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CORTISONE (HYDROCORTISONE)
Very commonly given by doctors, cortisone can be seemingly effective in what is termed "first flush" plantar fasciitis (an early and short-lived burst of heel/arch pain that "fades out" over weeks leading the sufferer to think it has gone, only to return later with a vengeance!)
However, for plantar fasciitis, these painful injections will very rarely ever offer a "cure" - simply because the biomechanics of the foot have not been corrected and, whilst cortisone can be excellent in other musculoskeletal problems or injuries, its effects soon wear off in foot pain cases and the pain returns to a greater degree.
There is a small limit to the number of cortisone injections your doctor can safely give you without weakening the tissue. These individual jabs wear off quickly and can only "work" if the doctor locates the exact spot which can prove tricky! (these injections are also extremely painful.
Best avoided
 "OFF-THE-SHELF" ORTHOTICS “a steel orthotic”
These merely push your foot from one wrong position to the next. Avoid these at all costs! The long term implications can be disasterous
 PRESCRIPTION ORTHOTICS “Various failed prescription orthotics”
These tend to be either too rigid and irritate the area it is supposed to heal or they act as "pads" in the case of "soft" orthotics.
 HEEL GELS “Heel gels (not recommended!)”
These cup the heels with gel which allow the feet to "shift" at the heel area which can make tearing at the heel worse in the long term, although these may appear to give temporary relief
PHYSIOTHERAPY AND SIMILAR (OSTEOPATHY, CHIROPRACTIC, MASSAGE ETC)
Any treatment regime whether ultrasound, massage, manipulation, acupuncture etc can only offer temporary relief and is therefore a waste of time and money unless the source of the pain is corrected with orthotics prior to treatment (and even then is rarely necessary)
 PAINKILLERS / ANTI-INFLAMMATORIES (CREAMS OR TABLETS) “off-the-shelf remedies”
Short-term relief which, along with all the long term side effects these drugs bring, will merely mask the pain and allow you to use the foot when nature is telling you not to. In other words, you can do more harm to your condition this way
 STRETCHING EXERCISES OR NIGHT SPLINTS
“The infamous night splint”
Beware! In cases of plantar fasciitis and many metatarsal conditions, the "strut" under your foot (the plantar aponeurosis) is inflamed and micro-torn. Most medical practitioners, with the best will, give you stretching exercises. These can make the problem worse and are best avoided at all costs as they can simply worsen the tearing and inflammation.
STRAPPING
Strangely, this is fairly effective if done daily and properly by a physiotherapist but is time consuming and generally requires a "live-in" practitioner (very costly!) and is therefore completely impractical and laborious. Also it limits how many showers or baths you can have, so its effect is anti-social!
OPERATIVE PROCEDURES
It has been estimated that 20% of the population have calcaneal spurs and never suffer a single symptom. Heel "spurs" only occur on some patients with arch and heel pain so we can therefore conclude that spur formation is non-symptom-producing. The NHS very rarely carry out this procedure anymore.
Operations to the plantar aponeurosis also make no sense as, if "lengthened", its rigid "body" still exists and merely carries on tearing and inflaming in its new longer shape!
Any operative procedure also carries a major risk of going wrong and causing new or more severe problems, especially in the foot where surgery is in its infancy
HERBAL / CHINESE OR ALTERNATIVE MEDICINE
The same problems occur as with painkillers (see painkillers/anti inflammatory section)
 ELECTROTHERAPY TREATMENTS
Short-wave or similar electrotherapy treatment including ultrasound, laser and interferential may induce short-term relief but simply cannot cure these problems as the cause has not been firstly corrected.
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