Plantar Fasciitis Treatment Guide | From Conservative Care to Minimally Invasive Therapies

At Physio Center, we provide advanced conservative care to help you recover from plantar fasciitis effectively and safely.

In this article, we’ll walk you through a practical, evidence-based approach to treating plantar fasciitis — a common cause of heel pain. Whether you’re newly diagnosed or struggling with ongoing symptoms, we hope this guide offers helpful insight.

What is Plantar Fasciitis?

Plantar fasciitis is a condition caused by repetitive stress to the plantar fascia — the thick band of tissue running along the bottom of your foot. This leads to microtears and chronic heel pain.
Recent studies suggest the condition is more degenerative in nature (fasciosis) than inflammatory, challenging the traditional "-itis" concept.

A Step-by-Step Approach to Treatment

Treatment for plantar fasciitis typically follows a three-phase progression, depending on symptom severity and duration.

Phase 1: Conservative Treatment (The Starting Point)

The initial focus is on relieving stress on the plantar fascia through lifestyle adjustments and guided exercises.

Key strategies:

• Stretching of the plantar fascia and calf muscles
• Supportive footwear and custom insoles
• Activity modification (reduce high-impact activities, but avoid total rest)
• Taping to manage pain in the short term
• Use of night splints or rocker-bottom shoes if needed

Whenever possible, these exercises and therapies should be done under the guidance of a physical therapist.
Most patients see improvement within several weeks to a few months at this stage.

Phase 2: Minimally Invasive Therapies (If Conservative Measures Aren’t Enough)

If symptoms persist despite proper conservative care, additional interventions may be considered.

Recommended treatments:

• Extracorporeal Shockwave Therapy (ESWT):
  Proven effective for mid- to long-term relief. Often considered the top non-invasive option.
• Platelet-Rich Plasma (PRP) Injections:
  Shows promise in some cases, but variability in formulations limits consistency.
• Corticosteroid Injections:
  May provide short-term relief, but repeated use carries potential risks.

Other treatments such as dry needling, myofascial release, radiofrequency, low-level laser therapy, and prolotherapy have also shown short-term benefits in select cases.

Phase 3: Surgical Options (For Rare, Refractory Cases)

When both conservative and minimally invasive therapies fail to relieve symptoms, surgery may be considered.

Options include:

• Ultrasound-guided partial plantar fascia release
• Percutaneous procedures
• Surgical intervention by a foot and ankle specialist

Fortunately, very few patients require surgical treatment.

Self-Management & Long-Term Care Are Essential

Alongside clinical treatment, consistent self-care plays a critical role in both recovery and relapse prevention.

To prevent recurrence:

Physio Center – Tokyo Jikei Medical University Hospital, E Building, 2nd Floor
 info@physiocenter.jp
TEL  03-6402-7755

Physical therapist： Kosaku Ota