Beverly Hills · Heel Pain · Ultrasound-Guided

Plantar Fasciitis Treatment in Los Angeles

If your first step out of bed feels like stepping on a nail, and months of stretching, new shoes, and maybe a cortisone shot haven’t fixed it, the missing piece is usually the diagnosis. We measure your plantar fascia on ultrasound, check the nerve and calf structures that mimic it, and treat the tissue that’s actually causing your pain.

Start Here

The most common cause of heel pain — and one of the most stubborn

Plantar fasciitis accounts for roughly one million doctor visits a year in the United States.1 It is the heel pain most people have heard of: a sharp pain under the heel with the first steps in the morning or after sitting, easing as you warm up, then returning after a long day on your feet. Across 96 systematic reviews, the most consistent risk factor identified is body weight, and the most consistently supported procedure is shockwave therapy.2

The name is a little misleading. “-itis” means inflammation, but when plantar fascia removed during 50 chronic heel-pain operations was examined under the microscope, pathologists found degeneration — fragmented, disorganized collagen — rather than inflammatory cells.3 That is why many clinicians now call chronic cases plantar fasciosis, and why treatments aimed only at inflammation (ice, anti-inflammatories, cortisone) so often help for a while and then stop helping.

You may have been told it goes away on its own. Often it does, eventually. In one long-term follow-up of 100 patients treated conservatively, 82 had resolved at an average of almost four years.4 But “eventually” can be a long time. In a Danish cohort of 174 patients referred to a hospital clinic — a group that skews toward stubborn cases — 80.5% still had symptoms one year after onset, half still had them at five years, and 44% at fifteen.5

None of that means you’re stuck. It means “rest, stretch, and wait” runs out of road for a meaningful number of people, and at that point the question changes from what should I try next? to what exactly is hurting?

At The Fascia Institute and Treatment Center of LA in Beverly Hills, we answer that with a physician-performed Fascial Mapping® ultrasound exam, then match treatment to the finding: shockwave therapy, ProloBoost Dual PRP, dextrose prolotherapy, or Hydrofascia Release™ when a nerve is involved.

2.16 mm
thicker plantar fascia, on average, in chronic heel pain than in pain-free feet on ultrasound6
44%
still had symptoms 15 years after onset in a hospital-referred cohort5
1 month
roughly how long the pain benefit of a cortisone injection lasts in pooled trial data7

Why heel pain gets stuck: it’s rarely just the heel

The plantar fascia is a thick band of connective tissue running from the heel bone to the base of the toes. It is not an isolated strap. In a study combining dissection and MRI, anatomist Carla Stecco’s group showed that it is connected, through the heel bone’s outer lining, to the paratenon — the sheath around the Achilles tendon — and that the thickness of the two structures rises and falls together. The plantar fascia is also rich in hyaluronan and in Pacini and Ruffini mechanoreceptors, particularly along its inner edge.8 In other words, it is a sensory, load-sharing link in a chain that runs up the back of the leg. (New to the idea? Start with “What is fascia?”)

That is why the calf keeps coming up. In a matched case-control study, people whose ankles could not bend upward past neutral had 23 times the odds of plantar fasciitis compared with people who had more than ten degrees of motion. A BMI over 30 raised the odds more than fivefold, and spending most of the workday on your feet more than threefold.9 The confidence intervals in that study were wide, and a later meta-analysis of 51 studies found that body weight was the only clinical risk factor that held up consistently.10 We take that at face value: tight calves are not the whole story, but they are worth measuring rather than assuming.

And the heel spur on your X-ray? Spurs are somewhat more common in people with heel pain,11 but they are also found in 10% to 63% of people with no heel pain at all,12 and in the 15-year Danish follow-up, having a spur made no difference to who got better.5 A spur is not, by itself, the reason you hurt, and it is not what we treat.

