Question
I have visited a podiatrist three times, but my problem has not subsided.  He initially suggested Cortisone, but I am sensitive to it, so I declined.  Since September 2012, I have worn the orthotics purchased off the shelf in his office, which initially helped, and now from wearing them too long, cause me pain.  I have had high arches my whole life, and I gained weight last year, which I realize is a contributing factor.  I tried calf stretches. Recently, I bought a night splint to try on the right foot, and it helps me in the AM. I wish the doctor told me the first time about the splints.  

I have noticed under my arch on each foot, is a bump or small lump, along the faschia.  I am desperately seeking relief, and have just ordered some special insoles,and a little foot stretcher, which will come soon.  I have thrown excess money away, and yet feeling I am not addressing the root cause. Do you know what those bumps are under the arch ?  Also,could you please tell me what you would recommend for my problem of continual pain of varying degrees, both under the arch, and in the heel ?

Answer
Alexis,

It sounds like you have become frusturated with how difficult it is to treat plantar fasciitis.  I can tell you as a professional, it is just a frusturating to treat from a doctor's standpoint because no two people have the same effective treatment plan.  It is different for everyone.  People with high arches absolutely need custom orthotics for treatment of plantar fasciitis.  Over the counter orthotics do not fully capture the arch of people with high arches.  Over the counter orthotics are mass produced and unfortunately high arches are not as common as fallen arches; therefore companies do not produce effective orthotics for them.  Stretching is always important and using a night splint will help, but if you are not finding good support and stability with your inserts, then you need to invest in custom orthotics.

The bumps on your foot along the plantar fascial are most likely plantar fibromas.  The occur commonly on the medial (inside) and central aspect of the plantar fasica.  If they are not painful with ambulation or touch them, then don't bother them.  If you do have pain associated with them, topical verapamil has been effective in making them smaller.  Excising them is possible but I wouldn't suggest it as they high a really high rate of returning after excision.

Sincerely,

Dr. Leslie Johnston, DPM
www.thetampapodiatrist.com