Plantar Fascitis or heel pain and its Ayurveda Management

Plantar Fascitis and Its Ayurvedic Management (Vatakandaka)

Originally published in June 2013. Last updated on July 5, 2025

By Dr. Rimin Razak

🌿 Introduction

Plantar Fasciitis is a painful inflammatory condition of the plantar fascia — the thick connective tissue that runs across the sole of the foot, connecting the heel bone (calcaneus) to the toes. It supports the arch of the foot and absorbs impact while walking or standing.

Excess strain on this fascia leads to inflammation, weakening, swelling, or even microtears, causing intense heel pain, especially in the anterior portion of the heel. This condition is common among middle-aged individuals, athletes, or anyone who spends extended time on their feet. It’s also referred to as “Policeman’s Heel.”

🔍 Common Causes of Plantar Fasciitis

• Flat feet or high arches
• Calcaneal spur
• Prolonged standing or walking on hard surfaces
• Barefoot walking
• Excess body weight
• Wearing improper, tight, or high-heeled footwear
• Weak calf muscles
• Inward foot rolling (overpronation)

🧬 Pathology

Chronic plantar fasciitis is more degenerative than inflammatory. Since tendons and ligaments lack direct blood supply, damage often results from microscopic tears due to repeated stress. These injuries occur at the junction where the plantar aponeurosis attaches to the calcaneal tuberosity. This ongoing trauma may even cause calcaneal spur formation, worsening the pain.

🩺 Symptoms

• Sharp pain when taking the first steps in the morning or after rest
• Pain that worsens after long walks or standing
• Heel stiffness or mild swelling
• Numbness or tingling in chronic cases

⚠️ Aggravating Factors

• Long periods of walking, standing, or running
• Walking barefoot
• Use of improper footwear
• Lack of rest and recovery

🧪 Diagnosis

Diagnosis is primarily clinical through physical examination. Doctors check foot structure, walking posture, and pain points. Imaging may include:

• X-rays (to detect bone spurs)
• Ultrasound (for soft tissue inflammation)
• MRI (in resistant or complex cases)

🔄 Differential Diagnosis

• Heel spur (caused by plantar fascia tension, not the other way around)
• Metatarsalgia or capsulitis (pain in the ball of the foot)
• Inflammation of flexor digitorum brevis (not plantar fascia) in some recent studies

📈 Prognosis

While plantar fasciitis can be persistent, early intervention leads to full recovery in most cases. Chronic pain may require integrated therapies. Ayurveda offers curative potential with minimal side effects.

✅ Prevention Tips

• Use footwear with arch support
• Avoid barefoot walking
• Stretch your calves regularly
• Maintain healthy weight
• Warm-up before exercises
• Reduce intake of excessively spicy foods

 

 

🩺 Treatments for Plantar Fasciitis: Complete Guide

Plantar Fasciitis can be effectively managed with a combination of rest, therapy, lifestyle changes, medication, and in rare cases, surgery. While complete and permanent cure may be difficult in some chronic conditions, most individuals recover fully with proper care.

Below are the treatment strategies grouped under key areas:

🔄 1. Lifestyle Management

• Identify and avoid causative factors (long standing, barefoot walking, etc.)
• Maintain a healthy weight to reduce stress on feet
• Wear properly fitted, supportive shoes (avoid high heels)
• Avoid junk, spicy, and excessively hot foods (to prevent obesity and inflammation)
• Include yoga and stretching exercises in your daily routine
• Get adequate rest after physical exertion

🧘 2. Exercise Therapy

Goal: Reduce pressure on the heel and improve muscle strength and flexibility.

✅ Calf Muscle Stretch

• Stand facing a wall.
• One leg behind (straight), one in front (bent).
• Push hips forward and feel the stretch in your calf.
• Hold for 10 seconds and repeat 20 times per leg.

✅ Plantar Fascia Stretch

• Sit and cross affected leg.
• Pull toes back gently with hand or towel.
• Hold for 10 seconds and repeat several times before walking in the morning.

✅ Rolling Exercise

• While seated, roll a tennis ball or marble under the foot from heel to toe.

✅ Leg Out-Stretching

• Stand with one leg forward and knee bent, back leg straight.
• Keep back upright and stretch for 1–2 minutes.
• Repeat for the other leg.

 

💊 3. Medication

• OTC Pain Relievers: Acetaminophen, Ibuprofen, or Naproxen
• Note: Long-term use may lead to ulcers, GI discomfort, or bleeding. Always use under supervision.