What The Map Separates

Five things that feel like plantar fasciitis — and need different treatment

Plantar fasciitis is usually diagnosed from your story and a press on the heel, and that is usually right. When it is wrong — or only partly right — treatment stalls. Ultrasound lets us look at the tissue while you point to the pain. Your Fascial Map tells us which of these is driving it, and often it is more than one.

01 · The plantar fascia itself
Thickened, darker (hypoechoic) fascia at its attachment to the heel is the classic finding, and it can be measured: people with chronic heel pain average about 2.16 mm thicker than pain-free controls, and are more likely to measure over the usual 4.0 mm threshold.6 Because it is a number, we can re-measure it after treatment instead of guessing. One honest caveat: in the Danish long-term study, only about a quarter of people who had become symptom-free had a completely normal-looking fascia on ultrasound,5 so we treat you, not the picture.
02 · Baxter’s nerve
The first branch of the lateral plantar nerve — also called the inferior calcaneal nerve, or Baxter’s nerve — runs right beside the plantar fascia’s origin and can be entrapped there. It is a surgically documented cause of chronic heel pain,13 and on MRI, wasting of the small muscle this nerve supplies is significantly associated with both plantar fasciitis and heel spurs.14 Clues: burning or electric pain, pain toward the inside edge of the heel, pain that doesn’t follow the classic first-step pattern. This is the one where treating only the fascia can leave pain behind — the same logic we apply to the nerves that mimic sciatica in the low back.
03 · The calf and Achilles chain
Restricted gastrocnemius and soleus fascia, or a thickened Achilles paratenon, can load the heel from above.8,9 We scan it because it is part of the same connected chain, and because fascial adhesion at the level of the calf can masquerade as something else entirely — as in our case report of calf pain that had been misdiagnosed as restless legs.
04 · A tear or rupture
A sudden pop, bruising in the arch, or a change in the shape of the arch, particularly after cortisone injections, raises the question of a partial or complete plantar fascia rupture.15 That changes the plan: you protect and rebuild the tissue rather than stimulate it.
05 · Bone, fat pad and joints
A calcaneal stress fracture, a thinned heel fat pad, or inflammatory arthritis can all present as heel pain. Ultrasound helps sort these out, but it is not the most sensitive test for stress fractures — MRI is — so when we suspect one, we send you for an MRI.16

The Treatment Ladder

What actually works for plantar fasciitis, ranked honestly

Here is the treatment landscape as the research describes it, not as a sales list. We use several of these. We don’t use all of them on everyone, and the order matters.

