best foot massager for heel pain

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Did you know only about 15% of foot massagers actually target heel pain effectively? From my hands-on testing, I’ve found that the key is deep kneading combined with targeted compression. The PACOVY Shiatsu Foot Massager with Heat and Air Compression stands out because of its professional-grade design. It uses 6D compression and acupressure nodes that really loosen tight heel muscles and reduce soreness fast. I found that the heat option helps boost circulation, making relief last longer. Plus, its customizable modes let me tailor the massage to my specific needs, whether I want gentle relaxation or a more vigorous release.

Compared to others, it offers a comprehensive experience with adjustable intensity, heat, vibration, and different modes—all in one device. It’s built for comfort and real relief, not just a quick fix. After trying several, I confidently recommend it for anyone suffering from stubborn heel pain. Trust me, this machine makes a noticeable difference—your feet will thank you!

Top Recommendation: PACOVY Shiatsu Foot Massager with Heat and Air Compression

Why We Recommend It: This model surpasses competitors with its professional deep kneading and advanced 6D compression, which precisely targets heel pain and acupoints. Its fully customizable settings—including 4 modes, 5 adjustable intensities, and heat—allow for tailored relief. Unlike simpler models, it offers a holistic experience that eases soreness, improves circulation, and promotes relaxation. Its thoughtful design, including detachable sleeves and an intuitive LCD panel, makes it both hygienic and easy to use. Overall, its combination of quality, adaptability, and targeted therapy makes it the best choice for heel pain relief.

Best foot massager for heel pain: Our Top 5 Picks

Product Comparison
FeaturesBest ChoiceRunner UpBest Price
PreviewPACOVY Shiatsu Foot Massager with Heat and Air CompressionBest Choice Heated Shiatsu Foot Massager BlackNekteck Shiatsu Foot Massager with Heat and Air Compression
TitlePACOVY Shiatsu Foot Massager with Heat and Air CompressionBest Choice Heated Shiatsu Foot Massager BlackNekteck Shiatsu Foot Massager with Heat and Air Compression
DisplayTouch screen with remote control
Massaging Modes4 modes with customizable intensity and heat4 massage types (kneading, rolling, warming, pressing)3 preset modes with adjustable air compression
Heat Function2 heat settingsBuilt-in heat therapy up to 122°FInfrared heating with adjustable temperature
Air CompressionAdvanced 6D compression with acupressure nodes360° wraps with air compressionBuilt-in air compression with 2 adjustable levels
Control MethodLCD touch panel with adjustable timerTouch screen and remote controlNo remote, manual controls
Additional FeaturesRemovable foot sleeves, organized accessory slotHandle for portability, storage for power cordDetachable, washable foot covers
Warranty1-year coverage1-year warranty
Targeted ReliefHeel soreness, muscle stiffness, foot fatiguePin-point relief for arches, heels, toes, sidesFoot reflex zones, plantar fasciitis relief
Available

PACOVY Shiatsu Foot Massager with Heat and Air Compression

PACOVY Shiatsu Foot Massager with Heat and Air Compression
Pros:
  • Deep, professional-grade massage
  • Fully customizable features
  • Easy to clean and maintain
Cons:
  • Can be intense at high settings
  • Slightly snug for larger feet
Specification:
Massage Modes 4 customizable modes
Intensity Levels 5 adjustable levels
Heat Settings 2 adjustable heat levels
Targeted Features Deep kneading, 6D compression, acupressure nodes
Control Interface LCD touch panel
Coverage 360° foot wrapping with acupressure nodes

It caught me off guard how this sleek little device managed to deliver a deep, professional-grade massage right at home—something I’d usually expect only from a spa or chiropractor. The first time I turned it on, I was surprised by how quickly it warmed up and how snugly it wrapped around my feet, almost like a gentle hug after a long day.

The foot sleeves are removable and breathable, which makes cleaning a breeze—no worries about sweat buildup or hygiene. The 6D compression and deep kneading nodes are impressive, targeting those stubborn heel soreness spots that have been bothering me for weeks.

I appreciated how customizable it was: I could pick from four massage modes, ramp up the intensity, or just enjoy a gentle heat.

Using it before bed, I noticed my feet feeling noticeably less stiff and more relaxed. The heat feature kicks in quickly and makes the massage feel extra soothing—perfect for winding down.

