Plantar fasciitis (say “PLANT-ter fash-ee-EYE-tus”) is the most common cause of heel pain. The plantar fascia is the flat band of tissue (ligament) that connects your heel bone to your toes. It supports the arch of your foot. If you strain your plantar fascia, it gets weak, swollen, and irritated (inflamed). Then your heel or the bottom of your foot hurts when you stand or walk.
Plantar fasciitis is common in middle-aged people. It also occurs in younger people who are on their feet a lot, like athletes or soldiers. It can happen in one foot or both feet.
What causes plantar fasciitis?
Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling. This is more likely to happen if:
- Your feet roll inward too much when you walk (excessive pronation).
- You have high arches or flat feet.
- You walk, stand, or run for long periods of time, especially on hard surfaces.
- You are overweight.
- You wear shoes that don’t fit well or are worn out.
- You have tight Achilles tendons or calf muscles.
What are the symptoms?
Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. But your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time.
If you have foot pain at night, you may have a different problem, such as arthritis, or a nerve problem such as tarsal tunnel syndrome. How is plantar fasciitis diagnosed? Your doctor will check your feet and watch you stand and walk. He or she will also ask questions about:
- Your past health, including what illnesses or injuries you have had.
- Your symptoms, such as where the pain is and what time of day your foot hurts most.
- How active you are and what types of physical activity you do.
- Your doctor may take an X-ray of your foot if he or she suspects a problem with the bones of your foot, such as a stress fracture.
How is it treated?
No single treatment works best for everyone with plantar fasciitis. But there are many things you can try to help your foot get better:
Give your feet a rest. Cut back on activities that make your foot hurt. Try not to walk or run on hard surfaces.
To reduce pain and swelling, try putting ice on your heel. Or take an over-the-counter pain reliever like ibuprofen (such as Advil or Motrin) or naproxen (such as Aleve).
Do toe stretches calf stretches and towel stretches several times a day, especially when you first get up in the morning. (For towel stretches, you pull on both ends of a rolled towel that you place under the ball of your foot.)
Get a new pair of shoes. Pick shoes with good arch support and a cushioned sole. Or try heel cups or shoe inserts (orthotics. Use them in both shoes, even if only one foot hurts.
If these treatments do not help, your doctor may recommend splints that you wear at night, shots of medicine (such as a steroid) in your heel, or other treatments. You probably will not need surgery. Doctors only suggest it for people who still have pain after trying other treatments for 6 to 12 months.
How long will it take for the pain to go away?
Plantar fasciitis most often occurs because of injuries that have happened over time. With treatment, you will have less pain within a few weeks. But it may take time for the pain to go away completely. It may take a few months to a year.
Stay with your treatment. If you don’t, you may have constant pain when you stand or walk. The sooner you start treatment, the sooner your feet will stop hurting.