Start here · The home program
Plantar fascia–specific stretching beat Achilles stretching at eight weeks in a randomized trial of 101 patients who had been in pain for at least ten months.17 A high-load strength protocol — slow, heavy single-leg heel raises with the toes propped up — improved function faster than stretching at three months, although both groups ended up in the same place at a year.18 The 2023 physical therapy clinical practice guideline recommends manual therapy, fascia- and calf-specific stretching, taping, night splints for first-step pain, and dry needling, and advises against relying on orthotics alone for short-term relief.19 We make sure you are doing these correctly before we escalate.
Best-supported procedure · Shockwave
Extracorporeal shockwave therapy has the strongest procedural evidence for chronic plantar fasciitis. A meta-analysis of seven placebo-controlled trials found patients were about 30% to 44% more likely to reach at least a 60% improvement in heel pain with shockwave.20 In a 250-patient double-blind trial, heel pain scores fell 69.2% with focused shockwave versus 34.5% with placebo at twelve weeks,21 and a 2024 meta-analysis confirmed benefit for both focused and radial devices.22 The honest counterweight: a well-designed trial published in JAMA found no benefit over placebo,23 and results depend heavily on device settings.22 At FIT LA, shockwave therapy is delivered during Dr. Courseault’s Beverly Hills weeks.
Biologic · ProloBoost Dual PRP
In a 2025 meta-analysis of 24 randomized trials (1,653 patients), platelet-rich plasma produced better pain scores than cortisone at three and six months, though not at one year, along with better foot function at mid- to long-term follow-up.24 In one double-blind randomized trial, 84.4% of PRP patients had improved by at least 25% at one year versus 55.6% with cortisone,25 although not every participant was analyzed at the one-year mark. PRP preparations vary widely, which is one reason results vary. See ProloBoost Dual PRP.
Regenerative · Dextrose prolotherapy
A 2023 meta-analysis of eight randomized trials (444 patients) found that dextrose prolotherapy reduced pain, improved function, and thinned the plantar fascia in the short term, under six months.26 An earlier pilot study of ultrasound-guided dextrose injections reported good-to-excellent results in 16 of 20 patients at about a year,27 and a 2026 one-year ultrasound study of 56 patients found the fascia’s normal fiber pattern returned in most of them after 20% dextrose, even though its thickness did not change significantly.28 Uncontrolled and imaging-only data are promising, not proof. See dextrose & fascial prolotherapy.
Nerve-focused · Hydrofascia Release™
When the map points to Baxter’s nerve, the target changes from the fascia to the nerve. Ultrasound-guided hydrodissection uses fluid to free a nerve from the tissue it is tethered to; in a randomized, double-blind trial for carpal tunnel syndrome, perineural 5% dextrose outperformed control at six months.29 For Baxter’s nerve specifically, the published evidence so far is a single case report, with long-lasting relief.30 Separately, a randomized trial of 81 patients compared ultrasound-guided multi-puncture needling of the fascia with an ultrasound-guided cortisone injection and found that both groups improved in function and on ultrasound by four months.31 Dr. Courseault has published on fascial hydrodissection since 2019,32 including releasing a nerve tethered in fascia.33 See Hydrofascia Release™.
Proceed with caution · Cortisone
We don’t say never. We do say: know the trade-off. A Cochrane review of 39 studies (2,492 adults) found that cortisone injections produced a slight reduction in pain for up to one month and no clear benefit after that.7 In a series of 765 heel-pain patients, 51 ruptured their plantar fascia, and 44 of those ruptures followed a steroid injection; about one in ten of the authors’ own injected patients ruptured, with arch strain, midfoot pain, nerve symptoms, and stress fractures afterward.15 For balance, the Danish long-term study found that ultrasound-guided cortisone did not cause heel fat-pad thinning.5 If you’ve already had several injections, tell us. It changes what we look for.
Last resort · Surgery
Options range from open or endoscopic release of the plantar fascia to calf-muscle lengthening (gastrocnemius recession) and minimally invasive tenotomy. A 2022 systematic review of the randomized trials rated the certainty of evidence for surgery as very low, with side effects poorly reported,34 and studies of calf lengthening report a complication rate of around 8.5%, mostly persistent pain.35 Some people do need a foot and ankle surgeon, and we’ll tell you if you’re one of them. If you’ve already had surgery and still hurt, post-surgical scar and adhesion are things we can image — see scar care.

Where The Evidence Actually Stands

What is proven, what is promising, and what nobody has tested yet

We would rather you hear this from us than discover it later.

Best supported: the home program17,18,19 and shockwave, which has several placebo-controlled trials and meta-analyses behind it, along with at least one well-run negative trial.20,21,23 We treat shockwave as the best-supported procedure, not as a guarantee.

Promising, with randomized support: PRP and dextrose prolotherapy, mostly for the short to medium term of three to six months. Longer-term data are thinner.24,26

Not yet tested in a trial: there is no randomized controlled trial of fascial hydrodissection for plantar fasciitis, and Baxter’s nerve hydrodissection has been reported in a single case.30 We offer it when the exam points to the nerve because the underlying technique has randomized evidence elsewhere in the body,29 and we’ll tell you exactly that before we do it.

What we do about the uncertainty: we measure. Plantar fascia thickness is a number on ultrasound, and your Fascial Map is scored. We re-scan to see whether the tissue actually changed. If the number doesn’t move and your pain doesn’t move, we say so and change the plan, including referring you to a surgeon when that is the right answer.

