From the Guidelines
Plantar fasciitis treatment should begin with conservative measures, including rest, ice, and stretching exercises, and if no improvement occurs after six weeks, referral to a podiatric foot and ankle surgeon is appropriate. The initial treatment measures include applying ice to the painful area for 15-20 minutes, 3-4 times daily, and performing calf and plantar fascia stretches by pulling your toes toward your shin for 30 seconds, repeating 3 times, several times daily 1. Over-the-counter NSAIDs like ibuprofen or naproxen can reduce pain and inflammation. Night splints that keep the foot dorsiflexed while sleeping help prevent morning pain by maintaining a gentle stretch. Supportive footwear with good arch support and cushioning is essential, and custom or over-the-counter orthotic inserts can provide additional relief. Some key points to consider in the treatment of plantar fasciitis include:
- Continuing initial treatment measures until symptoms resolve
- Considering additional treatments such as a customized orthotic device, night splinting, or a limited number of corticosteroid injections if no improvement occurs after six weeks 1
- Exploring other diagnoses if no improvement occurs after two to three months
- Considering surgery or extracorporeal shock wave therapy as further options if other treatments are unsuccessful 1. It is essential to note that most cases of plantar fasciitis resolve within 6-12 months with consistent conservative treatment, and the condition occurs when the plantar fascia becomes inflamed due to repetitive strain, causing pain particularly with the first steps in the morning or after periods of rest.
From the FDA Drug Label
NSAID medicines are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as: different types of arthritis
- Plantar fasciitis is a type of inflammation, and NSAIDs like naproxen can be used to treat pain and inflammation.
- The FDA drug label for naproxen does not explicitly mention plantar fasciitis as an indication, but it does mention that NSAIDs can be used to treat inflammation from various medical conditions.
- Based on this information, naproxen may be used to treat plantar fasciitis, but it is essential to consult a healthcare provider for proper diagnosis and treatment 2.
From the Research
Treatment Options for Plantar Fasciitis
- Conservative treatments are often recommended as the initial approach for managing plantar fasciitis, including rest, activity modification, ice massage, oral analgesics, and stretching techniques 3.
- If heel pain persists, physician-prescribed treatments such as physical therapy modalities, foot orthotics, night splinting, and corticosteroid injections may be considered 3.
- Platelet-rich plasma has been shown to be helpful in managing chronic severe tendinopathies, including plantar fasciitis, when other techniques have failed 4.
- A combination of physical therapies, such as stretches and shock waves, may be effective in reducing pain and relieving symptoms of plantar fasciitis 5.
Effectiveness of Different Treatments
- Studies have shown that approximately 90% of patients with plantar fasciitis will improve with conservative treatments 3, 6.
- Local injection of platelet-rich plasma or corticosteroid has been shown to be an effective treatment option for chronic plantar fasciitis, with platelet-rich plasma injection being as effective as or more effective than corticosteroid injection 7.
- Shock waves have been shown to be effective in treating plantar fasciitis, especially when other techniques have failed 5.
Treatment Considerations
- The natural history of plantar fasciitis has not been established, making it unclear how much of symptom resolution is due to treatment versus the natural course of the condition 6.
- Advanced cases of plantar fasciitis may require more invasive treatments, such as extracorporeal shock wave therapy or plantar fasciotomy, which carry the potential for serious complications and permanent disability 4.