Plantar Fasciitis and Heel Spur Syndrome

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Dr. Huppin and Dr. Hale are experts in the effective treatment of heel and arch pain. Pain in the heels and arches is the most common problem treated in our clinic and we have become a referral center for treatment of even the most difficult and longest lasting cases of heel pain. We are usually able to help patients who have already seen numerous other practitioners.

Treatment Goals – Rapid Relief of Pain and Preventing Return of Symptoms

Our goal when treating your heel or arch pain is to relieve your pain as rapidly as possible and then prevent the problem from returning. There are many underlying causes of heel and arch pain. The first thing we do is evaluate the cause of your pain and then develop a program to get you back to full activity as soon as possible. When treated correctly surgery is almost never necessary.

How long does it take to get better?

The most common cause of heel and arch pain is plantar fasciitis. We find that plantar fasciitis is often not treated correctly or is under-treated, leading to a problem that lasts months or years longer than it should. When treated correctly, most patients see significant relief within several weeks. In order to achieve the most rapid relief, we will develop a treatment plan specifically designed to treat the cause of the pain in your feet. The sooner treatment is started; the easier the problem is to treat. If you are experiencing heel pain or arch pain, make an appointment today to see us in our Seattle office.

What is involved in treatment?

Plantar fasciitis occurs when the foot flattens too much, leading to a lengthening of the arch and increased tightness in the plantar fasica. Our first mission is to reduce the tightness in the plantar fascia. If this does not happen, treatment will likely fail.

Step 1: Decrease tightness on plantar fasica. This could include:

  • Ensuring you are wearing the correct shoes (bring some sample shoes with you to your appointment)
  • Using custom or prefabricated orthotics to support the arch
  • Use special taping or a “walking boot” to allow the painful area to rest for a couple weeks

Step 2: Reduce inflammation and pain. This could include:

  • Ice
  • Anti-inflammatory medication
  • Steroid injection
  • Physical therapy

Step 3: Prevent the pain from returning with custom orthotics or OTC arch supports

How Should Orthotics be made to best relieve arch and heel pain?

In 2001 and 2006 studies researchers concluded that custom foot orthoses and night splints were effective both short-term and long-term in treating pain from plantar fasciitis, stating that “..foot orthosis is the best choice for initial treatment of plantar fasciitis.” 1-3 Other studies have shown how to prescribe orthotics so that they work best to relieve arch and heel pain. A sophisticated 1997 study showed conclusively that orthotics should be prescribed with very specific wedging for the best results.4

Orthotics Must Conform Closely to the Arch

It is critical to support the arch and prevent it from collapsing. If the arch continues to collapse, you will have continued tension on the plantar fascia and pain will likely continue.

Several studies have shown that the most effective way to accomplish this is to use custom foot orthotics that conform extremely close to the arch of the foot.5-6 These are known as total contact orthotics. Many, if not most, typical orthotics fail to completely eliminate the problem because they do not hug the arch of the foot tight enough. This lets the foot flatten and increases tension on the plantar fascia. We see many patients coming into our office who have had orthotics made that simply do not provide enough support to cure plantar fasciitis.

Comfort Guaranteed

Dr. Hale and Dr. Huppin are both experts at prescribing, casting and troubleshooting all foot orthotics, including total contact foot orthotics. Comfort of your orthotics is 100% guaranteed.

Prefabricated Orthotics

Although custom orthotics, if correctly made, work the best at reducing tension on the plantar fascia, not every patient requires a custom orthotic for pain relief. Many patients will do fine with a prefabricated arch support. We will help you determine the best choice for your feet.

Non-invasive treatment for stubborn and persistent heel pain

For cases of plantar fasciitis that do not respond to our standard treatments, we have two options to help you avoid surgery:

Is Surgery Ever Necessary?

There are rare cases of plantar fasciitis which do not respond to conservative treatment. If surgery should be necessary, we will provide you with comprehensive, state-of-the-art care.

You should, however, always give conservative treatment at least 6 months to work. Conservative treatment should include several of the following: physical therapy, anti-inflammatory medications, exercises, shoe recommendations, prefabricated arch supports and quality prescription orthotics.

Other causes of heel and arch pain include arthritis, infection, fractures and sprains, or even certain systemic diseases. Because of the multiple possible causes you should see your podiatrist for a thorough evaluation if you are experiencing heel or arch pain.