How care actually proceeds

01 · Map it
A physician-performed Fascial Mapping® ultrasound exam of the heel, arch, Achilles, and calf: plantar fascia thickness at its origin, the Baxter’s nerve region, the calf–Achilles chain, and a side-to-side comparison. We press where it hurts while you tell us whether that is your pain. See what a fascial map actually finds.
02 · Treat the tissue
Shockwave, ProloBoost Dual PRP, dextrose prolotherapy, or Hydrofascia Release™, chosen by the finding rather than by a protocol. Injections are office-based and ultrasound-guided, with no sedation.
03 · Load it
Heel pain comes back when the tissue is never reloaded. You leave with a home program built on the trial evidence above — fascia-specific stretching and progressive heel-raise loading.17,18 Continuing care runs on monthly in-person visits during Dr. Courseault’s Beverly Hills weeks, with shockwave and HUMAN TECAR available while he is in town, and PEMF plus red light available between visits.
04 · Re-measure it
A repeat ultrasound tells us whether the fascia actually changed, not just whether you had a good morning. If a bigger pattern emerges — loose joints everywhere, pain in several places, slow healing — we look upstream at hypermobility and Ehlers-Danlos syndrome and at metabolic contributors through FIT GPS genomic screening.

Want the bigger picture first? Read our Fascia Medicine overview. Our pricing is published.

Is This You?

Three people this page is written for

01

Runners and athletes

Plantar fasciitis is the third most common running injury, behind only patellofemoral pain and IT band syndrome.36 If you’re in a marathon build, on the trails, or on the court and your heel is setting the limits, we can map it and help you keep training where it is safe to. Athletes, see also our hamstring injury page.

02

On your feet all day

Nurses, teachers, chefs, retail staff, film and production crews. In the case-control data, spending most of the workday on your feet raised the odds of plantar fasciitis more than threefold.9 You can’t stop standing, so the tissue has to be able to handle it.

03

You’ve tried everything

Stretching, orthotics, new shoes, a night splint, one or two cortisone shots, and it has been more than six months. That is the point at which the diagnosis deserves a second look. Start with why people get a fascial map.

An Important Boundary

When heel pain isn’t plantar fasciitis, and needs someone else first

Get seen promptly by your physician or urgent care, rather than waiting it out, if you have:

  • A foot that is hot, red, and swollen, especially with fever, or any open wound on the foot if you have diabetes
  • A sudden pop with immediate pain and bruising in the arch
  • Numbness, or burning that spreads across the sole or into the toes, particularly if you have diabetes
  • Pain in both heels along with swollen joints, morning back stiffness, or eye inflammation, which can signal inflammatory arthritis
  • Heel pain after a fall or a jump, or pain with every single step and when the sides of the heel are squeezed, which can signal a stress fracture

Diabetic foot wounds belong with podiatry or wound care. Inflammatory arthritis belongs with a rheumatologist. Structural problems that need an operation belong with a foot and ankle surgeon. Part of our job is telling you which category you’re in, and referring you if the answer isn’t in the soft tissue.

Beverly Hills · 415 N. Crescent Drive

Find out what’s actually hurting in your heel

A physician-performed ultrasound, a measured plantar fascia, a check of the nerve and calf structures that mimic it, and a treatment plan matched to what we find. Five to ten minutes from Century City; patients travel to us from across California and beyond.

Frequently asked questions

Is plantar fasciitis the same as a heel spur?

No. A heel spur is a bony projection on the heel bone; plantar fasciitis is degeneration of the fascia attached nearby.3 Spurs are somewhat more common in people with heel pain,11 but they are also found in 10% to 63% of people with no pain at all,12 and in a 15-year follow-up, having one made no difference to who recovered.5 We treat the soft tissue, not the spur.

Will plantar fasciitis go away on its own?