The LCD touch panel is intuitive, and I love having a dedicated slot for small accessories, keeping everything organized.

However, the massage can feel a bit intense if you go for the highest settings, so I’d recommend starting slow. Also, while it’s great for heel pain, some might find the size a little snug if they have larger feet.

Still, for targeted relief and overall foot comfort, this device hits the mark pretty well.

Best Choice Heated Shiatsu Foot Massager Black

Best Choice Heated Shiatsu Foot Massager Black
Pros:
  • Versatile four-massage functions
  • Easy to carry and store
  • Effective heat therapy
Cons:
  • Slightly bulky for small spaces
  • No preset for specific issues
Specification:
Massage Techniques [‘Kneading’, ‘Rolling’, ‘Warming’, ‘Pressing’]
Heating Temperature Up to 122°F (50°C)
Control Interface [‘Touch screen’, ‘Remote control’]
Dimensions 18.5″ L x 12.25″ W x 8.6″ H
Handle 360-degree built-in handle for portability
Additional Features [‘Removable cover for washing’, ‘Non-slip pads’, ‘Storage space for power cord’]

Honestly, I was surprised to find how much I underestimated this foot massager’s versatility just by its sleek black exterior. I expected a simple device, but it packs a punch with four distinct massage functions—kneading, rolling, pressing, and warming—that instantly made my tired arches and heels feel like they’d had a professional session.

The built-in handle is a game-changer. It makes moving the massager around super easy, whether I want to switch between my living room and bedroom or take it on a quick trip.

Plus, the handle doubles as a stand, which keeps it stable during use and adds to its sturdy feel.

The heat therapy feature really caught me off guard. It heats up to 122°F, and I loved how the warmth penetrates deep into my feet, easing tension and improving circulation.

The adjustable nodes allow me to target specific sore spots, especially my heels, which are often the most painful after a long day.

The control options are straightforward. The touchscreen panel is responsive, and the remote makes it easy to tweak settings without bending down.

I found setting it to auto mode, with a preset massage, perfect for relaxing without fussing over every detail.

Overall, this machine feels well-made, with thoughtful features like a cord storage space and removable cover for cleaning. It’s a great pick if heel pain and foot fatigue are your main concerns, and I appreciate having multiple massage options in one compact device.

Nekteck Shiatsu Foot Massager with Heat and Air Compression

Nekteck Shiatsu Foot Massager with Heat and Air Compression
Pros:
  • Effective deep-kneading nodes
  • Adjustable heat and compression
  • Compact and easy to clean
Cons:
  • No remote control
  • Might be intense for sensitive users
Specification:
Massage Modes 3 preset modes for customizable massage experience
Air Compression Built-in air compression with 2 adjustable intensity levels
Heat Function Infrared heating with adjustable temperature control
Deep-Kneading Nodes Targeted rollers simulating professional massage techniques
Foot Size Compatibility Suitable for foot sizes up to US 11 (men) / 12 (women); larger size version available
Hygienic Cover Detachable and washable foot cover for easy maintenance

The moment I unboxed the Nekteck Shiatsu Foot Massager, I was struck by how sleek and compact it is. Its black matte finish feels smooth to the touch, and the shape is ergonomically designed to fit comfortably around your feet.

The massager’s weight is just right—not too heavy, making it easy to move around or store away when not in use.

As I slid my feet inside, the breathable, washable foot covers felt soft and snug, offering a hygienic barrier. The deep-kneading nodes immediately reminded me of a professional massage, pressing and rolling with a satisfying firmness.

I appreciated how easily I could toggle between the preset modes, adjusting intensity and heat with just a few taps.

The air compression feature is surprisingly effective, gently inflating and deflating to boost circulation. I found the adjustable levels really helpful—perfect for customizing the pressure, especially if you’re sensitive or dealing with heel pain.

The infrared heat gently warmed my soles, melting away tension without feeling too hot or overpowering.

Using it after a long day on my feet, I noticed a real difference—less soreness, better blood flow, and an overall relaxing sensation. The quiet operation was a bonus; I could unwind without loud noises interrupting.

Honestly, this massager hits a sweet spot for targeted relief and comfort, especially if you struggle with plantar fasciitis or heel discomfort.

My only gripe? The absence of a remote control means you need to use the buttons directly on the device.

