Plantar fasciitis medical therapy
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Many different treatments have been effective, and although it typically takes six to eighteen months to find a favorable resolution, plantar fasciitis has a generally good long-term prognosis. The mainstays of treatment are stretching the Achilles tendon and plantar fascia, resting, keeping off the foot as much as possible, discontinuing aggravating activity, cold compression therapy, contrast bath therapy, weight loss, arch support and heel lifts, and taping. To relieve pain and inflammation, non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen are often used but are of very limited benefit. One small, placebo-controlled study has shown a beneficial effect from glucosamine.
Care should be taken to wear supportive and stable shoes. Patients should avoid open-back shoes, sandals, and flip-flops.
Custom foot orthoses may. or may not be more effective than prefabricated foot orthoses. Among prefabricated orthoses, foam covered rigid self-supporting plastic orthotic may be better than other orthoses.
Compared to other therapies, randomized controlled trials have found:
- Orthoses are more effective than night splints. 
Local injection of corticosteroids often gives temporary or permanent relief, but may be painful, if not combined with a local anesthetic and injected slowly with a small-diameter needle. Recurrence rates may be lower if injection is performed under ultrasound guidance.
Night splints can be used to keep the foot in a dorsi-flexed position during sleep to improve calf muscle flexibility and decrease morning pain. Pain with first steps of the day can be markedly reduced by stretching the Achilles tendon before getting out of bed. Patients should be encouraged to lessen activities which place more pressure on the balls of the feet. Over-the-counter arch support may help, and prescription orthoses are often prescribed. These can be made of many different materials, some of which may be hard and may press on the origin of the plantar fascia. Softer, custom devices, of plastizote, poron, or leather, may be more helpful. Orthoses should always be broken in slowly.
Ultrasonic shock waves
Ultrasonic therapy, also called ultrasonic shock waves or extracorporeal shock wave therapy, is a nonsurgical procedure, but must be done either under local anaesthesia either with or without intravenous sedation (twilight sedation). Ultrasonic shock waves can be classified as high power (electrohydraulic) and low-power (electromagnetic). Pulses of 0.34 mJ/mm2 or more require a regional nerve block. However, the use of local anesthesia reduces effectiveness. The proposed mechanism of ESWT is "destroying sensory unmyelinated nerve fibers and eliciting neovascularization in degenerative tissues".
Meta-analyses of trails have found:
- When all trials of over 100 patients are meta-analyzed, pain is reduced. However, there is no dose response effect, uncertain blinding, and no apparent registration of trials at public registries. (see Forest plot) .
- Low intensity ('energy <0.20mJ/mm2) to be significantly more successful than sham whereas high intensity (energy >0.2mJ/mm2) was not beneficial.
- Moderate (0.1 - 0.2 mJ/mm2) and high (> 0.2 mJ/mm2) may be more effective than low-energy (< 0.1 mJ/mm2) intervention.
Predictors of benefit include:
- Absence of radiographic plantar spur. Among patients with heel spurs, focusing therapy on the patient's indication of the most painful location may be better than focusing on the location of the heel spur.
- Focused waves may or may not be more effective than radial waves.
- Using maximum tolerated impulse density. 
- Local anesthesia reduces effectiveness, perhaps because the patient cannot direct the operator to the most tender location.
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- McMillan AM, Landorf KB, Gilheany MF, Bird AR, Morrow AD, Menz HB (2012). "Ultrasound guided corticosteroid injection for plantar fasciitis: randomised controlled trial". BMJ. 344: e3260. doi:10.1136/bmj.e3260. PMID 22619193.
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- Janet Cromley (November 13, 2006). "A foot hold that spurs healing". Los Angeles Times.
- Digiovanni BF, Nawoczenski DA, Malay DP, Graci PA, Williams TT, Wilding GE, Baumhauer JF (2006). "Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up". The Journal of bone and joint surgery. American volume. 88 (8): 1775–81. PMID 16882901.
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- Chang KV, Chen SY, Chen WS, Tu YK, Chien KL (2012). "Comparative effectiveness of focused shock wave therapy of different intensity levels and radial shock wave therapy for treating plantar fasciitis: a systematic review and network meta-analysis". Arch Phys Med Rehabil. 93 (7): 1259–68. doi:10.1016/j.apmr.2012.02.023. PMID 22421623.
- Ultrasonic shock waves for plantar fasciitis: a living systematic review. GitHub. Available at https://github.com/openMetaAnalysis/Ultrasonic-shock-waves-for-plantar-fasciitis/. Accessed Aug 17, 2015
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- Lohrer H, Nauck T, Dorn-Lange NV, Schöll J, Vester JC (2010). "Comparison of radial versus focused extracorporeal shock waves in plantar fasciitis using functional measures". Foot Ankle Int. 31 (1): 1–9. doi:10.3113/FAI.2010.0001. PMID 20067715.
- Chow IH, Cheing GL (2007). "Comparison of different energy densities of extracorporeal shock wave therapy (ESWT) for the management of chronic heel pain". Clin Rehabil. 21 (2): 131–41. doi:10.1177/0269215506069244. PMID 17264107.