Relieving Plantar Fasciitis Discomfort

Now that we are into our warmer weather, many of us will take up running outside. One of the common discomforts that can arise with running, indoors and outdoors, is plantar fasciitis. It is the most common cause of heel pain. The plantar fascia is the flat band of tissue (ligament) that connects the heel bone to the toes. It supports the arch of the foot. If the plantar fascia becomes strained, it can weaken, become swollen, and inflamed. This can result in pain in the heel or in the bottom of the foot while standing or walking. It can happen in one foot or both feet.

Plantar fasciitis is caused by straining the ligament that supports the arch. Plantar fasciitis most often occurs because of injuries that have happened over time. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling. There are many causes that can lead to this: excessive pronation which is rolling the feet inward while walking; having high arches or flat feet; walking, standing, or running on hard surfaces for a long period of time; wearing unsupportive shoes; and having a tight Achilles tendon. Another common cause of plantar fasciitis is arthritis. Certain types of arthritis can cause inflammation to develop in tendons, resulting in plantar fasciitis. This cause is particularly common among elderly patients. Some patients with plantar fasciitis also have a heel spur, which is an abnormal growth of the heel bone. The heel spur is not the cause of the plantar fasciitis but may coincide with it and cause further pain already induced from the plantar fasciitis.

One of the most common complaints associated with plantar fasciitis is a burning, stabbing, or aching pain in the heel. This discomfort is more apparent in the morning upon waking because the fascia ligament tightens up during the night while sleeping, causing pain to diminish. Although, after rising out of bed and placing pressure on the ligament, it becomes tight and pain is particularly acute. This pain will usually decrease as the tissue warms up, but may easily return again after long periods of standing or weight bearing, physical activity, or after getting up after long periods of lethargy or sitting down.

There are several options for treatment in Western medicine. They include giving the foot a rest bycutting back on activities that increase the pain; avoid walking or running on hard surfaces; icing the heel; using over-the-counter pain relievers; doing calf stretches  (especially when first waking in the morning); using a shoe with good arch support and a cushioned sole; using heel cups or shoe inserts (orthotics).  If these treatments do not help, the doctor may suggest splints to wear at night, steroid shots into the heel, or other treatments. Surgery is usually only suggested if the pain has not subsided after trying other treatments for 6 to 12 months.

Traditional Chinese Medicine (TCM) is a great way to treat the symptoms associated with plantar fasciitis. There are several modalities used to treat the pain associated with plantar fasciitis. These include acupuncture, moxibustion, and Chinese herbs.  All of these are helpful to relieve the pain and inflammation.

Acupuncture is a treatment of using fine, thin needles placed in specific acu-points along the meridians of the body. The meridians are the pathways that the qi (energy) runs throughout the body. If the qi becomes blocked along the meridians, many symptoms can arise-such as pain, insomnia, digestive issues, and many other ailments. Acupuncture, and all TCM therapies, balance this qi and keep it in check-which results in health and harmony throughout the body. The acupuncture needles are placed in various parts of the body and not always necessarily where the symptom is-especially with pain. A diagnosis is made to see where the imbalance of qi is and then that specific meridian is treated. For example, plantar fasciitis pain is in the heel of the foot and the “Kidney” meridian is one of the meridians which runs along the heel of the foot. So, there may be an imbalance within the “Kidney” meridian therefore, the needles may be placed along the Kidney channel which runs up the leg and into the torso. So the needles may be placed in distal areas and will still being relief from the pain.

Moxibustion is a treatment of using a blend of Chinese herbs that are burned over specific acu-points and/or areas that are painful. Moxibustion works in a similar manner as acupuncture in that it balances the qi in the body. It is also helpful in circulating blood throughout the body for nourishment to all muscles, tissues, and organs. The moxibustion comes in several forms but a commonly used form is in a roll that is lit with a flame and once the herbs begin to burn,  the “moxa-roll” is then gently moved over the area of the body as needed. The herbs’ medicinal actions help to soothe an achey muscle and bring more blood to an area that needs nourishment for healing.

Chinese herbs are a wonderful therapy to use for all kinds of pain in the body, including plantar fasciitis. Chinese herbs come in different forms: teas, tablets, tinctures, granules, and powders. They are powerful medicinals that are safe to use with most medications without interfering. Plantar fasciitis includes inflammation of the tissue which is thought of as a “warm” type of pathogen in TCM. Herbs that can help to cool the inflammation and nourish the muscle itself may be recommended to alleviate the heel pain. Specific herbs are also recommended in helping to nourish the blood, as the moxibustion does, but the Chinese herbs are used internally and have a stronger effect. Also, Chinese herbs are helpful in relieving arthritis, which can cause plantar fasciitis pain.

Pain is a symptom that is easily alleviated with TCM and usually results in decreased pain within the first few sessions. Treatment plans vary from patient to patient, depending on their degree of pain, how long they have had the pain, the amount of activity they are involved in, and many other factors. Once the pain symptoms are alleviated, then TCM therapies are used as a maintenance and preventative medicine to keep the plantar fasciitis in check-which leads to a continual flow of balance and harmony of qi throughout the mind, body, and spirit.

Caroline Jung, Dipl. Ac., MSOM