Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Managing Your Heel Pain is an interactive program to help you understand what causes heel pain, what you can do to ease the pain, and how to keep it from returning.
The plantar fascia is a thick ligament on the bottom of your foot. If it is repeatedly overstretched, it can become inflamed and painful, a condition we call plantar fasciitis. This common condition is not serious, but it can be uncomfortable.
The plantar fascia is a strong ligament that runs the length of your foot from the heel bone to the toes. Although it is strong, it is not very elastic, so repeated movements, such as running, can overstretch it and partially tear or pull it away from the heel bone. The plantar fascia can also overstretch or tear at the arch.
Usually, the symptoms begin gradually, but after several weeks, the pain gets worse and does not diminish. Generally, there is no swelling or bruising in the area. However, you may feel tenderness when you apply deep pressure to the heel pad or the arch.
Plantar fasciitis causes a number of symptoms that include:
Pain can last for several weeks or months and can range from mild to severe. Plantar fasciitis will likely go away on its own, with rest, but it may take several months or longer to resolve completely. There is treatment to help you recover faster.
We usually diagnose plantar fasciitis by asking you about your symptoms and physically examining your foot. We may order an imaging study, such as an X-ray, if we suspect that your symptoms may be caused by another condition, such as a stress fracture, but this is rare.
Excessive strain on the plantar fascia causes plantar fasciitis. Over time, this strain can tear the plantar fascia. Repeated stretching and tearing causes pain and inflammation. You may feel pain where the plantar fascia attaches to the heel bone, on the side of your heel, or in the arch area of your foot.
There are a number of factors that can increase the likelihood that you will develop plantar fasciitis including:
There are a number of things you can do to protect your feet and prevent injury to your plantar fascia:
It may take 3 to 12 months for your plantar fascia to heal completely. Treatment can help your foot heal faster. We recommend using a number of treatment approaches simultaneously, including home treatments and medical treatments. It is important that you continue treatment until you have been pain-free for at least 3 months.
The majority of people with plantar fasciitis recover within 3 to 9 months without the need for more aggressive treatment. In rare cases (less than 1%), surgical treatment may be considered.
Rest your foot for 2 to 6 weeks. Stand, walk, or run less.
While your foot is resting, try exercise that does not stretch your arch, like swimming or cycling.
Shoes and devices that support your foot can help protect your plantar fascia and allow it to heal. We recommend a combination of the following footwear and devices:
Massage the painful area with ice for 2 to 3 minutes, several times a day.
Stretch your calf muscles and Achilles tendon. It's important to stretch before and after you exercise. We recommend that you warm up a little and then stretch at the beginning of your exercise program, if possible.
If the home treatment methods do not completely resolve your symptoms, we may recommend additional treatments that may include:
We may recommend a cortisone injection to reduce inflammation and accompanying pain. Cortisone is a steroid that mimics natural hormones that reduce inflammation.
Nonsurgical treatments are effective for most people. However, if your symptoms are severe and other treatments have not worked for at least 6 to 9 months, plantar fascia release surgery may be an option.
Plantar fascia release surgery involves cutting part of the plantar fascia in order to relieve some of the tension on the ligament.
We may perform the surgery using tiny incisions (endoscopic surgery) or a traditional open incision on the bottom of your heel. Both types of surgeries are performed in our outpatient surgery center, and you will be able to go home the same day.
Most people recover within 4 to 12 months. You will need to wear a walking cast for several weeks after surgery. We will also advise you to use foot orthotics after the surgery on an ongoing basis.
For most people, this surgery is successful and their pain is significantly reduced. However, as with any surgery, there are a number of potential risks and complications that we will discuss with you before your surgery. These include:
Plantar fasciitis is a common cause of foot pain, and there are a number of effective things you can do at home to reduce pain and allow your plantar fascia to heal. We recommend that you try home treatments, including wearing semirigid arch supports and doing calf and plantar fascia stretches regularly, for several months. We may also arrange for you to attend a class about plantar fasciitis that explains the condition and the treatment options that are available.
If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you. Surgery is rarely indicated for plantar fasciitis, and we will generally try other treatments, such as cortisone injections and/or custom orthotic inserts, first.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
I will recommend you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.