Often, eventually. In one long-term study, 82 of 100 conservatively treated patients had resolved at an average of almost four years.4 In a hospital-referred Danish cohort, though, 80.5% still had symptoms at one year, half at five years, and 44% at fifteen.5 If it has been six months or more despite a good home program, the diagnosis deserves a second look.

Should I get a cortisone shot for plantar fasciitis?

That is a decision to make with your physician, with the trade-off in view. In pooled trial data, cortisone produced a slight pain reduction for up to about a month and no clear benefit after that.7 Plantar fascia rupture after injection is a documented complication.15 Many patients prefer to try options with longer-lasting trial data first, such as shockwave or PRP.20,24 If you have already had several injections, we will look specifically for tearing.

How many shockwave sessions does plantar fasciitis take?

The large placebo-controlled trial used three sessions a week apart,21 but protocols vary widely and device settings affect results.22 We give you an estimate after your exam. Because shockwave at FIT LA is delivered during Dr. Courseault’s Beverly Hills weeks, we schedule sessions around those visits. See pricing.

Do I need custom orthotics?

Not necessarily, and not on their own. The 2023 physical therapy guideline advises against relying on orthoses alone for short-term relief, and recommends stretching, taping, manual therapy, and night splints for first-step pain.19 Supportive footwear or inserts can be a useful part of a plan, especially if your feet flatten a lot when you stand.

My heel pain burns or tingles. Is that still plantar fasciitis?

Maybe not entirely. Burning, electric, or tingling pain, especially toward the inside edge of the heel, raises the question of Baxter’s nerve entrapment,13,14 as well as tarsal tunnel syndrome or neuropathy. That is exactly what the ultrasound exam helps separate. If the nerve is involved, ultrasound-guided hydrodissection is an option; for this particular nerve, the published evidence is a single case report so far.30

Do you take insurance, and can I come from outside Los Angeles?

Call us at (424) 378-3488 or use the contact page for current insurance and payment details; our pricing is published. Patients travel to our Beverly Hills clinic from around the country, and The Fascia Institute also has a flagship location in New Orleans. Telehealth consultations are available for California-based patients for the parts of care that don’t require the ultrasound probe.

