Is Heat or Ice Better for Plantar Fasciitis?

March

8

by Joe Armeli | Doctor of Physical Therapy

If you've ever experienced the sharp pain of plantar fasciitis, you know how important it is to find relief. One common question is whether to use heat or ice therapy to manage their symptoms. While both can be effective, neither is definitively better than the other. 

We'll explore when it's best to use heat therapy, when to use ice therapy, and specific situations where one may be more beneficial than the other. By the end, you'll better understand how to manage your plantar fasciitis symptoms using heat and ice therapy.

Heat Therapy for Plantar Fasciitis

Heat therapy, also known as thermotherapy, involves the application of heat to the plantar fascia to reduce pain and stiffness. Using heat for plantar fasciitis can increase blood flow, which delivers oxygen and nutrients to the plantar fascia, promoting healing. It can also reduce the stiffness of the plantar fascia. 

A hot pack, hot soak, and parafin wax are all ways to use heat for plantar fasciitis.

Heat therapy can be applied in various ways, including:

Heating pad: A heating pad can be a practical and efficacious method for administering heat therapy to the affected area. It is recommended to set the heating pad to low or medium intensity and carefully apply it to the affected foot. Ensuring that the heating pad features a temperature control function is crucial to minimize the risk of burns. 

Warm water soak:  A hot water soak is a straightforward and efficient approach to applying heat therapy to the foot. Begin by filling a container with hot water that is not boiling and carefully immerse the affected foot. It is essential to ensure the water is hot enough to provide warmth and comfort but not excessively hot to prevent burns. A significant advantage of hot water is that it can comfortably conform to the foot, enhancing the therapeutic effect.

Paraffin Wax: Although not typically an "at-home treatment," paraffin wax therapy can be obtained at a physical therapy clinic. This modality can be an efficacious approach to administering heat therapy to the plantar fascia. The paraffin wax is melted within a designated heating unit, and the affected foot is dipped into the molten wax. After cooling and hardening, the wax is peeled off. An added benefit is your skin will be nice and soft.

Ice Therapy for Plantar Fasciitis

Ice therapy has been proven an effective way to relieve pain and inflammation caused by plantar fasciitis. Applying ice to plantar fasciitis can help reduce swelling and numb pain. 

Different methods to ice for plantar fasciitis include: peas, ice pack, buck of ice, and frozen water bottle.

There are several ways to apply cold therapy to the foot, including:

Ice pack or bag of peas: One can use a commercial ice pack or a bag of peas to ice the bottom of the foot. Both an ice pack and a bag of peas can conform comfortably enough to the foot's contour (make sure you use a gel ice pack), enhancing the therapeutic effect. The use of ice therapy can help alleviate pain and reduce inflammation in the affected area.

Cold foot bath: An ice bucket is considered one of the most effective methods for icing the foot, as the water conforms perfectly around the affected area. To prepare, grab a bucket big enough to put your foot in and place ice in it. Fill the bucket with water until the depth is enough to cover the foot and ankle. Finally, submerge the affected foot in the ice bucket for the desired duration of treatment.

Frozen Water Bottle: The frozen water bottle massage is a commonly employed technique in treating plantar fasciitis. Keeping three to four water bottles in the freezer at all times is recommended to ensure a readily available therapeutic option. To ice your plantar fascia with a water bottle lay the frozen water bottle flat on the ground and position the affected foot on top of it. By rolling the bottle beneath the foot, the technique can massage and stretch the plantar fascia while simultaneously administering ice therapy.

Is Heat or Ice Better for Plantar Fasciitis? 

Depending on the situation both heat and ice can be good for plantar fasciitis

Neither heat nor ice is better than the other for plantar fasciitis. Heat and ice both have their benefits in managing plantar fasciitis. Heat can help with chronic pain and stiffness, while ice can help with acute inflammation and pain. 

Lets go over some specific situations to help guide you. 

When to Use Only Heat

Upon waking in the morning: The plantar fascia can become tense after a prolonged rest period, leading to pain upon initial steps. Applying heat to the affected area can help alleviate discomfort by loosening the plantar fascia.

Before engaging in a workout: Applying heat therapy to the area is recommended. Exercise can impose stress on the plantar fascia, potentially exacerbating symptoms. The use of heat therapy can aid in the relaxation of the plantar fascia, mitigating discomfort during exercise.

When to use Only Ice

After exercising: Following exercise, there is an increased risk of pain and inflammation at the plantar fascia due to heightened blood flow, leading to swelling and soreness. Ice therapy is an effective way to counteract these effects.

Before bedtime: Research indicates that applying cold therapy for 20 minutes before bedtime is among the most effective treatments for reducing symptoms of plantar fasciitis, with better outcomes than applying ice in the morning or using heat. 

During a flare-up: Ice therapy is a valuable tool to alleviate pain when the plantar fascia is painful. Applying ice for a 20-minute break during a flare-up can help manage symptoms.

Other Treatments for Plantar Fasciitis

While heat and ice can help alleviate your pain from plantar fasciitis, they will not cure it. You should use a combination of different strategies to cure your plantar fasciitis. These include:

A proper rehab program: If you want to rid your plantar fasciitis, a rehab plan for plantar fasciitis focused on stretching the plantar fascia and calf, and strengthening the hip and foot intrinsic muscles can help to fix the underlying issue of your plantar fasciitis. 

Plantar fasciitis rehab program

Footwear: Wearing supportive shoes with good arch support can help reduce stress on the plantar fascia.

Night splints: Wearing a plantar fascitis night splint can help keep the plantar fascia stretched and reduce pain in the morning.

Taping the Arch: Taping your arch for plantar fasciitis can help to redistribute the pressure and load on the foot, which can reduce pain and discomfort. Additionally, taping can help to improve the alignment of the foot and ankle, which can further alleviate the strain on the plantar fascia.

Cross training: If you are an active individual cross training can help you maintain your cardiovascular endurance and strength while reducing the repetitive stress on your feet. Cross training involves incorporating various low-impact activities, such as swimming, cycling, or using an elliptical machine for your plantar fasciitis.

Walking Boot: If you have tried everything and surgery is not an option as a last resort you can try using a walking boot for your plantar fasciitis

Conclusion

Heat and ice can both help manage plantar fasciitis, and neither is definitively better than the other.

In specific situations, heat or ice therapy may be more appropriate. Applying heat in the morning or before a workout can help loosen the plantar fascia and mitigate discomfort. Using ice after exercise or during a flare-up can help reduce inflammation and pain. Applying cold therapy before bedtime is especially effective.

However, it's important to note that heat and ice therapy alone may not be enough to fully treat plantar fasciitis. Other treatments, such as stretching, strengthening exercises, and footwear modifications, may be necessary for optimal results. It's also important to listen to your body and avoid activities that cause pain or discomfort.

About the author, Joe Armeli DPT

I'm Joe Armeli, a Doctor of Physical Therapy, Certified Athletic Trainer and Certified Strength and Conditioning Specialist, a movement enthusiast, and a fellow runner. I'm here to help you achieve your physical health and performance goals, whether you're just starting to run or are a seasoned vet. For questions or concerns, email me at joe.armeli.dpt@gmail.com. Look forward to hearing from you!

>