What didn’t cure my plantar fasciitis

As I recounted in a previous post, I apparently have cured my plantar fasciitis by going against medical advice and walking barefoot whenever possible. In this post, I would like to review the medically prescribed treatments that didn’t work. I tried quite a few approaches over several years, and I eschewed only the final, most draconian alternative. Some of these treatments border on quackery.

Tried and worked

Stretching has helped to alleviate my symptoms and perhaps has contributed to my eventual cure. However, by itself or in combination with any other medical advice or intervention, it was insufficient. Now I feel fine without stretching regularly.

Tried and didn’t work

• I underwent physical therapy, consisting mostly of ultrasound, stretching, and massages. This actually increased my pain on a day-to-day basis. Usually, it became excruciating about an hour after I left the therapy center, even if I was sitting down.
• I had a very expensive shockwave operation, under general anesthetic, as a next-to-last resort. I had developed doubts about the treatment’s efficacy after agreeing to it. The brochure explaining the procedure noted that something like 60 percent of patients experienced a successful recovery from plantar fasciitis, but in a footnote it said that a slightly lower percentage of patients recovered fully if they simply skipped the operation and followed the post-op instructions to rest for a month. That is, the main benefit of the shockwave therapy was to get patients to rest! Sadly, it didn’t work for me.
• I received cortisone injections at least twice. In neither case did I receive any perceptible, lasting benefit. Amazingly, the doctor suggested a third attempt, just in case. Perhaps equally distressing, one time he applied local anesthetic to the wrong foot and started aiming the very long needle at it. When I reminded him that my left foot was the right foot, he decided to make up for lost time by not waiting for the local anesthetic to take effect. I remember very clearly having that  long needle pushed slowly into the bottom of my foot.
• I was prescribed and fitted for expensive orthotic inserts for my shoes. These kept my feet from having to adjust to support my weight as I walked. That is, they weakened my feet while protecting them from injury. However, wearing them did not cure my condition. Several times, I became pain-free for a significant period. So I would begin to ease out of using the orthotic all the time. The pain recrudesced every time.
• A orthopedic specialist practically prescribed particular athletic shoes for me to wear.  Apparently, they were designed to structure my footfall to make it as different from walking barefoot as possible – lots of cushioning and support. My problem began to diminish only when I chose to junk the shoes and walk barefoot. I now happily wear the least-coddling shoes possible. Also, doctors told me that dress shoes, with heels, would be the best kind of shoe and would not need an orthotic insert. My experience has been that wearing them results in the most pain.
• Doctors cavalierly told me – a reasonably fit man then about 40 years old – that I might have to stop running for the rest of my life. Gullible, I took them at their word, but I believe that this inactivity only prolonged and exacerbated my problem by weakening my feet.

Not tried

Finally, the orthopedic surgeon who had helped to perform the shockwave operation told me that the only remaining treatment had the highest success rate. He would open up the bottom of my foot and indiscriminately cut half of my fasciae. He told me that he had no idea why this procedure worked, he could not even see which fasciae were damaged. I feared that this operation would permanently weaken my foot, reducing my capacity for high-intensity athletic endeavors. I suspect that much of his success rate with this operation was due to: 1) disgusted former patients refusing to continue contact with him, which is how I reacted to the shockwave operation, and 2) as with shockwave, the benefits of forced, post-operative rest.