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Plantar fasciitis - Management
How should I manage a person with plantar heel pain?

  • Advise conservative measures.
  • Consider prescribing analgesia on an 'as required' basis to relieve pain. Options are:
    • Paracetamol alone, or with the addition of codeine (if paracetamol alone is inadequate and a nonsteroidal anti-inflammatory drug [NSAID] is not suitable).
    • An NSAID: ibuprofen is the preferred.
  • Refer to a podiatrist (or physiotherapist) if, after 3 months, symptoms have not improved with conservative measures.
  • Injection with a corticosteroid (with a local anaesthetic) may be an effective option if the expertise is available. However there is little consensus from specialists regarding optimal use of corticosteroid injections for plantar fasciitis. Discuss the benefits and possible harms with the person before administration.
    • Usually this should only be considered when conservative measures and interventions provided by a podiatrist or physiotherapist have proved inadequate.
    • However, a corticosteroid injection can be considered sooner if symptoms are severe, or are having a significant impact on quality of life, or for people in particular occupations (such as athletes, or people whose job entails standing or walking for prolonged periods).
    • Consider repeating the treatment if symptoms return only if initial treatment was clearly beneficial:
      • Do not repeat if symptoms do not improve initially with the first dose (consider an alternative diagnosis).
      • Wait a minimum of 6 weeks before repeating administration. If the person requires three or more doses, consider referral.

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