condition
Plantar Fasciitis: Causes, Symptoms, and Treatment Options
Plantar fasciitis is the most common cause of plantar heel pain and one of the most frequent foot conditions seen in podiatry clinics. It typically presents as pain under the heel, particularly with the first steps in the morning or after periods of rest.
Although plantar fasciitis is often described as an inflammatory condition, it is more accurately a load-related and degenerative problem of the plantar fascia. Early diagnosis and appropriate treatment can significantly reduce pain and speed recovery.
What Is Plantar Fasciitis?
Plantar fasciitis affects the plantar fascia, a thick band of connective tissue that runs along the sole of the foot from the heel to the toes. The plantar fascia plays an important role in supporting the arch and absorbing load during walking and running.
Plantar fasciitis develops when the fascia is repeatedly overloaded, leading to micro‑damage, irritation, and reduced tissue capacity.
Plantar Fasciitis Symptoms
- Sharp, stabbing, or aching pain under the heel
- Heel pain with the first steps in the morning
- Pain after sitting or resting for long periods
- Localised tenderness on the inner aspect of the heel
- Pain that may ease with movement but worsen after prolonged activity
- Stiffness in the foot or ankle
Causes of Plantar Fasciitis
Plantar fasciitis is most commonly caused by repeated strain on the plantar fascia over time. This strain exceeds the tissue’s ability to recover.
Factors that increase risk include:
- Tight calf muscles or Achilles tendon
- Sudden increases in walking, running, or standing
- Poor foot biomechanics such as over‑pronation
- Unsupportive or worn footwear
- Prolonged standing on hard surfaces
- Reduced strength or endurance in the intrinsic foot muscles
How Plantar Fasciitis Is Diagnosed
Diagnosis is usually made through a clinical assessment and detailed history. Your podiatrist will assess pain location, foot posture, calf flexibility, and walking pattern.
Imaging such as ultrasound or MRI may be used to assess plantar fascia thickness or to rule out other causes of heel pain. Heel spurs may be present on imaging, but it is important to note that heel spurs do not cause plantar fasciitis pain.
Plantar Fasciitis Treatment Options
The vast majority of plantar fasciitis cases respond well to conservative treatment. Treatment is focused on reducing excessive load and improving the fascia’s ability to tolerate stress.
Common treatment options include:
- Manipulation of the foot and ankle joints
- Calf and plantar fascia stretching
- Progressive strengthening exercises for the foot and lower limb
- Load management and activity modification
- Orthotic insoles or footwear modification
- Extracorporeal Shockwave Therapy to stimulate tissue healing
For persistent cases, additional interventions such as corticosteroid injections or short‑term immobilisation may be considered. Surgery is very rarely required.
When to See a Podiatrist for Heel Pain
- Persists for more than 2–6 weeks
- Worsens despite rest or footwear changes
- Interferes with work, sport, or daily activities
- Does not respond to basic self-care measures
Early treatment leads to faster recovery and reduces the risk of chronic heel pain.
FAQs
Plantar Fasciitis FAQs
Is plantar fasciitis the same as plantar heel pain?
Plantar fasciitis is the most common cause of plantar heel pain, but there are many other potential causes.
Can plantar fasciitis go away on its own?
Mild cases may improve with reduced load and supportive footwear, but untreated plantar fasciitis often becomes persistent.
What shoes are best for plantar fasciitis?
Supportive shoes with cushioning, good arch support, and secure fastening are recommended. Quality running shoes such as Brooks, Saucony, or ASICS often work well.