Plantar fasciitis is one of the most common causes of heel pain that we evaluate in our office, and it affects people of every age and activity level, from runners and teachers to retirees who simply spend long hours on their feet. Because the condition tends to develop gradually and often improves slowly, many patients live with it for months before seeking care, and the longer it persists, the more it can alter the way a person walks and place additional stress on the knee, hip, and lower back. Below, we answer the questions our patients ask most often.
What Is Plantar Fasciitis?
The plantar fascia is a thick band of tissue that runs along the bottom of the foot, connecting the heel bone to the base of the toes and helping to support the arch, and plantar fasciitis occurs when this tissue becomes irritated, inflamed, or strained, most often near its attachment at the heel. With every step, the fascia stretches and absorbs force, so repeated stress or a sudden increase in load can overwhelm its ability to recover.
How Did I Get Plantar Fasciitis?
There is rarely a single cause, and in most patients several factors combine over weeks to months:
- A sudden increase in walking, running, or standing, particularly on hard surfaces
- Shoes that lack adequate arch support or cushioning, or that are worn beyond their useful life
- Foot structure, including flat feet and high arches
- Tight calf muscles or a tight Achilles tendon, which increase strain on the fascia
- Excess body weight, which adds load to the foot with every step
- Occupations that require long hours of standing or walking
What Are the Symptoms?
The classic symptom is a sharp or stabbing pain in the bottom of the heel with the first steps after waking or after a period of rest, which often eases as the foot warms up and then returns after prolonged standing or at the end of the day. Some patients also notice tenderness along the arch or a feeling of tightness in the bottom of the foot.
How Is It Diagnosed?
Diagnosis begins with a detailed history of when the pain occurs and what activities aggravate it, followed by a physical examination of the foot, heel, and calf. Because other conditions, including stress fractures, nerve irritation, and tendon problems, can cause heel pain that resembles plantar fasciitis, imaging may be recommended when the picture is unclear or when symptoms do not respond as expected.
How Is It Treated?
Most patients improve with conservative treatment, which is typically tailored to the severity and duration of symptoms:
- Activity modification to reduce repetitive stress on the heel
- Stretching exercises for the plantar fascia and the calf muscles
- Supportive footwear, and arch supports or custom orthotics
- Ice, and anti-inflammatory medication when appropriate
- Night splints or physical therapy
- Additional in-office treatments for pain that persists despite conservative care
Surgery is reserved for a small number of patients whose symptoms do not respond to an extended course of conservative treatment.
When to Seek Help
You should schedule an appointment if heel pain has lasted more than a few weeks, is worsening, or is interfering with work or exercise. Seek prompt evaluation if the heel pain began after an injury, or if you notice significant swelling, bruising, or difficulty bearing weight.
Caring for Every Step You Take
Compassionate, personalized care is here for every step you take. Schedule an appointment with Ashton Podiatry to find out what is behind your heel pain. This article is provided for general educational purposes only and does not replace a thorough evaluation by a qualified podiatric physician.
