Plantar Fasciitis Treatment in Los Angeles

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Man in Los Angeles with plantar fascilitis experiencing stabbing discomfort, a common cause

overview

What is Plantar Fasciitis?

The plantar fascia is a ligament attached to the bottom (plantar) of the heel bone (calcaneus). It begins as a narrow band in the center of the heel and then widens as it extends through the bottom of the foot, arch, and into the toes. The plantar fascia is an extension of the Achilles tendon and plays a pivotal role in supporting the arch and muscles during movement. Acting like a shock absorber, it stretches with each step to cushion impact.

When the ligament becomes inflamed due to injury, the condition is known as plantar fasciitis. In some cases, the ligament can suffer larger tears or partial rupture if the injury is severe. When considering your options for treatment, you should get guidance from the best plantar fasciitis doctor in Los Angeles, Dr. Soomekh. He, along with our expert pain relief team at our Beverly Hills office, can help prevent worsening symptoms.

Signs and Symptoms of Plantar Fasciitis

Patients will complain of different types of pain in the bottom of the heel. The pain is usually located on the bottom, inner portion of the heel, forward about an inch from the back of the heel. Descriptions of the pain range from a deep, achy pain to a sharp, knife-like pain. Common symptoms of plantar fasciitis include:

Pain on the bottom, inner portion of the heel
A deep, aching sensation or a sharp, knife-like pain
Increased pain with the first steps out of bed or after prolonged sitting
Temporary relief with movement, followed by worsening pain toward the end of the day
Increased discomfort when barefoot or wearing unsupportive shoes
Burning or numbness in the heel

In cases of severe injury, there may be noticeable swelling, bruising, and difficulty placing weight on the foot. If you suspect a tear, it's important to visit the best plantar fasciitis doctor in Los Angeles for prompt diagnosis.

Person in Los Angeles with plantar fasciitis, feeling an aching sensation and pain on bottom of foot.

Los Angeles woman with plantar fasciitis in pain due to tiny tears from excessive strain on ligament.

Causes of Plantar Fasciitis

Plantar fasciitis often results from excessive strain on the ligament, leading to tiny tears and inflammation. Contributing factors include:

Overuse (e.g., running, prolonged standing)
Poor footwear (e.g., unsupportive shoes, high heels)
Tight calf muscles
Obesity (added pressure on the plantar fascia)
Foot structure (e.g., flat feet or high arches)

Early diagnosis and treatment from the best podiatrist in Beverly Hills can prevent worsening symptoms and chronic pain.

diagnosis

How Is Plantar Fasciitis Diagnosed?

Diagnosing plantar fasciitis involves a clinical examination, imaging studies, and advanced diagnostic tools. It is important to distinguish plantar fasciitis from other problems that can cause heel pain, such as Tarsal Tunnel Syndrome. Dr. Soomekh uses the following methods:

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Patient Consultation

Discussing symptoms, concerns, and treatment goals

Hands-on Examination

Evaluating foot structure, tenderness, and gait patterns

Digital X-rays

Assessing bone positioning and identifying any associated deformities

Diagnostic, State-of-the-Art Ultrasound

Measuring ligament thickness, swelling, and potential damage or tearing

MRI (if needed)

Ordered for severe ligament tears, ruptures, or chronic plantar fasciitis cases

PLANTAR FASCIITIS VS HEEL SPUR

What Is a Heel Spur?

Plantar fasciitis should not be confused with a heel spur or heel spur syndrome. A heel spur is the formation of extra bone from the constant pull of the plantar fascia ligament on its attachment to the heel bone (calcaneus). When bone is stimulated, it grows. Extra bone can form in any location of the body where there is overstimulation of bone. When the plantar fascia is tight, and it constantly tugs and pulls on the heel bone, the bone will react by growing extra bone in the direction of the pull of the ligament on the bottom of the heel.

A spur can only form over a long period of time. A heel spur does not cause pain unless it has fractured from an acute injury. A heel spur on the bottom of the heel should not be removed surgically unless it has fractured, failed to heal, and causes chronic pain. Patients can have a large heel spur and no plantar fasciitis, and no pain.

Patients can have a very small heel spur and significant pain if they also have tearing of the ligament. The appearance of a heel spur only informs the doctor that the ligament has been very tight for a long time. A spur on the bottom of the heel should not be confused with a spur on the back of the heel called a retrocalcaneal exostosis.

Los Angeles doctor administering a non-surgical plantar fasciitis treatment option via foot injection

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Plantar Fasciitis Treatment Options

Dr. Soomekh states that early diagnosis and treatment of plantar fasciitis are the keys to successful treatment, faster recovery, and a painless lifestyle.

Conservative Treatment Options

Most cases of plantar fasciitis improve with non-invasive treatments, including:

Ice therapy and NSAIDs to reduce inflammation and pain
Rest and proper footwear that minimizes stress on the ligament
Stretching exercises to improve ligament flexibility, especially before getting out of bed
Custom orthotics, which provide support to reduce strain on the plantar fascia
Physical therapy that strengthens foot muscles and promotes healing
Cortisone injection therapy for acute plantar fasciitis

For patients with significant acute pain or those not responding to conservative treatments, a cortisone injection may help by reducing inflammation and breaking down scar tissue for faster recovery. Dr. Soomekh may recommend this as an adjunct to therapy, but results vary, and the effects do not "wear off.”