In order to eliminate your heel or arch pain as soon as possible, make an appointment today to see us in our Seattle clinic. And for more detailed information on the causes and treatment of plantar fasciitis, keep reading.

Medical Literature on Orthotics for Plantar Fasciitis

  1. Martin JE, Hosch JC, Goforth WP, Et al: Mechanical treatment of plantar fasciitis. JAPMA 91(2):55,2001
  2. Langdorf KB, Keenan Am, Herbert RD: Effectiveness of foot orthoses to treat plantar fasciitis. Arch Internal Med 166:1305, 2006
  3. Roos E, Engstrom M, Soderberg B: Foot orthoses for the treatment of plantar fasciitis. Foot Ankle Int 27(8):606, 2006
  4. Kogler G, Veer FB, Solomonidis SE: The influence of medial and lateral placement of orthotic wedges on loading of the plantar aponeurosis. JBJS 81A: 1403-1413, 1999
  5. Scherer PR et al: Heel spur syndrome, pathomechanics and non-surgical treatment. JAPMA 81:68-72,1991
  6. Lynch WP, Goforth J, Martin R, Odom R, et al: Conservative treatment of plantar fasciitis, A prospecitic study, JAPMA 88:375-380,1998


The most common cause of heel and arch pain is a condition called plantar fasciitis. This is an inflammation of a thick band of tissue that runs along the arch of your feet from your heel to your toes, and aids in stabilization of your arch during walking and running. Symptoms involve two areas — the arch, and more commonly, the inside heel area. Severe pain can be present, especially in the morning on arising. Common symptoms of plantar fasciitis include:

  • Pain in the morning when you first get out of bed
  • Pain and stiffness when you start to walk after sitting for a while
  • Increasing pain in your heel or arch towards the end of the day
  • Tired feet at the end of the day


Heel and arch pain is usually the result of faulty biomechanics ( walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. This increased stress causes local inflammation and pain.

The most common cause of this increased stress is a condition known as “over-pronation”, which means that your feet roll inward too much when you walk. As they roll inward the arch of the foot flattens and the arch lengthens. When the arch lengthens there is increased tension on the plantar fascia.


At the Foot & Ankle Center of Washington we are specialists in the treatment of plantar fasciitis and other causes of arch and heel pain. It is the most common complaint of clinic patients and we find that well over 99% of the time it responds well to our specialized treatment program. Surgery is almost never required.

Our treatment program focuses on two main areas:

  • We want to relieve your pain and get you back participating fully in the activities you enjoy. To this end, we try to relieve the inflammation which is causing your pain. This may involve exercises, physical therapy, anti-inflammatory medications, heel cups, OTC arch supports, custom orthotics, or a combination of therapies.
  • More importantly, we will find the underlying cause and devise a personalized treatment plan to not only relieve your pain in the short run, but also prevent it from reoccurring. We will evaluate your feet, walking pattern (gait), shoes, activities, exercise methods, and other relevant information and then devise your treatment plan.


In more difficult cases of plantar fasciitis you may have custom functional orthotics prescribed for you. Research indicates that in cases of mechanically induced heel and arch pain the most effective treatment is quality prescription orthotics.

Orthotics for plantar fasciitis are prescribed specifically to help take tension off of the plantar fascia. In order to ensure best outcomes we first perform a detailed examination, including slow motion video analysis, of how you walk and how your big toe joint works. A mold of your foot is then taken in a very specific position and the orthotic devices are prescribed in a manner to ensure best function of your feet.
Dr. Larry Huppin and Dr. Doug Hale are specialists in orthotic therapy and, in fact, teach orthotic therapy to other doctors at seminars throughout North America. We take great pride in providing our patients with the best possible orthoses for their particular problem. The quality of orthotic devices varies considerably and depends on many factors. We guarantee our patients that their orthoses are the finest quality and biomechanically accura

Other causes of heel and arch pain include arthritis, infection, fractures and sprains, or even certain systemic diseases. Because of the multiple possible causes you should see your podiatrist for a thorough evaluation if you are experiencing heel or arch pain.

Don’t live with heel pain or arch pain. Call today to make an appointment in our convenient Seattle office.

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