Plantar fasciitis

Overview

The plantar fascia is a thick band of tissue on the bottom of the foot that runs from the heel to the toes and supports your arch. When it's overstretched or overused, it can get irritated and swollen, causing heel pain.

It's one of the most common foot problems. People once thought heel spurs caused it, but research shows that's not true: many people with heel spurs never get plantar fasciitis. Treatment without surgery almost always helps, though it can take months.

Symptoms

The pain may come on slowly or start suddenly after intense activity.

• Heel or arch pain, worst with your first steps in the morning
• Foot pain after standing or sitting for a while
• Pain that's sharp or dull in the bottom of the heel

Less common

• Aching or burning in the bottom of the foot
• Pain when climbing stairs or after intense activity
• Mild swelling or redness

How it usually goes

• Mornings: Pain is worst with the first steps, then eases as you move.
• Weeks: Stretching, ice, and good shoes start to help.
• 6 to 18 months: Most people feel better in this time.

When to get medical care

Causes

Plantar fasciitis happens when the plantar fascia is overstretched or overused.

Things that raise the risk include flat feet or high arches, running long distances or on uneven ground, being overweight or gaining weight quickly, a tight Achilles tendon, shoes with poor arch support, and changing your activity level.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• Runners and people who stand a lot
• Flat feet or high arches
• Being overweight, or gaining weight quickly
• A tight Achilles tendon or calf muscles
• Shoes with poor support

Possible complications

• Long-lasting heel pain: Can change how you walk and lead to knee, hip, or back pain

Diagnosis

A healthcare professional can usually diagnose plantar fasciitis with a physical exam.

Questions you may be asked

• Where your foot hurts, and when it's worst
• Whether the pain is worse with your first steps in the morning
• Whether you've changed your activity, shoes, or weight
• Whether you run or stand a lot

The exam

They'll press on the bottom of your foot to find the tender spot, check your arch, and test the flexibility of your ankle, Achilles tendon, and calf.

Tests

Tests are usually not needed:

• X-ray: To check for other problems, like a stress fracture.

Treatment

Most people get better with simple treatments. It can take several months, so keep at it.

Self-care

• Stretch your heel, arch, calf, and Achilles tendon every day, including before you get out of bed
• Ice the painful area 10 to 15 minutes at least twice a day
• Rest as much as you can for at least a week; switch to low-impact activities like swimming or biking
• Wear supportive shoes with good arch support and cushioning; avoid going barefoot and flat, worn-out shoes
• Take a pain reliever if you need it

Medicines

Pain relievers can ease pain while you stretch and rest.

Medicine names link to drug information from the U.S. National Library of Medicine (MedlinePlus). OwieClear doesn't give doses: follow the label or your healthcare professional.

If these steps don't help, your healthcare professional may suggest physical therapy, night splints that stretch the foot while you sleep, custom shoe inserts (orthotics), a walking boot for 3 to 6 weeks, or a steroid shot. Surgery is rarely needed.

How it compares

Prevention

These steps help prevent heel pain:

• Stretch your calves, Achilles tendon, and feet regularly
• Wear supportive shoes and replace running shoes often
• Increase exercise slowly
• Keep a healthy weight
• Do activities in moderation

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a podiatrist (foot doctor).

Back to school, work, or sports

• Most people keep up normal school and work. Rest when you need to.

Children, pregnancy, and older adults

• Children: Heel pain in active kids is often Sever's disease, a growth-plate problem, rather than plantar fasciitis.
• Runners: Cut back on mileage and hills, run on softer surfaces, and build back up slowly.
• People with diabetes: Check your feet daily and see a healthcare professional for any foot pain, sore, or numbness.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Treatment without surgery almost always improves the pain. Most people feel better within 6 to 18 months; surgery is rarely needed.

Myths and facts

Getting ready for your visit

A little preparation helps.

What to bring

• When the pain started and when it's worst
• The shoes you wear most often
• Changes in your activity, work, or weight

Questions to ask

• Which stretches should I do, and how often?
• Would shoe inserts or a night splint help?
• Should I see a physical therapist?
• When can I go back to running?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Plantar fasciitis