I’ve seen three different doctors for my plantar fasciitis. I’ve gotten three different suggestions for treatment. I’ve been told to leave it alone because it will eventually go away on its own. Orthotics have been suggested for inside my shoes. And I’ve been told to go see a physical therapist. What is the best treatment for this problem?

All three suggestions have some merit. It is true that plantar fasciitis (PF) does get better on its own in six to 12 months for many people. But it’s also a painful condition that can be very disabling while you have it.

Studies using shoe inserts called orthotics for this condition do show they help. Pain is decreased and function improved in the first three months. When comparing patients with PF who use orthotics with patients who don’t use these inserts, there’s no difference in outcomes between the two groups at the end of 12 months.

Physical therapy can be helpful to teach you how to manage symptoms. Stretching and a particular form of massage called cross-transverse friction massage (CTFM) can help keep the connective tissue soft and pliable.

The therapist may use deep heat in the form of ultrasound followed by CTFM to stretch the fascia. The therapist can also help you find the best off-the-shelf orthotic to use to reduce pain during the interim.