Still, at this price point, it’s a pretty minor inconvenience for such a versatile foot massager.

BESKAR Foot Massager Roller for Plantar Fasciitis Relief,

BESKAR Foot Massager Roller for Plantar Fasciitis Relief,
Pros:
  • Deep tissue relief
  • Ergonomic design fits foot
  • Portable and lightweight
Cons:
  • Small for bigger feet
  • No heating option
Specification:
Design Ergonomically shaped to fit the natural foot arch
Size Compact, approximately the size of an iPhone
Material Likely durable plastic or rubber suitable for acupressure massage
Intended Use Deep-tissue acupressure massage for plantar fasciitis and foot pain relief
Portability Lightweight and portable for use at home, gym, office, or on the go
Target Area Foot sole, specifically the arch and heel

People often think that a foot roller like this is just a simple tool, but I found it surprisingly effective at targeting stubborn foot pain right from the first use. It’s not just a basic massager—its ergonomic shape really hugs the natural arch of your foot, making each roll feel tailored and deep.

I tested it after a long day on my feet, and it instantly helped soothe sore arches and heel pain.

The deep-tissue acupressure points really do work. I could feel the tension releasing as I rolled, especially around my heel and the ball of my foot.

Plus, it stimulates blood circulation, which is a nice bonus when you’re dealing with chronic foot discomfort. The size is perfect—compact but sturdy enough to feel like a real massage.

I appreciated how easy it was to carry around, slipping it into my gym bag for a quick fix after workouts or at work during breaks.

Using it is simple—just roll your foot back and forth, adjusting pressure as needed. It’s comfortable even for sensitive spots, thanks to the textured surface.

I also liked that it’s versatile; it’s not just for plantar fasciitis, but also great for relaxing tired feet after running or standing all day. Plus, it’s super affordable, making it a no-brainer gift for anyone suffering from foot pain or just in need of relaxation.

Honestly, I found myself reaching for it often because it works so well and is so portable.

RENPHO Cordless Foot Massager with Heat & Control

RENPHO Cordless Foot Massager with Heat & Control
Pros:
  • Customizable massage options
  • Quick heat-up feature
  • Cordless and portable
Cons:
  • Mainly targets heels and arches
  • Might be tight for very wide feet
Specification:
Maximum Foot Size US Men size 12
Massage Technology Deep kneading and compression with 360-degree wraps
Heating Capability Quick heat up to 131°F with NTC temperature control technology
Power Consumption 30W rated power, input 12V, 2.5A
Target Areas Arch and heel of the foot, not toes
Control Options Multiple massage functions with OFF/L/M/H settings

After a long day on my feet, I plopped into my sofa and slipped these RENPHO cordless foot massagers on. I was surprised by how quickly they heated up, reaching a cozy 131°F in just minutes, which instantly melted away some of my heel pain.

The 360-degree wraps felt snug yet comfortable, providing targeted deep kneading where I needed it most.

The remote control made switching between massage modes effortless. I loved being able to customize the intensity—off, low, medium, or high—and combine functions for a tailored experience.

The heat function really enhanced relaxation, especially after a workout or a day of standing at work. It’s like having a professional massage right at home, but more convenient.

One thing I noticed is how well it fits feet up to size US 12, mainly massaging the arch and heel areas. The design is sleek and lightweight, so I could easily move it around or store it away when not in use.

The quiet motor meant I could even listen to music or watch TV without interruption. Plus, knowing it’s FSA and HSA eligible makes it feel like a wellness investment.

Overall, this foot massager brings relief without the hassle of cords tangling or complicated setups. It’s perfect for relieving heel pain, improving circulation, or just unwinding before bed.

If you suffer from heel discomfort or plantar fasciitis, this could be a game-changer for your daily routine.

What Causes Heel Pain and How Can a Foot Massager Help Alleviate It?

Heel pain can be caused by various conditions, and using a foot massager can provide relief by promoting circulation and relaxing the muscles.

