Plantar Fasciitis

Plantar fasciitis is a painful swelling of the plantar fascia. The plantar fascia is a thick, fibrous layer of tissue that covers the bones on the bottom of your foot. It supports the foot bones in an arched position.

Plantar fasciitis can happen slowly or suddenly. It often affects 1 foot at a time. Heel pain can be sharp, like a knife sticking into the bottom of your foot. You may feel pain after exercising, long-distance jogging, stair climbing, long periods of standing, or after standing up.

Risk factors include: non-active lifestyle, arthritis, diabetes, obesity or recent weight gain, flat foot, high arch. Wearing high heels, loose shoes, or shoes with poor arch support for long periods of time adds to the risk. This problem is often found in runners and dancers. It's also found in people who stand on hard surfaces for long periods of time.

Foot pain from this condition is often worse in the morning. But it often improves with walking. By the end of the day there may be a dull aching. Treatment requires short-term rest and controlling swelling. It may take up to 10 months for plantar fasciitis to improve using simple treatment methods. But symptoms can improve in most people in 2 months after initial treatment. In rare cases, you may need a steroid shot (injection) into the foot, or surgery.

Home care

  • Weight loss can help with healing if you are overweight.

  • Choose supportive shoes with good arch support and shock absorbency. Replace athletic shoes when they become worn out. Don’t walk or run barefoot. Don't wear flat shoes.

  • Premade or custom-fitted shoe inserts may be helpful. Inserts made of silicone seem to be the most effective. Custom-made inserts can be provided by a foot specialist, physical therapist, or orthopedist.

  • Premade or custom-made night splints keep the heel stretched out while you sleep. They may prevent morning pain.

  • Limit activities that stress the feet: jogging, prolonged standing or walking, contact sports, etc.

  • First thing in the morning and before sports, stretch the bottom of your feet. Gently flex your ankle so the toes move toward your knee.

  • Icing may help control heel pain. Apply an ice pack to the heel for 10 to 20 minutes 3 to 4 times a day to relieve symptoms. Or ice your heel after a severe flare-up of symptoms. To make an ice pack, put ice cubes into a plastic bag that seals at the top. Wrap the bag in a thin towel or cloth before using.

  • You may use over-the-counter pain medicine to control pain, unless another medicine was prescribed. Anti-inflammatory pain medicines, such as ibuprofen or naproxen, may work better than acetaminophen. If you have chronic liver or kidney disease, ever had a stomach ulcer or gastrointestinal bleeding, or take blood thinners, talk with your healthcare provider before using these medicines.

  • Stretching exercises are an important part of treatment. They can help improve flexibility in your lower leg, ankle, and plantar fascia relieving tight muscles that tend to aggravate the plantar fascia. A physical therapist can recommend a specific set of stretching exercises.

Follow-up care

Follow up with your healthcare provider, physical therapist, or foot specialist as advised

Call for an appointment if pain worsens or there is no relief after a few weeks of home treatment. Shoe inserts, a night splint, or a special boot may be required.

If X-rays were taken, you will be told of any new findings that may affect your care.

When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Foot swelling

  • Redness or warmth with increasing pain

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