Based on current research, recommendations for immediate relief and reduction of inflammation include heel and foot stretching exercises as can be tolerated, rest, wearing shoes with good support and cushions. Other steps to relieve pain include: Applying ice or ice-heat-ice, using night splints to stretch the injured fascia. Customized functional foot orthotics can offer a decrease in the pain associated with plantar fasciitis and may provide an additional benefit in terms of increased functional ability in patients with plantar fasciitis.[8] There is no evidence to support the use of foot orthotics for long-term pain management or function improvement.[4][9]
Some evidence shows that stretching of the calf and plantar fascia may provide up to 2–4 months of benefit.[4] One study has shown improvement over a four-month period with stretching.[10] One study has shown high success rates with a stretch of the plantar fascia,[11] but has been criticized[4] because it was not blinded, and contained a bias because the analysis did not use the intention to treat method. Because it is impractical to do double-blind experiments involving stretching, such studies are vulnerable to placebo effects.
Pain with the first steps of the day can be markedly reduced by stretching the plantar fascia and Achilles tendon before getting out of bed. Night splints can be used to keep the foot in a dorsi-flexed position during sleep to improve calf muscle flexibility and decrease pain on waking. These have many different designs. The type of splint has not been shown to affect outcomes.
