Radiation therapy for plantar fasciitis

The plantar fascia is a strong band of tissue that stretches along the underside of the foot, under the skin, from your heel to the middle of the foot.²

This ligament normally acts as shock-absorber and supports the arch of your foot, but when it becomes overloaded or over-used, the plantar fascia can start to degenerate. This results in pain in the heel, known as plantar fasciitis.³

For many people who are later diagnosed with plantar fasciitis, the main symptom is pain under the heel, which is often described as sharp. Pain occurs with the first few steps taken in the morning and tends to improve throughout the day.²

Plantar fasciitis is a repetitive strain condition affecting approximately 10% of the population at some point in their lives.⁴ For most people, the pain improves with general measures such as rest, stretching, and changing footwear. However, in about 20% of people who suffer from the condition, the heel pain can persist.^2,4

Factors which may increase your risk of developing plantar fasciitis include:⁴

• Standing for very long periods
• Increased weight
• Excessive running
• Sedentary lifestyle
  

Assessment

An initial assessment and discussion is important to help understand the uncertainties and alternative treatment options.

At the assessment, your specialist will discuss whether radiotherapy might be helpful for your condition, as well any as side-effects you may experience.

Note: You will need a referral from a GP or specialist for an assessment.
 

Treatment

Radiation therapy may be used to help relieve the pain associated with plantar fasciitis.^4,6,7 In general, radiation therapy is best suited for people who are still experiencing pain and discomfort after failure of other treatment measures for more than 6 months.^5,7,8

During your treatment, radiation is aimed towards the area of pain in your heel.¹ Radiation therapy has an anti-inflammatory effect and promotes healing in the fascia.⁸

A clinical trial has shown radiotherapy to be more effective than steroid injections, with approximately 85% of patients noting an improvement in discomfort 6 months after treatment.¹

A technique called external beam radiation therapy is used to treat plantar fasciitis, and it is delivered by a linear accelerator (LINAC).^6,9

Treatment is usually delivered over 6 outpatient visits, with the option to repeat another 6 treatments after 12 weeks.

1. Canyilmaz E, et al. Int J Rad Oncol 2015;92(3):P659–666.
2. Thompson J, et al. J Osteo Med 2014;114(12):900–906.
3. Buchanan BK, Kushner D. Plantar Fasciitis. [Updated 2022 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431073/ (accessed July 2023).
4. Trojian T and Tucker A. Am Fam Phys 2019;99(12):744–750.
5. Schwartz E. Perm J 2014; 18(1):e105–e107.
6. Ott OJ, et al. Strahlenther Onkol 2015;191:1–6.
7. Royal College of Radiologists. Recommendations for using radiotherapy for benign disease in the UK. March 2023.
8. Rogers S, et al. Front Med (Lausanne) 2020;7:195.
9. Hermann RM, Bruns F and Nitsche M. (2017). Low dose radiotherapy of painful heel spur/plantar fasciitis as an example of treatment effects in benign disease. In Onal C (Ed.), Radiotherapy (pp 143–172). InTechOpen.