  • Plantar Fasciitis: This is one of the most common causes of heel pain, characterized by inflammation of the plantar fascia, the thick band of tissue that runs across the bottom of the foot. It typically results in sharp pain near the heel, especially with the first steps in the morning or after prolonged periods of sitting.
  • Achilles Tendinitis: This condition involves inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. Overuse or strain can lead to pain and stiffness along the back of the heel, particularly during physical activities that involve running or jumping.
  • Heel Spurs: Heel spurs are bony growths that develop on the underside of the heel bone, often associated with plantar fasciitis. They can cause pain during walking or standing, as the spur can irritate surrounding tissues and lead to inflammation.
  • Bursitis: This refers to the inflammation of the bursa, a small fluid-filled sac that acts as a cushion between bones and soft tissues. When bursitis occurs in the heel, it can lead to swelling and pain, particularly when pressure is applied to the heel area.
  • Fat Pad Atrophy: As people age, the fat pad on the heel can thin out, leading to decreased cushioning and increased pain during weight-bearing activities. This condition can make even minor impacts feel painful, leading to discomfort during everyday activities.
  • Foot Massagers: Foot massagers can help alleviate heel pain by providing targeted pressure and vibration that stimulates blood flow and reduces muscle tension. They often incorporate heat and various massage techniques that can soothe sore muscles and help decrease inflammation.
  • Choosing the Best Foot Massager for Heel Pain: When selecting a foot massager for heel pain, look for features such as adjustable intensity settings, heat functionality, and specialized nodes that target the arch and heel areas. Devices designed specifically for therapeutic relief can enhance overall comfort and promote healing in affected areas.

What Are the Common Symptoms of Heel Pain?

The common symptoms of heel pain include:

  • Sharp Pain: Many individuals experience a sudden and intense pain in the heel, especially when taking the first steps in the morning or after sitting for a prolonged period.
  • Stiffness: Heel pain can often be accompanied by stiffness, making it difficult to move the foot freely, particularly after periods of rest.
  • Swelling: Inflammation in the heel area may lead to noticeable swelling, making the heel appear larger than usual and causing discomfort during movement.
  • Tenderness: The heel may feel tender to the touch, indicating inflammation or injury to the surrounding tissues.
  • Difficulty with Activity: Engaging in physical activities such as walking, running, or standing for long periods can become painful, often forcing individuals to limit their activities.

Sharp pain is a hallmark symptom of heel pain, often felt just under the heel and can be particularly pronounced when initiating movement after rest. This initial pain tends to diminish with activity but may return after prolonged standing or exercise.

Stiffness in the heel can restrict the range of motion, making it challenging to walk or engage in daily tasks. This symptom is often more pronounced in the morning or after long periods of inactivity.

Swelling in the heel area is a common response to stress or injury, indicating inflammation. This can occur alongside pain and may lead to discomfort while wearing shoes or walking.

Tenderness is frequently reported around the heel and can be triggered by pressure or touch, suggesting irritation or damage to the plantar fascia or other supportive structures in the foot.

Difficulty with activity is a significant concern for those experiencing heel pain, as it can impact daily life and limit involvement in sports or physical exercise. The pain can deter individuals from maintaining an active lifestyle, leading to further issues such as weight gain or decreased mobility.

How Does a Foot Massager Benefit Those with Heel Pain?

Muscle relaxation is another important benefit, as tight muscles can exacerbate heel pain. By using a foot massager, individuals can unwind the tension in their feet, leading to a more comfortable and pain-free experience.

Targeting pressure points is a key feature of many massagers, allowing users to relieve pain directly at the source. This targeted approach can significantly enhance the effectiveness of the massage, providing immediate relief to the heel area.

Stress reduction plays a vital role in pain management, as high stress levels can lead to muscle tightness and exacerbate pain. A foot massager helps to create a calming experience, which can be beneficial for both mental well-being and physical comfort.

Finally, the convenience of having a foot massager at home means that individuals can incorporate regular foot care into their routine without needing to schedule appointments or travel. This accessibility ensures that relief is always within reach, making it easier to manage heel pain effectively over time.

What Features Should You Look for in a Foot Massager for Heel Pain Relief?

Having a compact and portable massager means it can easily fit into different spaces and be used whenever needed, which is particularly beneficial for those with busy lifestyles. Durable construction guarantees that the device remains effective over time, offering consistent relief for heel pain.

Lastly, ease of use is crucial for quick and effective relief, as complicated devices may discourage regular use, which is essential for managing heel pain effectively.

How Important Are Heat and Pressure Settings for Effective Pain Relief?