👟 4. Shoe & Foot Support

• Wear well-fitted footwear with proper arch and heel support
• Use orthotic inserts, heel cups, or insoles
• Walk around before buying shoes; ensure toe space and comfort
• Avoid high-heeled shoes and tight-fitting styles

✅ Orthopaedic Molds

• Easily available and effective
• Insert inside shoes to cushion the heel and reduce strain

❄️ 5. Other Conservative Methods

• Apply ice packs for 10–15 minutes twice a day
• Use night splints to keep the foot flexed while sleeping
• Massage the inflamed heel area for temporary relief

💉 6. Injections

• Corticosteroid + Local Anesthetic (e.g., Xylocaine): Reduces inflammation temporarily
• Botox injections may be used in rare cases
• ⚠️ Side effects: Fat necrosis, fascia rupture, worsening symptoms

🔊 7. Extracorporeal Shock Wave Therapy (ESWT)

• Uses sound waves to stimulate tissue healing
• Typically used in chronic or resistant cases

🏥 8. Surgery

Surgery is considered only when all other treatments fail after 10–12 months.

Surgical Techniques Include:

• Plantar fascia release
• Instep plantar fasciotomy (removes part of fascia to relieve nerve pressure)
• Spur removal
• Endoscopic plantar fasciotomy (minimally invasive but risk of nerve damage)

Pre-Surgical Requirements:

• Imaging and clinical assessment
• Post-op care: rest, cold compression, controlled weight-bearing
• May require bandages, splints, or casts

Possible Complications:

• Nerve damage
• Recurring heel pain
• Permanent numbness
• Infection, scarring
• Instability, foot cramps, stress fractures

🔬 Alternative Minimally Invasive Options:

• Ultrasound-guided needle fasciotomy: Disrupts fibrous fascia tissue
• Coblation (Topaz procedure): Uses radiofrequency ablation with smaller incisions

🏠 Home Remedies for Heel Pain

🧊 Cold & Heat Therapy

• Roll cold and warm water-filled bottles alternately under the heel for relief
• Effective but short-lived benefit

🧂 Salt Water Immersion

• Soak affected foot in warm salt water for 20 minutes daily

🥛 Sour Buttermilk Immersion

• Mix 2–3 liters of sour buttermilk (or lemon-added buttermilk)
• Soak foot in it for 20 minutes

💧 Chlorinated Water Soak

• Helps reduce inflammation and swelling.

🌿 Natural Packs

• Flaxseed paste or cabbage leaf wraps on heel
• Soak feet in borax solution regularly

🍎 Apple Cider Vinegar

• Cut paper in the shape of your heel
• Soak it in apple cider vinegar
• Apply to heel daily for 4–5 days for relief

 

Heel Pain or Plantar Fasciitis in Ayurveda – Understanding Vatakandaka

In Ayurveda, Plantar Fasciitis or chronic heel pain is known as Vatakandaka, a condition caused by the vitiation of Vata and Kapha doshas. It is a well-described and curable disease in classical Ayurvedic texts.

Although commonly observed in the elderly due to natural vata dominance in old age, Vatakandaka is also prevalent among middle-aged individuals, especially those with high physical strain or poor lifestyle habits.

🔬 Ayurvedic Pathology: Why Heel Pain Happens

• Kapha Dosha Imbalance causes abnormal bone formation, excessive calcium deposits, and the development of heel spurs.
• Vata Dosha Imbalance disrupts movement and nerve functions, causing pain, stiffness, and burning sensations.
• Blockage of vata srotas (channels) by aggravated kapha leads to chronic inflammation and pain at the heel region.

Ayurveda believes that when these doshas are corrected, symptoms can be relieved naturally—without the need for injections or surgery.

⚠️ Common Causes of Vata Vitiation (Vata Dushti)

• Excessive physical exertion or high-impact exercise
• Walking barefoot on cold, hard surfaces
• Frequent consumption of hot, pungent, and spicy foods
• Aging (vata naturally increases in old age)
• Inadequate sleep or irregular sleep habits
• Chronic mental stress or anxiety
• Environmental exposure to cold and dry conditions.

⚠️ Common Causes of Kapha Vitiation (Kapha Dushti)

• Sedentary lifestyle or lack of physical activity
• Overeating heavy, sweet, or oily foods
• Obesity and excess body weight
• Diabetes mellitus (a classic Kapha-type disorder)
• Poor metabolic fire (Agni) causing sluggish digestion

🔹 Treatment Plan for Vatakantaka in Ayurveda

Treatment should be planned by assessing the Vyadhi Lakshanas (symptoms) and correcting the doshic imbalance—primarily Vata, secondarily Kapha.

🔸 1. Abhyanga (Oil Massage) – Snigdha Therapy

A gentle oil massage using warm medicated oils helps to pacify the aggravated Vata and strengthen bone and soft tissue. Common oils used include:

• Mahanarayana Taila
• Ksheerabala Taila
• Dhanwantharam Tailam

🔸 2. Swedana (Fomentation Therapy) – Ruksha Sweda

Dry fomentation therapies, especially:

• Ishtika Sweda (heated brick fomentation), help reduce stiffness, pain, and inflammation.

