Plantar fasciitis and its treatments don't make sense - Upright Health

Plantar fasciitis and its treatments don’t make sense

Imagine waking up in the morning, putting your foot down on the floor, and feeling like someone had replaced your carpet with a sheet of thumbacks (pointy-side up). That’s roughly what it’s like to have a real good bout of plantar fasciitis. It’s not pleasant, but what’s even less pleasant is the list of standard treatments for it.

The list of treatments includes, ice, heat, stretching, pills, orthotic inserts, cortisone injections, and — of course when all else has failed — surgery!

A few months ago, NPR ran a story about a brand new therapy for plantar fasciitis called schock-wave therapy that’s catching on in the U.S.

It’s like shock and awe for your feet and your pocketbook.

The main idea is to blast your foot with micro trauma so that the fascia (connective tissue) of your feet have to heal.  “Micro-bleeding” is the term a surgeon from Massachusetts uses in the article.  Hopefully, it makes the pain go away.  The price tag: from five hundred to several thousand dollars.  Effectiveness: unknown.

The problem is that the theories of what is going on with plantar fasciitis keep changing, so the technology and approaches keep getting more elaborate.

Many think that plantar fasciitis is caused by heel spurs, bony hook-like growths that develop on many people’s heels due to stress. But specialists don’t think that anymore.

As ideas of what plantar fasciitis is change, so have treatments. Doctors don’t do surgery for it anymore except in rare cases, largely because they’ve found surgery often makes people worse off.”

Patients have to be patient,” Duggal says. “They have to understand that this condition unfortunately is not fully understood.” [emphasis added]

via Experimental Therapy For Sore Heels Has Skeptics : NPR

The point here is that the focus on the symptomatic site forces the medical system to look at a body-wide problem as a mysterious local problem. This leads to an incomplete understanding of what’s happening.  And this incomplete understanding yields treatments that don’t make sense and often don’t work.

When the treatments don’t work, doctors either have to invent new treatments (like shockwave) or resort to the worst option of all: surgery.

If your foot hurts, look higher up! Look for knee alignment.  Look for proper hip mobility.  Look at the mid and upper back and see how extreme the curves are.

In my practice and in my personal life, I’ve noticed a correlation between a strong curve in the mid and upper spine and the symptoms of plantar fasciitis. It’s not 100% causative, but it’s definitely involved!  Hip mobility is also involved. Stretching the calf muscles alone barely makes a dent in the pain experienced with plantar fasciitis because it’s too narrowly focused.


About the Author

Matt Hsu is a trainer and orthopedic massage therapist. He fought a long battle with chronic pain all over his body and won. He blends the principles he learned in his journey, empirical observations with clients, and relevant research to help others get their lives back.