Can plantar fasciitis heal on its own?

In about 30% of cases, symptoms resolve spontaneously within 6 to 12 months. However, treatments significantly accelerate healing and prevent recurrence.

Are stretches really effective?

Yes, they are the most important treatments. Specific daily stretches of the plantar fascia and triceps surae (calf) provide excellent long-term results.

Is cortisone injection risky for the plantar fascia?

Yes, if repeated. More than 2 to 3 injections increase the risk of plantar fascia rupture. Therefore, cortisone is reserved for acute flare-ups and should be performed under ultrasound guidance.

Are shockwaves painful?

Some discomfort is felt during the session, but it is well tolerated. The discomfort disappears quickly after treatment. Focal shockwaves are more intense than radial ones but also more effective.

When should surgery be considered?

Surgery (plantar fascia release) is rare, considered only after 12 to 18 months of failure of all conservative and interventional treatments. PRP and shockwave therapy offer effective alternatives that often avoid surgery.

Plantar Fasciitis: Effective Treatments from Conservative to Injection Therapy

Plantar Fasciitis: A Common Cause of Heel Pain

Plantar fasciitis (or plantar aponeurositis) is the most common cause of pain under the heel. It affects both athletes and sedentary individuals. This condition involves inflammation or degeneration of the plantar fascia, the band of fibrous tissue that supports the arch of the foot.

Characteristic Symptoms

The most typical sign is first-step pain in the morning or after a period of inactivity — the famous "first-step pain." The pain subsides after a few minutes of walking but may return at the end of the day or after prolonged standing.

Conservative Treatments (First Line)

Before considering more invasive interventions, several conservative approaches are tried:

Plantar fascia and Achilles tendon stretching: essential daily exercises (wall stretch, rolling a tennis ball under the foot)
Orthotics: custom insoles or cushioned heel pads
Appropriate footwear: avoid flat shoes, opt for a slight heel
Ice: massage the fascia with a frozen water bottle (5 to 10 minutes)
Anti-inflammatories: short course to calm the acute phase

Second-Line Treatments

If conservative treatment fails after 6 to 8 weeks:

Radial or focal shockwave therapy: proven efficacy for chronic plantar fasciitis. 3 to 5 sessions one week apart. Success rate of 60 to 80%.
Ultrasound-guided cortisone injection: rapid but temporary relief (4 to 8 weeks). To be used with caution, limited to 2 to 3 injections to avoid fascia rupture.
PRP (platelet-rich plasma): increasingly used for chronic cases, promotes tissue healing rather than simply reducing inflammation.

In most cases, a combination of conservative measures and second-line treatments leads to complete recovery within 6 to 12 months, with surgery reserved for rare refractory cases.