Orthopedic doctors absolutely treat plantar fasciitis, providing comprehensive care from initial diagnosis to advanced surgical solutions. Orthopedic specialists focus on the musculoskeletal system, including the bones, joints, ligaments, tendons, and muscles of the foot and ankle. They possess the necessary expertise to accurately diagnose the issue and differentiate it from other causes of foot pain. They offer a broad spectrum of treatment options, typically beginning with non-invasive therapies and only progressing to surgery if conservative methods fail.
Understanding Plantar Fasciitis
Plantar fasciitis is a disorder involving the thick band of tissue called the plantar fascia, which runs along the bottom of the foot, connecting the heel bone to the toes. This fibrous tissue helps support the arch of the foot and plays a role in normal walking mechanics. The condition is characterized by pain near the heel, which can feel dull, sharp, or stabbing. The most common symptom is severe pain with the first steps taken in the morning or after rest, often improving slightly with movement before worsening later in the day. It is frequently caused by repetitive stress, such as running or long periods of standing, and contributing factors include structural issues, tight Achilles tendons or calf muscles, and excess body weight.
Diagnostic Approach of the Orthopedic Specialist
An orthopedic specialist’s diagnostic process begins with a detailed physical examination and a thorough review of the patient’s medical history. They check for tenderness near the heel bone, a classic indicator of plantar fasciitis, and assess the foot’s range of motion and gait to identify biomechanical factors. While clinical examination often confirms the diagnosis, imaging tests are frequently used to rule out other possible causes of heel pain. X-rays may be ordered to check for a stress fracture or a heel spur, a bony growth that is often present but not the direct cause of pain. In complex or chronic cases, specialized imaging like ultrasound or magnetic resonance imaging (MRI) may be used to distinguish plantar fasciitis from conditions such as nerve entrapment or Achilles tendon issues.
Conservative Treatment Options
Orthopedic doctors overwhelmingly favor a conservative approach, as 80 to 90% of patients experience improvement within 12 months using non-operative methods. The initial phase of treatment focuses on reducing strain and inflammation to allow the damaged tissue to heal. This involves activity modification, rest, and the use of over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to manage pain and swelling.
A frequent recommendation is physical therapy, which includes targeted stretching exercises for the plantar fascia and the Achilles tendon. Strengthening exercises for the lower leg muscles are also important for correcting underlying biomechanical imbalances and improving shock absorption. Furthermore, the specialist may prescribe a night splint, a device that holds the foot in a gentle dorsiflexion position overnight. This sustained stretch helps prevent the intense morning pain associated with the condition.
The use of supportive footwear and orthotic devices is another cornerstone of conservative management. Off-the-shelf or custom-fitted arch supports distribute pressure more evenly across the foot, reducing direct tension on the fascia. If pain persists after several months of these initial treatments, the doctor may consider a corticosteroid injection, which delivers a potent anti-inflammatory medication directly into the tender area for temporary relief. Multiple injections are typically avoided due to the risk of weakening the fascia.
Surgical Considerations for Chronic Cases
Surgery is considered a last resort for plantar fasciitis, reserved for chronic cases that have not responded to six to twelve months of conservative treatment. The goal of surgical intervention is to permanently reduce the excessive tension within the plantar fascia. The most common procedure is a partial plantar fascia release (fasciotomy), where a section of the ligament is cut to relieve strain. This can be performed using an open incision or a minimally invasive endoscopic technique. In select patients, the surgeon may also perform a gastrocnemius recession, lengthening a calf muscle to improve ankle flexibility and reduce tension; recovery typically requires limited weight-bearing and several months for a full return to activity.