, to get his perspective on the best way to resolve the condition.

Q: What is plantar fasciitis?

A: The plantar fascia is a ligament in the arch that attaches to the heel and runs the length of the foot. Fasciitis represents a condition where the plantar fascia gets inflamed and irritated, resulting in heel pain in the bottom of the foot.

Q: Who gets plantar fasciitis?

A: It is more common in active people but can be witnessed in anyone. It is more common with foot structural issues such as high arch feet and flat feet. Walkers, runners and hikers are particularly prone to it. As running is a major part of conditioning for many sports, it is witnessed as one of the most common sports overuse injuries.

Q: How do I know if I have plantar fasciitis?

A: Fasciitis symptoms are expressed as heel pain on the bottom of the foot that is exacerbated by standing and walking. People express their worst pain when first getting out of bed, out of a chair or when exiting a car.

Q: How do you treat plantar fasciitis in your office?

A: The first line of treatment involves simultaneous approaches such as temporary use of anti-inflammatory medicines (if medically allowed) like Advil or Aleve, over-the-counter orthotics or padded heel cups, icing, stretching (arches, calves and hamstrings), night splints (check out nightsplints.com) and elimination of irritating weight-bearing activities.

Q: How long does plantar fasciitis last?

A: Be patient, because it can take months to totally improve.

Q: Any quick fixes?

A: Check out your shoes and make sure that they are supportive enough, or maybe it’s just time to replace that worn-out running shoe.

Q: What if it doesn’t get better?

A: Options for stronger treatment include prescription-strength anti-inflammatory medications, limited use of cortisone injections or custom orthotics. Stress fractures of the heel bone are not that uncommon. They typically present with pain on the sides of the heel versus the bottom. An X-ray, and maybe an MRI, is needed for a more precise diagnosis.

Acupuncture for plantar fasciitis

While needles in the foot may seem counterintuitive for this kind of pain, acupuncture can be really effective in releasing foot tension. That’s because acupuncture works to increase circulation to certain parts of the body and can release acute muscle spasm.

One acupuncture point in particular has been especially effective in treating plantar fasciitis. Master Tung, among the most famous acupuncturists in modern times, used a point halfway up the inside of the upper thigh to treat heel pain. This point releases tension in the Achilles tendon, thereby taking tension off the bottom of the foot.

Whether you start with massage, physical therapy or a new pair of shoes, many approaches to treating plantar fasciitis will work. The trick is to find the therapy – or therapies – that work for you. A podiatrist, physical therapist or acupuncturist is a good place to start.

Ted Ray is a licensed acupuncturist and herbalist in private practice in Mountain View. For more information, call 564-9002 or visit peninsulaacupuncture.com.

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