Electromyography is rarely helpful diagnostically. In some cases of plantar fasciitis, ultrasonography shows a thickened fascia at the tip of the heel. Often, a technetium Tc 99m bone scan reveals increased isotope uptake at the site of plantar fascia insertion. In addition, a fiberglass splint fabricated to extend the foot to its full length and place the heel at a 90-degree angle is worn during sleep. A semiflexible orthotic device with additional longitudinal arch support is constructed for use during the day.
Corticosteroid administration is helpful only in decreasing the inflammatory response.
Although one or two injections of a corticosteroid may provide prolonged symptomatic relief, permanent relief is possible only if such therapy is combined with phase 1 measures. If the patient is then pain-free, maintenance physiotherapy is beneficial. Surgical techniques that involve partial or complete resection of the plantar fascia are based on the erroneous premise that total release of the plantar fascia is necessary. Comment Plantar fasciitis is not an inflammatory but rather a degenerative process. Nonetheless, a great number of inappropriate therapeutic procedures and orthotic devices have been used in response to the erroneous belief that inflammation is the problem.