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Last reviewed on: 6/8/2022
Reviewed by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Plantar fasciitis is a degenerative condition of the thick band of tissue (also called a fascia) at the bottom of your foot that runs from your heel to your toes.
Doctors once thought bony growths called heel spurs brought on the pain. Now they believe that heel spurs are the result -- not the cause -- of plantar fasciitis.
Symptoms of Plantar Fasciitis
Plantar fasciitis causes pain in your heel. It’s usually worse when you take your first steps in the morning or after you’ve been sitting for a long time. It tends to feel better with activity but worsens again after you spend a long time on your feet.
Plantar Fasciitis Causes and Risk Factors
Your fascia supports the muscles and arch of your foot. When it’s overly stretched, you can get tiny tears on its surface. This can bring on pain and inflammation.
You’re at greater risk of plantar fasciitis if you:
- Are female
- Are 40 to 60 years old
- Are obese
- Have flat feet or high arches
- Have tight Achilles tendons, or “heel cords”
- Have an unusual walk or foot position
- Often wear high-heeled shoes
- Spend many hours standing each day
- Wear worn-out shoes with thin soles
Diagnosing Plantar Fasciitis
Your doctor will ask about your symptoms and check your feet to see where you’re having pain. They sometimes want you to have imaging tests to make sure something else isn’t causing your problem. These tests include:
- An X-ray to rule out bone fractures or arthritis
- An MRI to look for fractures
Plantar Fasciitis Treatment
Your treatments may include:
- Icing the area.
- Night splints. You wear these to stretch your calf and foot while you sleep.
- Physical therapy. Certain exercises can stretch your fascia and Achilles tendon and strengthen your leg muscles, which will make your ankle and heel more stable.
- Rest. Stop doing things that make the pain worse. This might include some types of exercise, like running or jumping.
- Supportive shoes or inserts. Shoes with thick soles and extra cushioning will make it less painful for you to stand or walk. Arch supports can distribute pressure more evenly across your feet.
- Taking pain-relieving non-steroidal anti-inflammatories (NSAIDs) like ibuprofen or naproxen sodium. You shouldn’t take these for more than a month, so talk with your doctor.
Once you begin treatment, you’ll usually see improvement within 10 months. If you aren’t better then, your doctor might try treatments like injections of platelet rich plasma (PRP) to ease inflammation. In rare cases, you might need surgery.
Plantar fasciitis is pain on the bottom of your foot, around your heel and arch. You can usually ease the pain yourself but see a GP if it does not improve within 2 weeks.
Check if you have plantar fasciitis
The main symptom of plantar fasciitis is pain on the bottom of your foot, around your heel and arch.
Credit:
NHSD/Rich Kelly/Turbosquid
It's more likely to be plantar fasciitis if:
- the pain is much worse when you start walking after sleeping or resting
- the pain feels better during exercise, but returns after resting
- it's difficult to raise your toes off the floor
How to ease plantar fasciitis yourself
If you see a GP, they'll usually suggest you try these things:
Do
rest and raise your foot on a stool when you can
put an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every 2 to 3 hours
wear shoes with cushioned heels and good arch support
use insoles or heel pads in your shoes
try regular gentle stretching exercises
try exercises that do not put pressure on your feet, such as swimming
take painkillers like paracetamol and ibuprofen
try to lose weight if you’re overweight
Don’t
do not take ibuprofen for the first 48 hours
do not walk or stand for long periods
do not wear high heels or tight pointy shoes
do not wear flip-flops or backless slippers
try not to walk barefoot on hard surfaces
A pharmacist can help with plantar fasciitis
You can ask a pharmacist about:
- the best painkiller to take
- insoles and pads for your shoes
- if you need to see a GP
Find a pharmacy
Non-urgent advice: See a GP if:
- you have pain in the bottom of your foot that is severe or stopping you doing normal activities
- the pain is getting worse or keeps coming back
- the pain has not improved after treating it yourself for 2 weeks
- you have any tingling or loss of feeling in your foot
- you have diabetes and foot pain – foot problems can be more serious if you have diabetes
Severe pain:
- always there and so bad it's hard to think or talk
- you cannot sleep
- it's very hard to move, get out of bed, go to the bathroom, wash or dress
Moderate pain:
- always there
- makes it hard to concentrate or sleep
- you can manage to get up, wash or dress
Mild pain:
- comes and goes
- is annoying but does not stop you doing daily activities
Treatment for plantar fasciitis from a foot specialist
If plantar fasciitis does not get better, a GP might refer you to a physiotherapist or foot specialist (podiatrist).
A physiotherapist can show you exercises to help ease your symptoms. A podiatrist can recommend things like insoles and the right shoes to wear.
Physiotherapy is available free of charge on the NHS throughout the UK but waiting times can sometimes be long.
Depending on where you live, you may be able to self-refer or you may need to visit a GP or consultant first.
Podiatry may not be available for free on the NHS everywhere and waiting times can sometimes be long.
You can also pay to see a podiatrist or physiotherapist privately.
Find a registered podiatrist
Find a registered physiotherapist
Read more about accessing physiotherapy.
Common causes of plantar fasciitis
Plantar fasciitis is caused by straining the part of your foot that connects your heel bone to your toes (plantar fascia).