Plantar fasciitis is painful inflammation that occurs in the arch of your foot usually near the heel. Most people who suffer from plantar fasciitis complain of a very painful first step in the morning and often pain after sitting for long periods of time. The pain is described as a sharp burning sensation in the heel or pain in the arch. Unfortunately many people continue to suffer from plantar fasciitis until the tension on the plantar fascia is relieved.
When a collapsed arch increases the tension on the plantar fascia, then raising of the arch back to its correct position may reduce the tension and hence reduce the pain. Pain relief is the goal of all treatments.
A custom orthotic can create this change but not all orthotics are created equal. Unfortunately, at times what are considered “custom orthotics” does not even attempt to raise the arch of the foot. Many medical professions cast the foot in a position where the arch is already halfway collapsed. This “orthotic” would not have a chance of supporting the patient’s arch correctly.
While plantar fasciitis treatment may include non-steroidal oral medication, local steroid injections, icing and stretching exercises, the main focus of treatment should be addressing the biomechanical imbalance in which orthotic devices plays a major role.
Arch supports that are not custom (i.e. over the counter) may be useful in patients with acute plantar fasciitis as well as mild pes planus (flat feet). Relief of pain is variable depending on the type of material the orthotic is made from. Some over the counter supports may be too soft and will most likely collapse over time and with heavy use. It is recommended that the patient seek a device that has the more dense material that is soft enough to be comfortable on but provides the proper support to ensure adequate relief of tension and pain from the stressed plantar fascia.
Custom orthotics are usually made by taking an impression of the patient’s feet and thereby constructing an insert specifically designed to control biomechanical risk factors that may be contributing to the patient’s plantar fascial heel pain. The most commonly recommended prescription for custom orthotics for individuals with plantar fasciitis calls for semi-rigid, three-quarters to full-length orthotics with longitudinal arch support. The successful treatment of plantar fasciitis with orthotics should control over-pronation in addition to metatarsal head motion, specifically focusing on the head of the 1st metatarsal (big toe joint).
Construction of a custom orthotic after a negative plaster impression is created may be created from a material called Spenco which is a closed-cell neoprene impregnated with nitrogen bubbles. The orthosis is composed of a shell, which is a layer of material against the foot and a posting, which is the material that fills in the space between the shell and the shoe. Additional materials may be added to the orthotic to further provide customization based on the needs of the patient to correct the biomechanical imbalance that may contribute to the plantar fascial pain.
If over the counter supports or conservative treatments such as oral medications and steroid injections do not provide the adequate treatment that a patient is looking for, then custom orthotics are highly recommended not only for the short term treatment but more importantly for the long term as well. If you feel that custom orthotics may be the treatment that best fits your needs, don’t hesitate to schedule an appointment with Absolute Foot Care Specialists so that we may fit you for your very own pair of custom orthotics to allow your feet to have a healthy life, pain free!