References & further reading

  1. Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int. 2004;25(5):303–310. PMID 15134610
  2. Rhim HC, Kwon J, Park J, Borg-Stein J, Tenforde AS. A systematic review of systematic reviews on the epidemiology, evaluation, and treatment of plantar fasciitis. Life (Basel). 2021;11(12):1287. PMID 34947818
  3. Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003;93(3):234–237. PMID 12756315 (surgical specimens, no control group)
  4. Wolgin M, Cook C, Graham C, Mauldin D. Conservative treatment of plantar heel pain: long-term follow-up. Foot Ankle Int. 1994;15(3):97–102. PMID 7951946 (retrospective follow-up)
  5. Hansen L, Krogh TP, Ellingsen T, Bolvig L, Fredberg U. Long-term prognosis of plantar fasciitis: a 5- to 15-year follow-up study of 174 patients with ultrasound examination. Orthop J Sports Med. 2018;6(3):2325967118757983. PMID 29536022 (hospital-referred cohort; skews toward chronic cases)
  6. McMillan AM, Landorf KB, Barrett JT, Menz HB, Bird AR. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis. J Foot Ankle Res. 2009;2:32. PMID 19912628
  7. David JA, Sankarapandian V, Christopher PR, Chatterjee A, Macaden AS. Injected corticosteroids for treating plantar heel pain in adults. Cochrane Database Syst Rev. 2017;6(6):CD009348. PMID 28602048 (low-quality evidence)
  8. Stecco C, Corradin M, Macchi V, Morra A, Porzionato A, Biz C, De Caro R. Plantar fascia anatomy and its relationship with Achilles tendon and paratenon. J Anat. 2013;223(6):665–676. PMID 24028383
  9. Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg Am. 2003;85(5):872–877. PMID 12728038 (wide confidence intervals)
  10. van Leeuwen KDB, Rogers J, Winzenberg T, van Middelkoop M. Higher body mass index is associated with plantar fasciopathy/’plantar fasciitis’: systematic review and meta-analysis of various clinical and imaging risk factors. Br J Sports Med. 2016;50(16):972–981. PMID 26644427
  11. Menz HB, Zammit GV, Landorf KB, Munteanu SE. Plantar calcaneal spurs in older people: longitudinal traction or vertical compression? J Foot Ankle Res. 2008;1:7. PMID 18822162
  12. Kirkpatrick J, Yassaie O, Mirjalili SA. The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations. J Anat. 2017;230(6):743–751. PMID 28369929
  13. Baxter DE, Pfeffer GB. Treatment of chronic heel pain by surgical release of the first branch of the lateral plantar nerve. Clin Orthop Relat Res. 1992;(279):229–236. PMID 1600660 (surgical case series)
  14. Chundru U, Liebeskind A, Seidelmann F, et al. Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot. Skeletal Radiol. 2008;37(6):505–510. PMID 18286281
  15. Acevedo JI, Beskin JL. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int. 1998;19(2):91–97. PMID 9498581 (retrospective single-practice series)
  16. Wright AA, Hegedus EJ, Lenchik L, Kuhn KJ, Santiago L, Smoliga JM. Diagnostic accuracy of various imaging modalities for suspected lower extremity stress fractures: a systematic review with evidence-based recommendations for clinical practice. Am J Sports Med. 2016;44(1):255–263. PMID 25805712
  17. DiGiovanni BF, Nawoczenski DA, Lintal ME, et al. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain: a prospective, randomized study. J Bone Joint Surg Am. 2003;85(7):1270–1277. PMID 12851352
  18. Rathleff MS, Mølgaard CM, Fredberg U, et al. High-load strength training improves outcome in patients with plantar fasciitis: a randomized controlled trial with 12 months follow-up. Scand J Med Sci Sports. 2015;25(3):e292–e300. PMID 25145882 (benefit at 3 months; no difference at 12 months)
  19. Koc TA Jr, Bise CG, Neville C, Carreira D, Martin RL, McDonough CM. Heel pain – plantar fasciitis: revision 2023. J Orthop Sports Phys Ther. 2023;53(12):CPG1–CPG39. PMID 38037331 (clinical practice guideline)
  20. Aqil A, Siddiqui MRS, Solan M, Redfern DJ, Gulati V, Cobb JP. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs. Clin Orthop Relat Res. 2013;471(11):3645–3652. PMC3792262
  21. Gollwitzer H, Saxena A, DiDomenico LA, et al. Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am. 2015;97(9):701–708. PMID 25948515 (FDA device trial; placebo group improved 34.5%)
  22. Lippi L, Folli A, Moalli S, et al. Efficacy and tolerability of extracorporeal shock wave therapy in patients with plantar fasciopathy: a systematic review with meta-analysis and meta-regression. Eur J Phys Rehabil Med. 2024;60(5):832–846. PMID 39257331
  23. Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: a randomized controlled trial. JAMA. 2002;288(11):1364–1372. PMID 12234230 (no benefit over placebo)
  24. Zuo A, Gao C, Jia Q, et al. Platelet-rich plasma versus corticosteroids in the treatment of plantar fasciitis: a systematic review and meta-analysis. Am J Phys Med Rehabil. 2025;104(7):613–621. PMID 39778212
  25. Peerbooms JC, Lodder P, den Oudsten BL, Doorgeest K, Schuller HM, Gosens T. Positive effect of platelet-rich plasma on pain in plantar fasciitis: a double-blind multicenter randomized controlled trial. Am J Sports Med. 2019;47(13):3238–3246. PMID 31603721 (82 of 115 participants analyzed at one year)
  26. Chutumstid T, Susantitaphong P, Koonalinthip N. Effectiveness of dextrose prolotherapy for the treatment of chronic plantar fasciitis: a systematic review and meta-analysis of randomized controlled trials. PM R. 2023;15(3):380–391. PMID 35338597 (short-term outcomes)
  27. Ryan MB, Wong AD, Gillies JH, Wong J, Taunton JE. Sonographically guided intratendinous injections of hyperosmolar dextrose/lidocaine: a pilot study for the treatment of chronic plantar fasciitis. Br J Sports Med. 2009;43(4):303–306. doi:10.1136/bjsm.2008.050021 (uncontrolled pilot)
  28. Saura-Sempere A, Sanchez-Gomez R, Ortuño-Soriano I, Zaragoza-García I, et al. Ultrasound evidence of fibrillar and thickness changes in plantar fasciosis following 20% dextrose prolotherapy: perifascial vs. intrafascial injection during a 1-year follow-up. Life (Basel). 2026;16(7):1051. PMID 42514122 (imaging outcomes; no sham group)
  29. Wu YT, Ho TY, Chou YC, et al. Six-month efficacy of perineural dextrose for carpal tunnel syndrome: a prospective, randomized, double-blind, controlled trial. Mayo Clin Proc. 2017;92(8):1179–1189. PMID 28778254
  30. Sahoo RK, Peng PWH, Sharma SK. Ultrasound-guided hydrodissection for Baxter’s neuropathy secondary to plantar fasciitis: a case report. A A Pract. 2020;14(13):e01339. PMID 33185409 (single case)
  31. Montes-Salas R, Mahillo-Durán R, Gómez-Carrión Á, et al. Ultrasound-guided procedures for plantar fasciitis: a randomized clinical study. J Orthop Surg Res. 2024;19:436. PMID 39060929
  32. Courseault J, Kessler E, Moran A, Labbe A. Fascial hydrodissection for chronic hamstring injury. Curr Sports Med Rep. 2019;18(11):416–420. PMID 31702723
  33. Gerard NO 3rd, Mortell TM, Kingry C, Couture C, Courseault J. Hydrodissection of an ulnar nerve fascial adhesion in a baseball pitcher. JSES Rev Rep Tech. 2023;3(2):252–255. PMID 37588433
  34. MacRae CS, Roche AJ, Sinnett TJ, O’Connell NE. What is the evidence for efficacy, effectiveness and safety of surgical interventions for plantar fasciopathy? A systematic review. PLoS One. 2022;17(5):e0268512. PMC9116678
  35. Arshad Z, Aslam A, Razzaq MA, Bhatia M. Gastrocnemius release in the management of chronic plantar fasciitis: a systematic review. Foot Ankle Int. 2022;43(4):568–575. PMID 34766860
  36. Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002;36(2):95–101. PMID 11916889