🔸 3. Internal Medications

Internal Ayurvedic medicines (under physician guidance) are used to:

• Support Vata-Kapha balance
• Reduce inflammation
• Strengthen Asthi Dhatu

Some formulations may include:

• Guggulu-based preparations
• Kashayams (decoctions) like Dashamoola, Rasnaadi
• Ghrithams like Gulgulu Tikthakam Ghritham

🔸 4. Panchakarma Therapies

Depending on the individual’s constitution and severity, Panchakarma procedures may be advised, such as:

• Abhyanga (oil massage)
• Raktamoksha (bloodletting)
• Agnikarma (therapeutic cautery)
• Suchi Daha (therapeutic needling)

These specialized therapies help relieve chronic pain, correct the pathology, and rejuvenate tissues.

🔸 5. Lifestyle Modifications

Ayurveda emphasizes restoration of lifestyle balance, including:

• Adequate rest between work or walking sessions
• Avoiding triggers like prolonged standing or walking barefoot
• Maintaining healthy body weight
• Using supportive footwear

🔸 6. Yoga and Mental Health

Practicing specific yoga asanas and relaxation techniques can help improve joint flexibility, reduce mental stress, and support healing from within.

 

Shodhana/ Samana Chikitsa and Ayurvedic Management of Vatakantaka (Plantar Fasciitis)

Ayurveda identifies Vatakantaka, or Plantar Fasciitis, as a Vata-Kapha disorder with involvement of Asthi Dhatu Vaishamya (bone tissue irregularity). Kerala’s classical Ayurveda offers a range of internal and external treatments—Shodhana (purificatory therapies) and Samana (pacifying therapies)—for effective healing and pain management.

🔹 What Is Shodhana and Samana Chikitsa?

• Shodhana Chikitsa involves purificatory therapies like Virechana (purgation) and Vasti (enema) that eliminate the vitiated doshas from the body.
• Samana Chikitsa involves palliative treatments to balance doshas and manage symptoms without eliminating toxins.

🔸 1. Shodhana Treatments

✅ Virechana (Purgation)

Gentle cleansing using:

• Gandharvahastadi Eranda
• Sukumara Erandam

✅ Matra Vasti (Medicated Enema)

Given with:

• Guggulu Tikthakam Ghritham
• Narayana Taila + Guggulu Tikthakam Ghritham
• Dhanwantharam Tailam (Mezhuku Pakam)

🔸 2. Useful Kashayams (Herbal Decoctions)

• Rasnadi Kashaya
• Dhanadanayanadi Kashaya
• Rasnerandadi Kashaya
• Dashamoola Kashaya
• Jeeraka Shatapushpa Ksheera Kashaya
• Adaree Sahacharadi Kashaya
• Guggulu Tikthakam Kashaya
• Sahacharadi Kashaya
• Sundi Baladi Kashaya

🔸 3. Arishta & Asava (Medicated Fermented Preparations)

• Balarishta
• Jeerakarishta

🔸 4. Tablets/Gulika

• Chandraprabha Vati
• Yogaraja Guggulu
• Rasnadi Guggulu
• Kaishora Guggulu

🔸 5. External Applications (Lepana)

• Dasanga Lepam
• Karutha Vattu (prepared with egg white and applied locally)

🔸 6. Tailas (Medicated Oils)

🔹 External Use

• Chinchadi Taila
• Kottamchukkadi Taila
• Pinda Taila
• Mahanarayana Taila
• Dhanwantharam Tailam

🔹 Internal Use

• Gandha Taila
• Ksheerabala Taila

🔸 7. Ghritha (Medicated Ghee)

• Rasnadi Ghritham
• Guggulu Tikthakam Ghritham

🔸 8. Herbal Powders (Churna)

• Turmeric Powder
• Triphala Powder

🔹 Ishtika Sweda (Heated Brick Fomentation)

One of the most effective, affordable, and simple home remedies used in Kerala for Plantar Fasciitis.

✅ Materials Required

• Medicated oil for massage (e.g., Pinda Taila, Mahanarayana Taila)
• 2 medium-sized bricks
• Boiled rice water or Dashamoola Kashaya (1 litre)
• Clean cloth for bolus (for Method 2)

🧪 Procedure

🔸 Method 1

1. Apply warm oil on the heel.
2. Heat brick till red-hot.
3. Place it in a vessel, pour rice water or kashaya over it.
4. Let steam rise. Expose the affected heel to the steam.
5. Alternate bricks to maintain temperature.
6. Continue until signs of proper sudation (Samyak Swinna Lakshana) appear.

