Plantar Fasciitis Medication

Updated: Jan 22, 2019
  • Author: Craig C Young, MD; Chief Editor: Craig C Young, MD  more...
  • Print
Medication

Medication Summary

The overall goals of pharmacotherapy in patients with plantar fasciitis are to reduce morbidity and prevent complications. Medications are used primarily to decrease pain and inflammation. The most commonly used medications are oral nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections, which may be employed in conjunction with physical therapy.

Next:

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Class Summary

NSAIDs have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase (COX) activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell-membrane functions.

NSAIDs can help decrease pain and inflammation in patients with plantar fasciitis. Various oral NSAIDs can be used; there are no particular drugs of choice. The choice of NSAID is largely a matter of convenience (eg, the frequency with which doses must be taken to achieve adequate analgesic and anti-inflammatory effects) and cost.

Ibuprofen (Motrin, I-Prin, Advil, Caldolor)

Ibuprofen is a member of the propionic acid group of NSAIDs. It is available in a low-dose form as an over-the-counter (OTC) medication. It is highly protein-bound, is metabolized in the liver, and is eliminated primarily in the urine.

Ibuprofen is used for analgesia and anti-inflammatory effect and is the drug of choice for patients with mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis. It may reversibly inhibit platelet function.

Naproxen (Aleve, Anaprox, Naprosyn, Naprelan)

Naproxen is a member of the propionic acid group of NSAIDs. It is available in low-dose form as an OTC medication. It is highly protein-bound, is metabolized in the liver, and is eliminated primarily in the urine. Naproxen may reversibly inhibit platelet function.

Sulindac (Clinoril)

Sulindac decreases COX activity and, in turn, inhibits prostaglandin synthesis. This results in decreased formation of inflammatory mediators.

Celecoxib (Celebrex)

Celecoxib primarily inhibits COX-2. COX-2 is considered an inducible isoenzyme, induced during pain and inflammatory stimuli. Inhibition of COX-1 may contribute to NSAID gastrointestinal (GI) toxicity. At therapeutic concentrations, COX-1 isoenzyme is not inhibited; thus, GI toxicity may be decreased. Seek the lowest dose of celecoxib for each patient.

Meloxicam (Mobic)

Meloxicam decreases COX activity, and this, in turn, inhibits prostaglandin synthesis. These effects decrease the formation of inflammatory mediators.

Ketoprofen

Ketoprofen is used for relief of mild to moderate pain and inflammation. Small dosages are indicated initially in small patients, elderly patients, and patients with renal or liver disease. Doses higher than 75 mg do not increase the therapeutic effects. Administer high doses with caution, and closely observe the patient's response.

Flurbiprofen

Flurbiprofen may inhibit COX, thereby, in turn, inhibiting prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.

Previous
Next:

Corticosteroids

Class Summary

In contrast to the widespread systemic distribution achieved with oral administration of an anti-inflammatory drug, local injection of a corticosteroid can achieve focal placement of a potent anti-inflammatory agent at the site of maximal tenderness or inflammation. Various corticosteroid preparations from which to choose. Commonly, the corticosteroid is mixed with a local anesthetic agent before injection. Again, there are various local anesthetic agents from which to choose.

Triamcinolone (Aristospan, Kenalog-10, Kenalog-40)

Triamcinolone is an injectable corticosteroid anti-inflammatory agent used to treat localized areas of inflammation. It has an intermediate duration of action.

Betamethasone sodium (Celestone, Soluspan)

Betamethasone is an injectable corticosteroid anti-inflammatory agent used to treat localized areas of inflammation. It has an intermediate duration of action.

Methylprednisolone (Depo-Medrol, A-Methapred, Medrol)

Methylprednisolone decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability. It is commonly given via local injection of bursae or joints to provide a local anti-inflammatory effect while minimizing some of the GI and other risks of systemic medications.

Previous