Plantar Fasciitis is inflammation of a band of tissue on the bottom of the foot, which connects the heel to the base of the toes. This inflammation can cause an intense stabbing pain in the heel and arch of the foot.

Currently, treatment is mainly limited to rest, stretching exercises, and pain killers, in the hope that inflammation will reduce and the pain will subside. In more severe cases, where pain does not stop, some level of physiotherapy may be necessary as well as a visit to a podiatrist; where a professional may recommend the use of insoles or more suitable footwear, to prevent plantar fasciitis.¹ 

Extracorporeal shock wave therapy (ESWT) is a new potential treatment for plantar fasciitis. This is a form of therapy that uses sound waves to treat chronic tendon issues.

What Causes Plantar Fasciitis?

Plantar fasciitis is generally caused by inflammation of the plantar fascia, which connects the heel and base of the toes. This occurs because of repeated stretching and tearing of the fascia, which can be due to extended exercise, above average weight, or constant standing/walking. Although there is no established cause for each case of plantar fasciitis.² 

Symptoms of Plantar Fasciitis

The main symptom of plantar fasciitis is a sharp stabbing pain around the heel of the foot. This usually occurs first thing in the morning or after a period of inactivity, and it can be exacerbated due to long periods of standing or walking on hard floors.³ 

Current Treatment for Plantar Fasciitis

Currently, treatment for plantar fasciitis focuses on rest and the use of pain relief treatment strategies until the inflammation subsides.¹ 

If severe pain is prolonged and the plantar fasciitis is causing issues with movement and normal activities, a podiatrist can suggest supportive insoles that support the arch of the foot and could hopefully alleviate pain and inflammation.

In some cases a physiotherapist may help treat plantar fasciitis, they would usually recommend some stretching exercises that can be done at home daily to stretch the plantar fascia and the achilles tendon, strengthen the muscles in the lower leg, and hopefully reduce any pain.

Rarely, in the most extreme cases, surgery may be an option.  Surgery can be used to lengthen the achilles tendon and its connection to the gastrocnemius (thickest muscle of the calf). However, this is usually not necessary, as rest, stretching, and support would generally stop any plantar fasciitis over a few weeks to months.³ 

What is Shockwave Therapy?

Extracorporeal shockwave therapy (ESWT) is a form of treatment that uses sound waves to treat, in particular, tendon injuries/problems. It is often considered a secondary form of treatment after other treatments (e.g., rest and physiotherapy) have failed.

It works by delivering sound waves through the skin into the injured area, which stimulates blood flow, in order to reduce recovery time from injury.⁴ 

ESWT is not an alternative to standard plantar fasciitis treatment, but for more severe cases where initial treatment fails to address the pain and altered movement caused by plantar fasciitis. It is a non-invasive procedure and can provide great benefit for those people suffering from severe tendon injuries, and other injuries such as plantar fasciitis.

ESWT has been shown to be a successful conservative form of treatment for plantar fasciitis, but there are some potential side effects from the treatment. Side effects include pain or an unpleasant sensation during the therapy, which can then lead to some redness around the area of application. Moreover, less common side effects include dizziness and deeper skin injuries. There should be no further complications from ESWT and if it is performed by a trained professional the risk of side effects would be greatly minimized. ESWT is a safe non-invasive procedure that can be done easily by a healthcare professional.⁵

Summary

Plantar fasciitis is the inflammation of a thick band of tissue that supports the arch of the foot, known as the plantar fascia. This is a very common cause of heel pain.

This is often caused by over exercising, which results in tears in the fascia resulting in pain. Risk factors for this condition include being overweight and standing/walking for long periods of time, but there is no certain common cause of plantar fasciitis.

Generally, the initial treatment of plantar fasciitis is rest, icing the affected area, and the use of painkillers to address the pain; it can take a few weeks until the pain and inflammation subside. Pain can return with further over exercising, particularly for those that are overweight.

In cases where this initial treatment and rest does not work, further treatment can be recommended such as supportive insoles, which support the arch of the foot; but, in particular, a physiotherapist can teach a patient exercises for stretching the foot and ankle, which, if performed daily, can help reduce the chance for plantar fasciitis.

Extracorporeal shock wave therapy (ESWT) is a new form of non-invasive conservative therapy for injuries like plantar fasciitis, that uses sound waves to treat a range of tendon issues This works by stimulating blood flow to the affected area, in the hope of decreasing recovery time. ESWT is usually done over three sessions, over a three week period. ESWT can be used by trained professionals once other forms of treatment have proved of no benefit to someone suffering with plantar fasciitis. ESWT has been shown to be successful in treating plantar fasciitis with little to no side effects or complications.