When you’re dealing with heel pain, you want relief: fast. But, depending on the cause of your heel pain, not all treatments will be equally effective. In fact, a new study has just revealed the best way to treat pain caused by inflammation in the thick connective tissue in your feet (plantar fasciitis.) And, as it turns out, the most appropriate (and least invasive) option takes time to reveal its effectiveness! 

Treating Heel Pain: Injections vs. Orthotics Orthotic devices are a great long-term treatment option for heel pain!

In the study, published in the Journal of Orthopaedic and Sports Physical Therapy, researchers compared two heel pain treatments: corticosteroid injections and custom orthotic devices. What they found was surprising! After four weeks, the injections were offering greater relief. After 12 weeks, however, the orthotics were offering greater relief. And, perhaps the most interesting finding? Most of the study participants couldn’t really notice a difference between the two treatments!

To reach these findings, the study authors followed 103 patients aged 21 to 72. The participants were split into two randomized groups: one received custom orthotics designed to contour their arches. The other group received ultrasound-guided corticosteroid injections. At four and twelve weeks after the initial treatments, researchers assessed pain levels in both groups, using a Foot Health Status Questionnaire. Patients in both groups were also given special instructions for stretches and care (like icing and OTC anti-inflammatories) that can help manage plantar fasciitis.

In revealing their findings, the study authors made one factor clear: patients should understand that steroid injections are really intended for short term relief. A better option, they suggest, is teaching patients how to care for their plantar fascia, and correcting contributing biomechanical problems with custom orthotics.

 

Long Term Relief for Heel Pain

In our Elmhurst podiatry practice, we don’t just want to put a bandaid on your heel pain. We want to get to the root of the problem, so your pain doesn’t return as soon as your steroid injection wears off!

First, we want to figure out why your plantar fascia is acting up. Many times, the inflammation is due to overuse, a change in your shoes, taking up a new activity, or just stepping up your general activity levels.  People who have very low or very high arches are also very susceptible to this type of heel pain, as are people with jobs that require prolonged standing or walking (especially if you can’t wear properly supportive shoes while doing so!) And, as with so many other foot problems, athletes are always at risk for plantar fasciitis, either from over-training or from choosing the wrong footwear for their individual sport.

Once we figure out why your plantar fascia has been irritated, we can come up with a unique, long-term treatment plan. We’ll examine everything from your shoes to your job and activity levels, suggesting supports and stretches that can complement a custom orthotic which we can build from a model of your foot.

We may find that a night splint will help you avoid that stabbing heel pain you get when you first step out of bed. We may recommend an EPAT treatment (Extracorporeal Pulse Activation Technology), which is a highly effective, non-invasive, in- office modality used to treat heel pain—and many other ailments. And, if your immediate pain levels are really debilitating, we may even recommend an injection for pain relief.  But, we will always make it clear that the injection is just one piece of our long-term attack plan to keep that heel pain from coming back (or getting worse!)

Jordana White
Jordana Rothstein White