Plantar fasciitis is a painfully frustrating injury because it tends to heal
slowly and reoccur frequently. Overuse or overpronation can cause micro-tearing and inflammation of the plantar fascia. The body copes by putting a patchwork of fibers over the damaged area. But this scar tissue isn't as resilient as healthy tissue, making the plantar fascia vulnerable to further injury. If you've had heel pain for more than three months, tried other therapies with no success, and are willing to pony up for relief, ask your doctor about these innovative procedures.
Learn the 10 laws of injury prevention.
Extracorporeal Shock Wave Therapy
Focused sound waves break up scar tissue and encourage collagen production, which helps heal the area. High-energy therapy works in one treatment but is painful, so sedation is required. You stay awake for low-energy therapy, but you'll need multiple sessions.
Research reports an 82 percent cure rate in patients who didn't respond to other treatments. Clint Verran, a marathoner and physical therapist who uses the low-energy version, gives it high marks: "After the first treatment, you'll feel like the area has been stretched out. After two more sessions, you'll notice a dramatic improvement."
About $150 per session; covered by some insurance plans
Blood is drawn and spun down into concentrated platelets that are then injected into the injured area. Platelets contain growth factors, which stimulate the regeneration of tissue.
Most studies have been done on ligaments and tendons, but emerging research on plantar fasciitis is promising. Washington, D.C., podiatrist Stephen Pribut says it could be the sports-medicine treatment of the future, but it's not yet practical for recreational athletes.
About $1,000 to $2,000; usually not covered by insurance
Protect your feet from injury with this guide.
Botulinum toxin is injected into plantar fascia to cause nerve paralysis and reduce pain and inflammation.
In one study, plantar fasciitis sufferers reported a significant reduction in pain following treatment. But more research is needed, says Pribut, to see if effects are long-term. Also, Botox may block the pain, but not cure the injury.
About $350 to $500 per session; usually not covered by insurance
A needle is used to puncture the plantar fascia of your numbed foot. This breaks up scar tissue and causes minor bleeding, which recruits blood cells to heal the tissue. Some doctors follow up with a steroid injection.
A study reported a 95 percent cure rate for dry needling combined with steroids. Though that may not even be necessary. "I use dry needling alone, and it's about 90 percent effective," says Levon Nazarian, M.D., of Thomas Jefferson University in Philadelphia.
$150 to $250 per session; covered by some insurance plans