🔸 Method 2 (Bolus Method)

1. Break hot brick into small pieces.
2. Dip in rice water or Dashamoola Kashaya.
3. Wrap in cloth and use it as a bolus to massage the affected area.

Note: Not suitable for diabetic patients with sensory issues.

🔹 Agnikarma for Heel Pain

A classical thermal cauterization technique for chronic heel pain relief.

✅ Required Materials

• Loha Shalaka (metal rod)
• Aloe vera leaf
• Jatyadi Taila or turmeric powder

🧪 Procedure

1. Use heated Loha Shalaka to create Bindu (dot burns) over the heel.
2. Soothe with aloe vera application.
3. Apply Jatyadi Taila post-procedure.

🔹 Yoga & Lifestyle Support for Plantar Fasciitis

✅ 1. Vajrasana

• Sit in Vajrasana, followed by Viparita Karani or Sarvangasana.
• Repeat 3 times daily.
• Use elastic foot support and elevate foot when needed.

✅ 2. Pranayama

• Practice Anuloma Viloma for mental calm and dosha balance.

✅ 3. Kathakali Posture

• Maintain heel alignment and support during prolonged standing or activity.

🔹 Preventive Measures

• Avoid excessive walking, barefoot movement, and high heels
• Maintain ideal body weight
• Ensure adequate rest and proper footwear
• Address mental stress, which worsens Vata disorders

 

Recent and Complementary Treatments for Plantar Fasciitis

In addition to traditional Ayurvedic therapies, several modern and integrative treatments have emerged that offer faster or enhanced relief for chronic plantar fasciitis. These therapies are especially helpful when the condition becomes resistant to conventional management.

 

🔬 1. Platelet-Rich Plasma (PRP) Therapy

PRP involves extracting and concentrating a small amount of the patient’s own blood, rich in healing growth factors. This plasma is then injected into the affected area of the heel to promote natural tissue repair and reduce inflammation.

✔️ Effective for chronic and stubborn cases.

🔊 2. Extracorporeal Shockwave Therapy (ESWT)

A non-invasive therapy that uses sound waves to stimulate healing in the plantar fascia. It helps increase blood flow, reduce pain, and accelerate recovery.

✔️ Used when other conservative methods have failed.

🪡 3. Dry Needling and Acupuncture

These techniques involve inserting fine needles into trigger points of the foot and fascia. Acupuncture can relieve pain and restore energy balance, while dry needling targets muscular knots directly.

✔️ Sometimes integrated with Ayurvedic Marma therapy.

 

🩻 4. 3D Custom Orthotic Insoles

Modern podiatry now uses 3D scanning to design custom-made insoles that perfectly support the foot’s arch and redistribute pressure evenly.

✔️ Helpful for preventing recurrence.

 

🌿 Emerging Ayurvedic and Natural Approaches

🔥 5. Agnikarma (Therapeutic Cauterization)

A traditional Ayurvedic method where heated metal instruments are applied at specific points on the heel to reduce pain and inflammation.

✔️ Provides fast pain relief, especially in chronic conditions.

🔘 6. Marma Chikitsa (Vital Point Therapy)

This involves stimulating specific marma (vital) points on the foot, which can release blocked energy and enhance neuromuscular function.

✔️ An advanced yet gentle Ayurvedic technique.

💧7. Localized Kshara Basti (External Herbal Enema)

A modified Ayurvedic treatment where medicated oil or herbal decoction is retained around the heel in a herbal dough ring to deliver localized healing.

✔️ Helps pacify Vata and rejuvenate tissues.

🧘‍♂️ 8.Home-Based Supportive Therapies

• Foot Roller & Massage Ball Therapy Rolling a massage ball or wooden foot roller under the arch helps loosen the fascia and improve circulation.
• Yoga Poses for Fascia Release Poses such as Adho Mukha Svanasana (Downward Dog), Toe Stretches, and Legs-Up-The-Wall (Viparita Karani) can reduce stress on the heel and promote flexibility.

 

✨ Conclusion

Combining traditional Ayurvedic therapies with modern innovations can significantly enhance recovery from plantar fasciitis. These newer treatments offer hope for those with chronic heel pain and can be safely integrated with Ayurveda under professional guidance.

 

 

🧾 Credits & References:

·       Classical Ayurvedic texts

·       Clinical insights

·       Wikipedia & verified medical sources.

📜 Disclaimer

This article is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified Ayurvedic physician before beginning any treatment.

✍️ About the Author

Dr. Rimin Abdul Razak, BAMS. Ayurvedic physician and experienced medical insurance specialist. Founder of Vaidyaveekshan, an Ayurvedic knowledge blog aimed at spreading holistic wellness based on classical wisdom.

📧 contact me