• Dr. Jason Rountree

Plantar Fasciitis Pain Relief!

Let's talk a little bit first about what plantar fasciitis is. Then we'll go over how to figure out if that's what you're dealing with. And then we'll talk about a pretty neat review on laser therapy to treat plantar fasciitis pain, how that works, and what the treatment process looks like.


What is Plantar Fasciitis?

Plantar fasciitis is an inflammatory disorder of the plantar fascia. The plantar fascia is just a big, thick band of tissue that runs along the bottom of your foot. You've got one on both feet. And what happens is that gets irritated or stressed or strained somehow and begins to get inflamed. And because of the way that structure is built, it tends to trap inflammatory fluid underneath it.


So once that gets inflamed, what you'll notice is sharp, pretty intense pain on the bottom of the foot, especially when you step down onto it. And that is how we start to get into the diagnosis of this disorder. The classic symptom for plantar fasciitis is those first few steps in the morning become exquisitely painful on the bottom of the heel. Also, if you sat for a while or you've driven a long ways and you go to get out, those first few steps are really painful. And after you've taken a few steps, it starts to get less painful. And in many cases, once you're up and moving throughout the day, it's really not painful at all or minimally painful.


Another way to kind of tell if plantar fasciitis is the right diagnosis is to squeeze each side of the heel, not right on the bottom of the heel, but each side of the heel. If squeezing the sides of the heel is painful, that's one more piece of evidence that probably you have a plantar fasciitis condition. Now, of course, this blog is not meant to replace actual medical care and medical evaluation. If you think this is something they've got going on, if you have any foot pain, it's a good idea to get it checked out.


Many times once you go to get it checked out, if it's been chronic, if you've had multiple issues of pain in the feet, a lot of times we'll get an x-ray of the foot to see if there is a bone spur, because sometimes if you have ongoing inflammation on the bottom of the foot, you'll start to get excess calcification on that plantar fascia, that thick band of tissue. Once you have excess calcium buildup, it'll turn into a bone spur. And that can mean that we have a much more chronic problem to look at, so many times an x-ray will be taken from the side of the foot so you can see if there's a bone spur underneath that heel. And sometimes we'll use diagnostic ultrasound to look at the soft tissues underneath the foot, too, because with chronic plantar fasciitis, you get a lot of degeneration of that plantar fascia. If the generative process goes on for long enough, you can even end up tearing the plantar fascia, which can lead to ongoing dysfunction, dropped arch and some further problems with the foot. That's not going to happen with every case. That's may not happen the first time a person has this, but if you've had a repetitive plantar fasciitis issue it could become a concern.


It's absolutely something you need to get checked out and you need to get some kind of care for, because there can be more than just pain. You can have ongoing dysfunction and disability from this condition, like inflammation progressing to bone spurs, and then tissue tearing even.


Laser Therapy for Plantar Fasciitis

The study that we're looking at with this condition today is titled "Parameters and Effects of Photobiomodulation and Plantar Fasciitis; a Meta-analysis and Systematic Review" and it was published in 2019 in the Journal of Photobiomodulation, Photomedicine, and Laser Surgery. A systematic review is a kind of top level research where the researchers gather a lot of different individual trials and studies together and look at the results overall and then determine, is this particular type of care effective or not?


So "parameters and effects of photobiomodulation" AKA laser therapy or light therapy. That means the researchers were looking at the settings and the effects for laser in plantar fasciitis care over multiple, multiple studies. They say that plantar fasciitis will affect about 10% of people at some point in their life, and every year about 2 million people will seek treatment. What can be done about it? Well, obviously laser therapy must be an option because that's what we're talking about today. But in this study, they do say that many times there are options like stretching exercises, therapeutic ultrasound, anti-inflammatory drugs, shockwave therapy, and cortisone injections.


Why are there so many different options? Well, plantar fasciitis is a little complex. It isn't simple inflammation. You have to get figured out what the cause of that inflammation is. What started it in the first place? Because no matter what therapy you end up going with, if you haven't figured out the cause and the cause is still ongoing, then the therapy you've chosen is not going to be successful no matter how great it is. For example, if you've got the wrong kind of shoes that don't give you enough support and you're overstretching that plantar fascia with every step, you're going to have ongoing irritation.