Across The Fascia Institute Network

The heel-pain approach on this page is shared with our New Orleans flagship, The Fascia Institute and Treatment Center. See their shockwave therapy page, their review of dextrose prolotherapy for lower-extremity injuries, which includes the plantar fasciitis trials, and their explainer on what a fascial hydrodissection is. Learn more about our founder and physician, Dr. Jacques Courseault, MD, or read his Los Angeles page.

Heel and arch pain in someone whose joints are loose everywhere deserves a broader look. Our dedicated Hypermobility & Ehlers-Danlos Clinic has a practical guide to shoes for hypermobile feet and an EDS blog, and New Orleans covers ankle stability in hypermobility and EDS. In Los Angeles, see our hypermobility and EDS protocol.

This page is for educational purposes only and is not medical advice, diagnosis, or treatment, and it does not create a physician–patient relationship. Shockwave, PRP, dextrose prolotherapy, and ultrasound-guided hydrodissection are not appropriate for every cause of heel pain, and no outcome is guaranteed; individual results vary. Seek prompt care for a hot, red, or swollen foot, fever, a foot wound if you have diabetes, a sudden pop with bruising, or spreading numbness. The Fascia Institute and Treatment Center® of LA · 415 North Crescent Drive, Suite 130, Beverly Hills, CA 90210 · (424) 378-3488 · fit@fasciala.com.