Plantar Fasciitis

What is plantar fasciitis?

Plantar fasciitis is inflammation in the plantar fascia in your foot. It’s the most common cause of heel pain.

The plantar fascia is a strong, fibrous attachment (similar to a ligament) that runs from your heel to the ball of your foot and your toes. It's stretchy like a thick rubber band. The plantar fascia connects the bones in your foot together and forms the arch on the bottom of your foot.

Plantar fasciitis happens when your plantar fascia is overused or stretched too far. Anything that damages your plantar fascia can make it swell. This inflammation makes it painful to walk or use your foot. Most people experience plantar fasciitis in one foot at a time, but it’s possible for it to affect both your feet at once.

Visit a healthcare provider if you’re experiencing heel or foot pain for more than a week.

How common is plantar fasciitis?

Plantar fasciitis is extremely common. More than 2 million people in the U.S. are treated for it each year. Around 1 in 10 people will develop plantar fasciitis at some point throughout their life.

What are the symptoms of plantar fasciitis?

The most common symptoms of plantar fasciitis include:

• Heel pain.
• Pain in the arch of your foot.
• Stiffness.
• Swelling around your heel.
• A tight Achilles tendon.

What does plantar fasciitis feel like?

Plantar fasciitis usually causes an achy pain in your heel or along the bottom of your foot. The pain can change depending on what you’re doing or the time of day. Some types of pain you might feel include:

• Pain when you stand up after sleeping or sitting down. The pain usually goes away after walking for a few minutes.
• A dull, constant ache.
• Sharp or stabbing pain when you use your affected foot or put pressure on your heel.
• Exercising or moving might temporarily relieve your pain, but it’ll usually get worse as soon as you stop.
• Increased pain first thing in the morning or when you stand up after sitting or sleeping.

What causes plantar fasciitis?

Anything that irritates or damages your plantar fascia can cause plantar fasciitis, including:

• Being on your feet all day for work.
• Playing sports.
• Exercising or working on a hard surface (like a warehouse floor or the sidewalk).
• Exercising without stretching or warming up.
• Wearing shoes that don’t support your feet well enough (like flip flops or flat, flexible sneakers).
• Walking or standing barefoot while you’re at home.

Some health conditions can cause plantar fasciitis, including:

• High arch feet.
• Flat feet.
• Obesity (or gaining more than 15 pounds in a few months).

How is plantar fasciitis diagnosed?

A healthcare provider will diagnose plantar fasciitis with a physical exam. They’ll ask you about your symptoms and look at your foot. They might lightly press on your plantar fascia to feel for inflammation and check your level of pain.

Tell your provider about the pain you’re experiencing in your daily routine. Tell them where on your foot it hurts and when it’s the most painful throughout the day.

What tests do healthcare providers use to diagnose plantar fasciitis?

A healthcare provider usually won’t need any tests to diagnose plantar fasciitis. They might use imaging tests to take pictures of your foot if they think another issue or condition is causing the pain. Some imaging tests you might need include:

• X-rays.
• An ultrasound.
• An MRI.

How is plantar fasciitis treated?

You can usually manage plantar fasciitis with at-home treatments and over-the-counter (OTC) medicine.

Your healthcare provider will suggest options for relieving your symptoms and supporting your feet to reduce the chances you’ll experience plantar fasciitis again in the future.

The most common treatments for plantar fasciitis include:

