Heal Your Aching Heel! Acupuncture for Plantar Fasciitis
Inflamed plantar fascia—a common cause of bottom-of-the-foot pain
You wake up from a solid night of sleep, turn off your alarm, and are ready to head out for your morning run (New Year’s resolution unlocked!). You get out of bed and take a few steps, and already your day is off to a less-than-stellar start. Yup, it’s the unmistakable stabbing pain of plantar fasciitis, also known as plantar heel pain. And while it’s a relatively common condition–it’s estimated that 10% of people may experience plantar fasciitis in their lifetime (Cotchett et al., 2010)--there is no clear cut Western treatment providing consistently effective results. Fortunately, acupuncture and other Chinese medicine modalities can help treat the nagging pain of plantar fasciitis.
What Is Plantar Fasciitis?
Plantar fasciitis is a common cause of heel pain. It is caused by repetitive microtrauma causing degradation of the fascial fibers on the bottom (“plantar” surface) of the foot. Some note that the term “fasciitis” can be a misnomer. as the degeneration of the plantar fascia can take place with or without inflammation; it has been suggested that the term “fasciosis,” describing a degradation of the tissue on the cellular level, is a more accurate description of the condition.
Degradation of the fascial fibers can cause the tissue to calcify, which can in some cases also result in a heel spur forming. Not everyone with plantar fasciitis has a heel spur, and not everyone with heel spurs has foot pain.
Athlete or not, anyone can get plantar fasciitis. Risk factors include:
running–plantar fasciitis accounts for up to 25% of running injuries (Cotchett, 2010);
work-related weight bearing activities, including jobs that require long days on one’s feet;
high BMI (body mass index).
Women between the ages of forty and sixty are the demographic subgroup most likely to be diagnosed with this bottom-of-the-foot pain (Lee & Marx, 2018). In the U.S., it leads to approximately one million patient visits to physicians each year, with an associated annual cost of $300 million (Al-Boloushi, 2019). While sports acupuncture is a specialty of mine, at my acupuncture clinic Oakland, I commonly treat plantar fasciitis among runners and non-runners alike.
Plantar fasciitis is diagnosed clinically, meaning based on your symptoms--most patients report localized heel pain that is worse with the first steps of morning, or after a period of rest. Typically the pain improves after “warming up” in the morning, but will often return after a long run, or a long day on one’s feet. There may be tenderness over the fat pad on the heel. Plantar fasciitis tends to resolve on its own within 6-18 months–which can feel like a lifetime when you’re eager to hit the pavement, pain-free.
Plantar Fasciitis and Chinese Medicine
In Chinese medicine, the Kidney meridian is the only meridian located on the sole of the foot. With plantar heel pain, qi stagnation and blood stasis in the Kidney meridian manifests as stabbing, sharp or dull pain, and/or pain on pressure.
In addition, internal organ imbalances may also be contributing factors. Common patterns found in plantar fasciitis patients include qi and blood stagnation with cold, qi and blood stagnation with underlying Liver blood deficiency, and Liver and Kidney yin deficiency with blood stagnation. In Chinese medicine, we always seek to treat your body’s root cause imbalances in addition to providing pain relief.
Acupuncture for Plantar Fasciitis Pain
Acupuncture treatment for plantar fasciitis will involve treating points on the bottom of the foot, especially Shimian, as well as local points like Kidney 7 and 8. I will often use electroacupuncture as part of plantar fasciitis treatment. Other modalities I sometimes include in plantar fasciitis treatments are:
Moxibustion heat therapy to enhance needling, or in cases whether the heel is too sensitive to needle;
Dry needling, a type of acupuncture that targets trigger points, on tight calves;
Gua sha, a massage technique that I perform in my office and also teach heel pain sufferers to do at home;
Red light therapy, particular cold laser treatment of the inflamed heel;
High quality topicals with blood moving herbs–I use lots of Evil Bone Water at my practice.
When runners or other plantar fasciitis patients limp into my East Bay acupuncture office, I let them know that, as with most orthopedic issues, they should plan on seeing me 4-6 times over the course of a few weeks for optimal results. Be patient during your treatment and recovery. Studies have found that both acupuncture treatment and steroid injection for plantar fasciitis demonstrate maximum pain improvement compared to control groups at the one-month post treatment follow-up (Zhang et al., 2011).
Struggling with nagging heel pain? I’d love to help get you back on your feet!—schedule a discovery call or book an appointment at my Oakland acupuncture office.
SOURCES
Al-Boloushi, Z. et al. (2019). Comparing two dry needling interventions for plantar heel pain: a protocol for a randomized controlled trial. Journal of Orthopaedic Surgery and Research, 14(31). https://doi.org/10.1186/s13018-019-1066-4
Cotchett, M., Landorf, K., & Munteanu, S. (2010). Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review. Journal of Foot and Ankle Research, 3(18). https://doi.org/10.1186/1757-1146-3-18
Lee, T., & Marx, B. (2018). Noninvasive, Multimodality Approach to Treating Plantar Fasciitis: A Case Study. Journal of Acupuncture and Meridian Studies, 11(4), 162–164. https://doi.org/10.1016/j.jams.2018.04.002
Zhang, S. P., Yip, T., & Li, Q. (2011). Acupuncture Treatment for Plantar Fasciitis: A Randomized Controlled Trial with Six Months Follow-Up. Evidence-Based Complementary and Alternative Medicine, 2011, 1–10. https://doi.org/10.1093/ecam/nep186
Dr. Lisa Franzetta is a licensed acupuncturist in Oakland, California. She has done specialized sports medicine training with Whitfield Reaves, author of The Acupuncture Handbook of Sports Injuries & Pain, and she is a Road Runners Club of America certified running coach.