Plantar Fasciitis: Acupuncture and Exercises for Pain Management

June 16, 2020 - by Dr. Katherine Chung, ND - in Uncategorized

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Plantar fasciitis is a common problem that many face in their lifetime and costs the U.S. healthcare system $192 – 376 million per year to treat. It accounts for about 15% of foot injuries a year in the U.S. – in 2018, about 1% of the U.S. population reported being diagnosed with plantar fasciitis. The prevalence is higher in the age group of 45 – 64 and the lowest in the age group of 18 – 44. Of those diagnosed, most are women – women are 2.5x more likely to suffer from plantar fasciitis due to the wider hip angle which predisposes their arches to fall/have flat arches. 

What is plantar fasciitis?

Plantar fasciitis is inflammation of the long plantar ligament that causes heel pain (where it connects to the calcaneous (aka heel bone)). There are several risk factors for this, however the top 2 are obesity/prolonged weight bearing and poor foot mechanics. Poor foot mechanics or arch support can cause your arches to fall leading to tension on the plantar ligament causing micro-trauma and inflammation. If you pair this with standing on your feet all day (e.g. cashiers) and obesity, it increases force on that ligament worsening the inflammation.

Plantar fasciitis doesn’t necessarily hurt all day, every day. It is usually most painful after prolonged inactivity (e.g. sitting for long periods of time or first thing in the morning) – the first few steps will cause the most agony. 

Treatments for plantar fasciitis

Technically, plantar fasciitis is considered self-limiting (i.e. will get better without treatment) however, it can take up to 18 months resolve on its own. Now, I’m not sure about you but 18 months of pain at the bottom of my foot does not sound enjoyable at all!

There are a variety of different treatments you can do to reduce healing time and get back on your feet quicker. I have found a mixture of acupuncture, chiropractics, massage therapy, and at home treatments to be the most effective.

Acupuncture

Acupuncture is an extremely effective way to treat plantar fasciitis.

It works in 2 ways:

  1. It will increase circulation to the local area to help flush out pro-inflammatory metabolites and introduce fresh blood and proteins into the area. 
  2. It can also reduce  pro-inflammatory proteins and neurotransmitters that send pain signals from the plantar fascia to the brain to be recognized as pain
 

For my students and practitioners out there – here is a great protocol I have used to successfully treat plantar fasciitis.

  • Target low back/hip pain that tends to present with plantar fasciitis PLUS plantar fascia pain using non-local points
    • Right: LU5-10A, HT3-8A (needling where you feel resistance or patient notes pain upon palpation), BL40, 60, 64
      • These points mirror the low back (proximal points) and the foot (distal points)
    • Left: LI4.5, LI3.5, SJ3.5, SI4
      • These points are some of the best points for back pain
    • Local points: KD2, 4, 7, 1, prime, 5-6A, N-LE-48 (Chuqixue, 0.5 cun posterior to KD2), Ashi points below feiss line
      • Notice how all these points are kidney points? The kidney meridian is the only meridian that flows through the bottom of the foot and the most indicated for local needling
      • N-LE-48 (Chuqixue) is one of the best points for plantar fasciitis 
At home treatments for acute flares and prevention

For acute flares: 

Rest and ice the plantar fascia – no need to do past 24 – 48 hours

For 48 hours after acute flare:

  1. Heat or alternating hot and cold for 5 cycles ensuring to end on cold
  2. Stretch – especially after inactivity/first thing in morning. Take a towel and put under toes/ball of the foot and pull towards you. Hold for 30 seconds then rest, do 5 times
  3. Using tennis ball or golf ball – roll along bottom of foot and spend extra time rolling over more uncomfortable areas 
  4. Consider a night splint or Strasoburg sock overnight to stretch out fascia

Diet and Nutrition
 
There is plenty that you can do to help with acute/chronic pain and inflammation through diet and nutrition. To learn more the top 3 nutritional changes you need to do today to reduce your pain click here.
 
References

Nahin RL. Prevalence and pharmaceutical treatment of plantar fasciitis in United States adults. Journal of Pain. March 26, 2018. ncbi.nlm.nih.gov/pubmed/29597082

Vizniak N. “Plantar Fasciitis”.Orthopedic Conditions. Prohealth sys. 2018.

Young CC. “Plantar Fasciitis”. Medscape emedicine. https://emedicine.medscape.com/article/86143-overview. Updated Jan 22, 2019.

 

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Dr. Katherine Chung, ND

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