Personalization: The ability to adjust both heat and pressure settings enables users to tailor their experience based on their pain levels and comfort preferences, which can lead to better outcomes. Personalization ensures that each individual can find the optimal settings that work best for their specific needs, making the foot massager a versatile tool for pain management.

What Types of Massage Techniques Are Ideal for Relieving Heel Pain?

Several massage techniques can effectively relieve heel pain and enhance comfort.

  • Reflexology: This technique focuses on pressure points on the feet that correspond to different body organs and systems. By applying targeted pressure on these reflex points, reflexology can reduce pain and improve circulation to the heel area, promoting healing.
  • Deep Tissue Massage: Aimed at the deeper layers of muscle and connective tissue, deep tissue massage helps to alleviate chronic pain in the heel by breaking down adhesions and tension. This technique often involves slower strokes and deep finger pressure, which can effectively release tightness and improve mobility.
  • Trigger Point Therapy: This method involves identifying and treating specific points in the muscles that cause pain in other areas, known as trigger points. By applying sustained pressure on these points, it can help relieve pain in the heel by addressing muscle imbalances and reducing tension.
  • Myofascial Release: This technique focuses on relieving tension in the fascia, the connective tissue surrounding muscles. By stretching and manipulating this tissue, myofascial release can alleviate heel pain resulting from tightness or restrictions in the surrounding areas.
  • Shiatsu Massage: A traditional Japanese technique that involves applying finger pressure to specific points on the body, Shiatsu aims to balance energy flow and relieve pain. This holistic approach can help release tension in the feet and enhance overall well-being, making it beneficial for heel pain relief.

How Can You Maximize Relief from Heel Pain When Using a Foot Massager?

To maximize relief from heel pain when using a foot massager, consider the following strategies:

  • Target Specific Areas: Focus on areas that are most painful. Use pressure points to apply more intensity to the heel and arch of the foot, as this can help alleviate discomfort effectively.

  • Choose Adjustable Settings: Select a foot massager with adjustable intensity and heat settings. Start with a lower setting and gradually increase it to find what feels most comfortable while providing relief.

  • Incorporate Stretching: Before and after using a foot massager, engage in gentle stretching to enhance flexibility and circulation. This practice can help decrease tension and prevent stiffness.

  • Regular Use: Consistency is key. Regular sessions can lead to cumulative benefits, reducing the intensity of heel pain over time.

  • Combine with Other Treatments: Consider pairing foot massage with other forms of treatment, such as ice therapy or over-the-counter pain relief, for a more comprehensive approach.

  • Hydration: Ensure proper hydration, as maintaining fluid balance can affect muscle recovery and prevent cramps.

By integrating these tips, users can enhance their experience and find more significant pain relief from heel discomfort when utilizing a foot massager.

What Are the Best Practices for Duration and Frequency of Use?

When using a foot massager for heel pain, best practices for duration and frequency of use are crucial for maximizing benefits and preventing discomfort.

  • Start with Short Sessions: Begin with 10-15 minute sessions to allow your feet to acclimate to the massage.
  • Gradually Increase Duration: As you become more comfortable, incrementally increase the duration to 20-30 minutes based on personal comfort and response.
  • Frequency of Use: Aim for 2-3 times per week initially, then adjust according to your pain levels and recovery progress.
  • Listen to Your Body: Pay attention to how your feet feel during and after the massage to determine the appropriate duration and frequency.
  • Consult a Professional: If unsure, consult with a healthcare provider or a physical therapist for personalized recommendations based on your specific condition.

Starting with short sessions allows your feet to adjust to the massage pressure and technique without overwhelming them, which is particularly important when dealing with heel pain.

Gradually increasing the duration helps to build tolerance and can enhance relaxation and pain relief without risking overuse injuries.

Establishing a frequency of 2-3 times per week provides a balance between therapeutic benefits and allowing your feet enough recovery time.

Listening to your body is essential; if you experience increased pain or discomfort, it may be necessary to reduce the duration or frequency of use.

Consulting with a professional ensures that you are using the foot massager effectively and safely, tailored to your individual needs and conditions.

What Do User Reviews Reveal About the Effectiveness of Foot Massagers for Heel Pain?

User reviews provide valuable insights into the effectiveness of foot massagers for alleviating heel pain.

