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doctor123, Doctor
Category: Medical
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Experience:  4 years of experience in primary care medicine
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I have Plantar Fasciitis. I have to wear steel toed work boots.

Resolved Question:

I have Plantar Fasciitis. I have to wear steel toed work boots. My pad under my toes is what swells and hurts. I have tried a variety of foot pads and ice packs without relief. I have also tried recommended stretches. What can I do? The pain is almost unbearable and getting on on my feet after a 10 minute break is very difficult.

Any suggestions?
Submitted: 7 years ago.
Category: Medical
Expert:  doctor123 replied 7 years ago.
Hello. Plantar fasciitis can be very painful. Here are some tips that will help you:
    Avoiding the precipitating activity; for example, take a few day off jogging or prolonged standing/walking. Just resting usually helps to eliminate the most severe pain, and will allow the inflammation to begin to cool down.
    Apply Ice Packs - Icing will help to diminish some of the symptoms and control the heel pain. Icing is especially helpful after an acute exacerbation of symptoms.
    Exercises and Stretches - Exercises and stretches are designed to relax the tissues that surround the heel bone. Some simple exercises, performed in the morning and evening, often help patients feel better quickly. These can include rolling a tennis ball with your foot back and forth.
    Anti-Inflammatory Medications - anti-inflammatory medications help to both control pain and decrease inflammation. Over-the-counter medications are usually sufficient, but prescription options are also available.
    Shoe Inserts - called orthotics - shoe inserts are often the key to successful treatment of plantar fasciitis. The shoe inserts often permit patients to continue their routine activities without pain.
    Night Splints - night splints are worn to keep the heel stretched out when you sleep. By doing so, the arch of the foot does not become contracted at night, and is hopefully not as painful in the morning.

These modalities alone will cure the plantar fasciitis pain in most patients. Be forewarned that the symptoms will not resolve quickly. Most patients find relief within about three months, and over 90% within one year.

If the pain does not resolve, an injection of cortisone can decrease the inflammation of plantar fasciitis. However, many physicians do not like to inject cortisone because there are potentially serious problems with cortisone injections in the heel area. The two problems that cause concern are fat pad atrophy and plantar fascial rupture. Both of these problems occur in a very small percentage of patients, but they can cause a worsening of heel pain symptoms.

A new treatment for chronic plantar fasciitis is being investigated. This treatment, called extracorporeal shock wave therapy, or ESWT, uses energy pulses to induce microtrauma to the tissue of the plantar fascia. This microtrauma is thought to induce a tissue repair process by the body. ESWT is recommended in patients who have failed the previously mentioned treatments, and are considering surgical options.

Good luck.
doctor123 and 3 other Medical Specialists are ready to help you
Customer: replied 7 years ago.
Thank you for your reply. I have had surgery on the pad of my right foot. I have tried just about all of your suggestions, with the exception of staying off of them. That is not an option I can afford at this time. Where are they using the microtrauma in Arkansas?

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