Evidence brief
Plantar Fasciitis Treatment: Evidence-Based Approach
Plantar fascia-specific stretching superior to Achilles stretching
Most cases resolve with conservative treatment
Night splints, orthotics provide benefit
Steroid injections short-term benefit only
Surgery reserved for recalcitrant cases
Plantar fasciitis is self-limiting in most cases. Evidence supports tissue-specific stretching as first-line treatment, with surgery rarely needed.
Know conservative treatment ladder: stretching (windlass mechanism), orthotics, night splints, physical therapy. Injections: short-term benefit, risk of rupture. ESWT has some evidence. Surgery: plantar fascia release ± gastrocnemius recession. Distinguish from other causes of heel pain.
DiGiovanni BF et al. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. J Bone Joint Surg Am. 2003;85(7):1270-1277.
Level I
Systematic review of RCTs or high-quality RCT