Plantar Fasciitis

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What is plantar fasciitis?

The most common cause of pain in the heel is plantar fasciitis. The condition involves the band of tissue—the plantar fascia—that stretches from the heel to the toes and supports your arch. The plantar fascia can become irritated leading to inflammation and heel pain. Pain is often worse first thing in the morning or after long periods of standing on a hard surface. Jogger’s heel or tennis heel are other ways to describe the condition, named after activities known to cause plantar fasciitis.

People who are overweight are at higher risk for developing plantar fasciitis. Runners and people who stand for long periods of time on hard surfaces are also at risk. It occurs more often in women than in men.

Plantar fasciitis symptoms include pain in the heel or along the arch of the foot. Plantar fasciitis pain may develop slowly and worsen over time. Most people find that nonsurgical plantar fasciitis treatment can relieve their symptoms. These treatments include pain medication, stretching exercises, icing the foot, and wearing shoes with better support. If the pain does not subside after trying nonsurgical options for several months, you may need surgery.

Without treatment, plantar fasciitis pain can interfere with your daily activities. If you begin to walk differently to avoid the pain, you could end up with foot, hip or back problems. Prevention and early treatment are the best ways to avoid long-term complications.

What are the symptoms of plantar fasciitis?

The most common plantar fasciitis symptoms are:

  • Stabbing pain in the heel or the arch of your foot

  • Heel pain when you first get out of bed in the morning

  • Heel pain after an extended period of sitting or standing

  • Heel pain that worsens after, rather than during, physical activity

  • Swelling in the heel

  • Pain that subsides after walking or stretching the foot

If you notice pain in your heel that doesn’t go away, talk with your primary care doctor or a foot specialist about the possibility of plantar fasciitis. The sooner you get a diagnosis, the sooner you can begin treatment and relieve plantar fasciitis pain. 

What causes plantar fasciitis?

Plantar fasciitis is often an overuse injury. Continuous, or repeated pressure and strain on the plantar fascia causes the inflammation, which is what creates pain. Any activity or condition that creates extra stress on the plantar fascia is a contributing factor to overusing this supportive tissue in the foot. Unusual arches—either flat or overly high arches—also strain the plantar fascia because they add extra or uneven weight on the foot.

Some people have what’s called idiopathic plantar fasciitis, meaning the condition develops without a known cause.

What are the risk factors for plantar fasciitis?

A number of factors increase the risk of developing plantar fasciitis. These risk factors include:

  • Obesity

  • Flat feet or exceptionally high arches, which is often hereditary

  • Tight calf muscles that make it difficult to flex the ankle upward and stretch the bottom of the foot

  • Participating in repetitive, high-impact activities, such as running

  • Standing for long periods of time on a hard surface

Also, plantar fasciitis occurs more often in women than in men.

Reducing your risk of plantar fasciitis

You may be able to lower your risk of developing plantar fasciitis by:

  • Avoiding walking barefoot

  • Wearing supportive shoes

  • Stretching your plantar fascia regularly

  • Maintaining a healthy weight

  • Choosing lower-impact sports and exercises

If you have a history of plantar fasciitis, your doctor might suggest using an orthotic device to protect your feet. These devices can include special inserts in your shoes to offer extra support. You can buy shoe inserts over the counter at select stores or request custom-fitted orthotics from a podiatrist or other healthcare professional who specializes in foot care.

How is plantar fasciitis treated?

Most of the time, you can treat plantar fasciitis effectively without surgery, although it may take several months to completely recover from the condition. Surgery is an option when conservative treatments are not enough.

Nonsurgical treatment

Rest the foot when you can. You may have to stop or change some of your activities, such as choosing a sport that creates less stress on your foot. Nonsteroidal anti-inflammatory drugs and icing the foot for 20 minutes several times a day can help relieve sore heels. A physical therapist can show you plantar fascia exercises and stretches for your foot, calf, and Achilles tendon. Shoe inserts can help support your arch and distribute your weight properly on your foot. Walking casts and positional splints that stretch your calf and foot at night while you sleep may also be part of your treatment plan.

Surgical treatment

Two options for surgery to treat plantar fasciitis include:

  • Gastrocnemius recession, which lengthens the calf muscle to allow for better flexing of the ankle and foot

  • Plantar fascia release, which is a partial cut in the plantar fascia to relieve tension

What are the potential complications of plantar fasciitis?

Without treatment, plantar fasciitis can cause so much pain that it interferes with your life. If you adjust the way you walk to prevent pain in your foot, it can lead to problems in your foot, knees, hips or back. If you have plantar fasciitis, shoes that fit and support your foot, daily stretches, and other at-home care can help prevent complications.

Surgery can be effective, but there are risks. Nerve damage is a potential complication of plantar fasciitis surgery. In addition, the surgery could weaken your arch and might not relieve all the pain of the condition. Consider the risks and benefits of the procedure your doctor recommends before deciding on surgery.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 22
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