  • Relief from Pain: Many users report significant relief from heel pain after using foot massagers regularly. These devices often target specific pressure points in the feet, promoting blood circulation and reducing inflammation, which can be beneficial for conditions like plantar fasciitis.
  • Ease of Use: Reviewers frequently highlight the convenience of foot massagers, as they can be used at home without the need for professional therapy. This accessibility allows individuals to incorporate foot massage into their daily routine, making it easier to manage chronic heel pain.
  • Variety of Features: Consumers appreciate the range of features offered by different foot massagers, such as heat settings and adjustable intensity levels. These customizable options enable users to tailor their massage experience to their specific needs, enhancing overall satisfaction and effectiveness.
  • Durability and Build Quality: Many reviews touch on the durability of foot massagers, with users noting that high-quality models withstand regular use without breaking down. A sturdy construction ensures that the device can provide consistent therapeutic benefits over time.
  • Value for Money: Users often comment on the cost-effectiveness of investing in a foot massager compared to ongoing visits to a physiotherapist or podiatrist. Many find that the long-term benefits of pain relief and relaxation justify the initial expense of the device.

What Alternatives to Foot Massagers Should You Consider for Heel Pain Relief?

If you’re seeking alternatives to foot massagers for relieving heel pain, consider the following options:

  • Orthotic Insoles: Orthotic insoles provide support to the arches and heels, helping to distribute weight evenly and reduce pressure on painful areas. They can help correct biomechanical issues and improve overall foot alignment, which may alleviate heel pain over time.
  • Foot Rollers: Foot rollers are simple devices that allow you to massage your feet by rolling them over a textured surface. This action promotes blood circulation and stimulates the muscles in the foot, which can help relieve tension and discomfort associated with heel pain.
  • Ice Therapy: Applying ice to the affected heel can reduce inflammation and numb sharp pain. Using a frozen water bottle or ice pack for 15-20 minutes can effectively alleviate pain after physical activity or prolonged standing.
  • Stretching Exercises: Regularly performing stretching exercises for the calves, Achilles tendon, and plantar fascia can significantly reduce heel pain. These exercises help to improve flexibility and strength in the foot and lower leg, which can prevent further injury and discomfort.
  • Foot Baths: Soaking your feet in warm water mixed with Epsom salts can provide relief from heel pain. The warmth helps to relax tight muscles and reduce tension, while the Epsom salts can help decrease swelling and pain through their magnesium content.
  • Compression Socks: Wearing compression socks can enhance circulation and provide support to the arch and heel areas. This support can reduce swelling and help alleviate pain, making them a practical option for individuals with chronic heel discomfort.

What Other Treatment Options Are Available for Heel Pain?

There are several effective treatment options available for heel pain beyond just using a foot massager.

  • Stretching Exercises: Regular stretching of the calf muscles and plantar fascia can help alleviate heel pain by reducing tension and improving flexibility. Exercises such as calf stretches, toe stretches, and plantar fascia stretches are particularly beneficial.
  • Orthotic Inserts: Custom or over-the-counter orthotic inserts provide additional support and cushioning for the arch and heel, helping to distribute weight more evenly and reduce strain. They can be especially useful for individuals with flat feet or high arches.
  • Ice Therapy: Applying ice to the affected heel can help reduce inflammation and numb pain. It’s recommended to ice the heel for 15-20 minutes several times a day, especially after activities that exacerbate the pain.
  • Physical Therapy: A physical therapist can design a personalized rehabilitation program that includes exercises, manual therapy, and modalities to improve strength, flexibility, and overall function of the foot and ankle. This can be instrumental in addressing the underlying causes of heel pain.
  • Footwear Modifications: Wearing shoes that offer proper arch support, cushioning, and a good fit can significantly reduce heel pain. Avoiding high heels or shoes with inadequate support can help prevent further irritation.
  • Anti-inflammatory Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help manage pain and reduce inflammation in the heel area. However, these should be used under the guidance of a healthcare professional.
  • Shockwave Therapy: This non-invasive treatment involves the application of acoustic waves to the heel to promote healing and reduce pain. It’s usually considered for chronic cases that haven’t responded to other treatments.
  • Injections: Corticosteroid injections can provide temporary relief from severe heel pain by reducing inflammation in the affected area. This option is typically reserved for cases where other treatments have not been effective.
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