Health Answers: Is plantar fasciitis chronic or can it be cured?

Q. Is plantar fasciitis chronic or can it be cured?

A. Plantar fasciitis is a common complaint that derails many people from sports and exercise routines. It’s an inflammation of the plantar fascia — a thick band of tissue at the bottom of the foot that runs between the heel and toes and supports the arch — which results in heel pain. A cause is not always known, but anatomical features (high arches, flat feet), obesity, poor footwear, and activities that stress the heels can contribute.

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Naven Duggal, an orthopedic surgeon at Beth Israel Deaconess Medical Center, admits that plantar fasciitis is “a really vexing problem,” because it has an unpredictable course and does not always have a straightforward solution. “I often describe it as a chronic condition,” he says, but adds that 90 percent of cases of heel pain do get better over time with simple treatments.

The first step is stretching the foot and calf, which Duggal says may require a commitment of daily stretching for several weeks or months. Modifying activities — such as running on a softer surface — and wearing cushioned footwear can help. Some doctors prescribe night splints, arch supports (orthotics), or corticosteroid treatments as well.

Extracorporeal shock wave therapy, which delivers sound waves to the heel, has been found to help some people with persistent pain. Surgery is also an option; it involves removing a portion of the plantar fascia to release tension on the arch. But Duggal says the long recovery time and potential complications make surgery a last resort.

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