Plantar Fasciitis: Non-Surgical Treatments
Before considering any intervention for your plantar fasciitis, non-surgical treatments are recommended by Dr. Julien Lopez.
This condition, also known as plantar fasciopathy, corresponds to inflammation of the plantar fascia (or aponeurosis), the fibrous membrane located beneath the foot. This involvement of the plantar arch causes pain when bearing weight and becomes debilitating during your movements
Particularly common among athletes, especially runners or dancers, these pains can result from repeated microtrauma. Dr. Julien Lopez specializes in sports and orthopedic pathologies, and he can guide you toward suitable treatments based on the severity of your condition. Initially, non-surgical treatments for plantar fasciitis can include orthotics, insoles, appropriate footwear, lifestyle changes, cushioned heel inserts, cross-friction massages, shockwave therapy, stretching, physiotherapy, correction of contributing factors, or corticosteroid injections, and more.
Would you like to schedule an appointment? You can book a consultation at one of his 4 offices located in Nice, Cap d'Ail, and Mandelieu directly through the Doctolib platform.
Analysis and Diagnosis of Plantar Fasciitis
Before considering various treatments for plantar fasciitis and defining a therapeutic strategy, the specialist in orthopedic pathologies seeks to understand the origin of the pain and looks for contributing and/or aggravating factors.
A precise diagnosis of the extent of the condition and associated lesions helps define non-surgical treatments to consider. They aim to reduce your daily discomfort and pain and also reduce the risk of the condition worsening, such as the development of fissures.
The consultation begins with an assessment of pain to determine the level of discomfort and the functional consequences of pain in your daily and sports life.
Heel pain or talalgia is one of the main symptoms of plantar fasciitis. It occurs when you stand up and increases in intensity when you place your foot down. Treatment should be considered as soon as possible to prevent these discomforts from becoming chronic and debilitating.
If you do not consult a specialist in a timely manner and your condition is not treated promptly, you may be at risk for complications such as:
- Aggravation of inflammation and thickening of the fascia
- Limping with changes in weight-bearing on the affected foot
- Compensatory pain in the non-affected foot
- Stress fractures secondary to changes in weight-bearing
- The development of fissures within the fascia
- The appearance of associated pathologies such as Achilles tendonitis
In the most advanced stage of the condition, you risk a rupture of the fascia, which is a complete tear in the plantar arch. In the case of fissured plantar fasciitis, the treatment involves total immobilization of your foot with a boot for 3 weeks. This helps reduce inflammation. Often, PRP (Platelet-Rich Plasma) injections performed under ultrasound guidance and rehabilitation sessions with a specialized physiotherapist are combined to allow the fascia to stretch and prevent retraction.
Certain factors can be responsible for this inflammation of the plantar fascia, such as:
- Regular and intense physical activity that significantly stresses your support
- Running on "too hard" and unsuitable surfaces
- Weight-bearing on the front or sides of your foot
- Wearing inappropriate footwear during sports and in daily life
- Orthopedic conditions like flat feet (valgus) or bunions (hallux valgus)
- Handling heavy loads with poor weight-bearing
To make an accurate diagnosis and analyze the inflammation of the fascia that you are suffering from, several tests are prescribed by the foot and ankle specialist.
- An X-ray of your heel to identify a spur, thickening, or microcalcifications
- An ultrasound to evaluate fibrous thickening, inflammation, and fissures
- An MRI for a more precise visualization of joints and "soft tissues" such as muscles and tendons. It also allows a detailed analysis of the plantar fascia and Achilles tendon.
The results of these tests are analyzed by Dr. Lopez, helping to establish a positive diagnosis, form an idea of the severity and associated lesions, and consider an appropriate treatment strategy.
Shoes, Injections, Physiotherapy, or Insoles: Treating Plantar Fasciitis Without Surgery
Whether through injections, physiotherapy, or insoles, plantar fasciitis can be treated without surgery. Dr. Julien Lopez will guide you to a range of non-surgical treatments tailored to your situation. However, surgery is sometimes the only way to relieve your pain and regain pain-free walking.
In case of overweight, the specialist may refer you to dietary follow-up to reduce pressure on your plantar arch and promote the healing of plantar fasciitis.
Physiotherapy follow-up through stretching exercises can also help you regain flexibility in your foot while reducing inflammatory risks.
Choosing shoes adapted to your morphology is also essential. With insoles that provide the best cushioning and a lighter heel, you can reduce pressure on your fascia and alleviate your pain. Heel lifts can also elevate the rear of the foot and avoid pressure on painful areas. Thus, in addition to reducing pain during walking, they limit the risk of complications.
Other solutions exist to support your feet and provide protection against potential impacts. Custom orthoses for your plantar fasciitis or insoles are good examples. Created by a podiatrist specializing in sports pathologies, they allow you to minimize pressure on the tissues of the fascia during sports activities or simply during walking.
Rest and applying ice also contribute to reducing your pain without resorting to surgery.
To relieve your pain, non-steroidal anti-inflammatory drugs and analgesics may be prescribed by Dr. Julien Lopez. However, these are not long-term solutions because your pain will only be temporarily reduced. Medications are part of comprehensive care.
Extracorporeal shock wave therapy aims to stimulate the production of collagen, which forms the majority of the fibers of the fascia. Thus, damaged and inflamed areas will begin their reconstruction without surgery.
Corticosteroid injections and Platelet-Rich Plasma (PRP) injections may be recommended by the specialist in orthopedic pathologies in case of ineffectiveness of previous non-surgical treatments.
If the pain from your plantar fasciitis does not decrease even with orthopedic insoles or other non-surgical methods, percutaneous surgical intervention may need to be considered. This minimally invasive technique is performed on an outpatient basis, under local or regional anesthesia, and reduces tissue trauma compared to traditional open surgery.