• Over-the-counter NSAIDs: NSAIDs (like aspirin, ibuprofen and naproxen) reduce pain and inflammation. Don’t take NSAIDs for more than 10 days in a row without talking to a healthcare provider.
• Rest: Take a break from playing sports or participating in the activity that caused the plantar fasciitis for at least a week (if possible).
• Icing your foot: Ice your foot for 10 to 15 minutes, twice a day. Cover a frozen water bottle in a thin towel to protect your skin, then roll it along the bottom of your foot to massage the inflammation.
• Wearing supportive shoes: Wear sturdy, well-cushioned shoes. Don’t wear sandals, flip-flops or other flat shoes without built-in arch support. Don’t walk with bare feet.
• Orthotics or shoe inserts: You can add inserts into your shoes that add extra arch support. Your provider will suggest either pre-made inserts you can buy over-the-counter or custom-made orthotics that are molded to the exact shape of your foot.
• Immobilization: Wearing a walking boot (sometimes called a walking cast or a pneumatic cam walker) for a few weeks will hold your foot in place and take pressure off your plantar fascia. Your provider will tell you how long you’ll need to wear a boot.
• Massaging and stretching: Your provider or a physical therapist will show you stretches and massage techniques you can perform on your foot and calf muscles.
• Corticosteroids: Corticosteroids are anti-inflammatory medicines. Your provider might inject a corticosteroid (like prednisone) into your plantar fascia.
• Platelet rich plasma (PRP): PRP is usually injected to heal and repair injuries.
• Extracorporeal pulse activation technology (EPAT): EPAT is a form of shockwave therapy. Your provider will apply concentrated acoustic waves (sound waves) to increase blood flow to your plantar fascia. This encourages it to heal faster.
• Percutaneous needle tenotomy: During a percutaneous tenotomy, your provider will poke a needle through your skin into your plantar fascia. Your body sends more blood than usual to the area, which will stimulate your plantar fascia’s ability to repair itself.

Plantar fasciitis surgery

The treatments listed above are usually all you’ll need to relieve your symptoms and treat plantar fasciitis. It’s very rare to need surgery. The two most common types of surgery include:

• Gastrocnemius recession: Your surgeon will lengthen your calf muscles to reduce pressure on your plantar fascia.
• Plantar fascial release: Your surgeon will make tiny incisions (cuts) in your plantar fascia to relieve some of the extra tension.

Your healthcare provider or surgeon will tell you which type of surgery you’ll need to treat plantar fasciitis.

How can I prevent plantar fasciitis?

The best way to prevent plantar fasciitis is to avoid overusing your feet. In general:

• Stretch before and after exercise.
• Give your feet time to rest and recover after intense activity or exercise.
• Wear supportive shoes.
• Don’t walk barefoot on hard surfaces.
• Replace your sneakers every six to nine months (or after you’ve walked or run between 250 and 500 miles in them).

If you have a health condition that makes you more likely to develop plantar fasciitis, you might not be able to prevent it.

How long does plantar fasciitis last?

You should notice your plantar fasciitis symptoms improving as soon as you start treating them. But it can take anywhere from a few weeks to a few months for your plantar fascia to heal.

If you feel better but then your symptoms return, try the same at-home treatments you used before. Talk to your provider if your symptoms feel different or worse than before.

Will I need to miss work or school if I have plantar fasciitis?

You might need to miss work or school for at least a few days while you’re recovering if an activity you do often caused the plantar fasciitis. Tell your healthcare provider about your daily routine — especially if you need to be on your feet all day for work.

You should avoid playing sports and other activities that put pressure on your feet for at least a week. Talk to your provider before resuming intense physical activity.

When should I see my healthcare provider?

Visit a healthcare provider if:

• You have pain in your heel or foot that doesn’t get better on its own in a week.
• Your symptoms don’t improve after two weeks of treatment.

What questions should I ask my doctor?

• What caused the plantar fasciitis?
• Will I need any tests?
• Which treatments should I try at home?
• How long will I need to avoid exercise or playing sports?
• What should I do if I need to be on my feet for work?

Are plantar fasciitis and heel spurs the same thing?

Plantar fasciitis and heel spurs both cause pain in your heel, but they’re different conditions.

A heel spur is a bony growth that pokes out from the bottom of your heel where your heel bone connects to your plantar fascia. It can happen as a reaction to stress and inflammation caused by plantar fasciitis. Most people don’t feel pain from a heel spur, but when they do, the pain is like plantar fasciitis pain.

Visit a healthcare provider if you’re experiencing pain in your foot or heel.

A note from Cleveland Clinic

Plantar fasciitis is the most common cause of heel pain. Talk to a healthcare provider if you’re experiencing pain in your heel or foot that doesn’t get better on its own in a week. They’ll help you find at-home treatments to reduce the pain and inflammation in your foot.

It’s always annoying to find out you need to skip a week (or more) of your favorite sport or activity. But don’t rush back onto the field or court. You might re-injure your plantar fascia if you put too much stress on your foot before it’s healed.