So even if you take anti-inflammatory drugs and it feels better, as soon as you go to walk in those shoes again, with improper support, it's gonna create a new inflammatory condition. And you're just really never going to feel like you get ahead, even with a cortisone injection. Those that's great at reducing inflammation, but if you don't have proper support in the shoe, then you're just going to create more inflammation every time you're on your feet.


I've also seen a lot of these cases even that trace bank to old sprains of the ankles. A lot of people have rolled their ankles before playing sports or hiking or what have you. If you have stretched ligaments in the ankles that does not give the foot proper support, so then you end up with more strain going into the structure of the foot because the ankle is just not stable. It overworks the foot. If you've got knee instability issues, you walk differently, you put strain on the foot differently too.


And plantar fasciitis, listen, this is more of a symptom than a disease. So you need to figure out what the cause is. And many times you're going to need help figuring that out. So make sure you're getting with a really good physical therapist or chiropractor or family care practitioner. who is really sharp on this and can help you figure out where those movement deficits are.

And I'm going to say that your best bet is really going to be a chiropractor or a physical therapist with additional training in gait management, and foot support and biomechanics.


Once you've gotten that figured out, though, these all these different options are out there right now. You can use anti-inflammatory drugs and stretching, there's bracing, shockwave therapy, cortisone injections, and more. Which way should you be going here? In just about every case, you're going to want to go for the therapy that has the least amount of side effects and the least risk, right? Stretching exercises are always a good idea for pretty much everybody. Your physical therapist is going to be great at getting you some exercises for plantar fasciitis. A lot of chiropractors are gonna do great at that too. Many times your primary care medical providers know a lot of these too, because this is a fairly common condition.


There are nighttime braces that can be worn. We've got good evidence too that shockwave therapy can work well, and while it's not well-proven, therapeutic ultrasound could be used. Anti-inflammatory drugs may be an option out there for a lot of people, but that's where we start talking about having side effects. Cortisone injections have been shown to have a risk of actually rupturing that plantar fascia. So it might make it feel better, but it does weaken those tissues and it makes you more vulnerable to long lasting injury if that plantar fascia actually does rupture. So, if you can go for therapies that are the least invasive, that's ideal.


So the researchers in this particular study that we're referencing today took over 1300 individual experiments and studies and clinical trials on plantar fasciitis and laser therapy; they narrowed it down to seven studies that met their criteria for being very high quality. And what they found is that when infrared laser was used for three times per week for four weeks, patients got better. That's not to say it's going to work for everybody or that nobody's going to need more than that, or less than that, but those were the best results they saw.


Laser Therapy is Safe and Effective for Foot Pain

The researchers reported that laser therapy and light therapy presents no serious side effects like those associated with NSAIDS (non-steroidal anti-inflammatory drugs). It's safe. It works quite well. You're going to have to be a little bit patient and you can't expect it to be immediately perfect. After two or three or four weeks, you should be starting to feel better. You may need more than that, but this can be a really tough disorder. And if you can stay away from some of the more invasive interventions, that is ideal. What I will say though, is that if you're not seeing anything within about four weeks of starting laser therapy for plantar fasciitis, if you're not seeing any change at all, you need to look at some additional or different treatment, maybe consider that you haven't really found the cause yet and you're continuing to strain those tissues.

And again, that is why I'm going to recommend it. You need to get to an expert in biomechanics and foot support and have them evaluate, "am I wearing the right shoes?" "am I walking in a way that puts extra strain on the foot?"


Again, I highly encourage you to look at those treatments with no side effects that are very, very safe and have been proven to work like laser therapy. Call us now to see if laser therapy in Kalispell, Montana could work for you.

Laser Therapy Specialists
  • Instagram
  • Montana Laser Facebook

© 2020 by Montana Laser and Medical Center

1327 US Hwy 2 W, Ste 2

Kalispell, MT 59901