Advanced Non-Surgical Treatments

For chronic or severe plantar fasciitis, advanced therapies include:

Interfyl Injection Therapy For Plantar Fasciitis

This advanced treatment is made up of human chorionic plates of the placenta of a healthy, full-term pregnancy. These tissues have special properties that can augment other tissues. The cells in this tissue are rich in healing factors like collagen, fibronectin, hyaluronic acid, and growth factors. These factors can help to decrease inflammation and regenerate new healthy tissues. The injection is placed into the damaged portion of the plantar fascia and approached from the side of the heel. Dr. Soomekh performs these injections under ultrasound guidance for accuracy. Dr. Soomekh is one of only a few specialists with experience using this advanced cell therapy.

Platelet-Rich Plasma (PRP) Therapy For Chronic Plantar Fasciitis

Platelet-rich plasma (PRP) can be used as a treatment option for chronic plantar fasciitis. The introduction of a high concentration of platelets can “jump-start” the ligament to begin healing by increasing blood flow, converting the chronic injury into an acute inflammatory one, and leading to an influx of inflammatory healing cells to the ligament. It is a relatively non-invasive method using the patient’s own healing potential. Dr. Soomekh offers PRP therapy in the office setting. Click here for our details on PRP therapy.

The patient’s blood will be drawn from their arm. The blood will then be placed in a centrifuge in order to obtain the highest concentration of platelets available. The area of the heel is anesthetized. Dr. Soomekh will use precision ultrasound guidance to deliver the PRP by injection into the plantar fascia. The patient can return home with special instructions for a post-treatment protocol. A walking boot is used to control the stress on the ligament during the healing period. Some patients may benefit from a second or third PRP therapy, depending on their progress.

Surgical Treatment For Chronic Plantar Fasciitis

After three to six months of unsuccessful conservative treatments, plantar fasciitis can become a chronic condition. At this stage, the body’s healing factors are not trying to heal the area of concern but are busy taking care of the rest of the body. Presumably, there are fewer inflammatory cells around the ligament to aid in healing. In these cases, Dr. Soomekh offers more advanced treatment methods.

The following treatments aim to convert the chronic condition into an acute condition. By doing so, the body will recognize the injury as a new injury and respond accordingly with the appropriate inflammatory response. Under this controlled setting, the new injury can be treated in order to heal it in a timely manner. These techniques will stimulate the tendon, break up scar tissue, and attempt revascularization of the plantar fascia by converting the chronic injury into an acute inflammatory one, leading to an influx of inflammatory healing cells to the tendon.

Minimally Invasive Procedures To Treat Chronic Plantar Fasciitis

Dr. Soomekh, the best foot surgeon in Los Angeles, always recommends and attempts conservative treatment when appropriate. However, when plantar fasciitis becomes chronically painful and other procedures and therapies have failed, surgery may be indicated.

Considering surgery can be intimidating. Foot surgery, including plantar fasciitis surgery in Los Angeles, should not be painful during recovery. When the skin and the soft tissues are handled with care and focus, most patients experience little to no pain immediately after surgery and throughout the recovery period. Dr. Soomekh takes great care and focus to minimize the chance of postoperative pain. The goal of plantar fasciitis surgery is to stop the tearing of the ligament, alleviate pain, allow a return to normal shoes, and allow a return to all activities. The procedure allows for immediate walking and a return to work while wearing a special walking boot.

Topaz Coblation Therapy

Topaz Coblation therapy is a minimally invasive option for the treatment of chronic plantar fasciitis. It is performed in an operating room. A grid of 12 to 20 tiny holes is made into the bottom of the heel in the areas of the most pain. A special probe is placed through the skin into each hole to the level of the ligament. The probe then “burns” small holes into the plantar fascia, stimulating the ligament. Since it only requires small holes compared to a larger open incision, it can heal faster and with no scarring. The patient will return home with special instructions for a post-treatment protocol. A walking boot is used to control the stress on the ligament during the healing period.

Tenex™ Plantar Fasciotomy

Tenex™ plantar fasciotomy is a minimally invasive option for the treatment of plantar fasciitis. It is performed in an operating room, often with simple local anesthesia. A small incision is made on the side of the heel in the area of the damaged and painful ligament. Under ultrasound guidance, the probe is placed under the skin and into the damaged fascia. When activated, the probe removes the damaged tissue while not interrupting the healthy fascia. The patient will return home with special instructions for a post-treatment protocol. A walking boot is used to control the stress on the tendon during the healing period.

Endoscopic Plantar Fasciotomy

Endoscopic plantar fasciotomy (EPF) is a minimally invasive procedure using a small surgical blade attached to a camera. A small incision is made on the inner side of the heel at the level where the plantar fascia attaches to the heel bone. The camera is guided into the area to inspect the anatomy. Using a precision surgical blade placed over the camera, the inner one-third portion of the ligament is cut. The plantar fascia is now released from its attachment. Once cut, the ligament cannot tear anymore. The ligament will heal and become more elastic, and will stop tearing. A walking boot and crutches are used to control the stress on the ligament during the healing period.

Frequently Asked Questions
‍About Plantar Fasciitis

Discover Lasting Relief with the Best Plantar Fasciitis Treatment in Los Angeles

At Foot and Ankle Specialty Group, we understand how debilitating and disruptive plantar fasciitis pain can be. That’s why we aim to provide the most comprehensive, best plantar fasciitis treatment in Los Angeles at our state-of-the-art, conveniently located Beverly Hills office. Our compassionate team, led by the best plantar fasciitis surgeon in Los Angeles, Dr. David J. Soomekh, is here to help get you pain-free and back on your feet quickly. Contact us today to schedule your appointment!

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