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20th May, 20218 min read

Plantar fasciitis: Symptoms, causes and treatment

Medical reviewer:Dr Ann Nainan
Author:Helen Brown
Last reviewed: 13/05/2021
Medically reviewed

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What is plantar fasciitis?

Plantar fasciitis is inflammation of the connective tissue that runs from your heels to your toes. It causes pain in your foot, heel and arch.

We spend much of our lives on our feet. When we move around, the plantar fascia – a flat band of tissue called a ligament – absorbs a lot of stress and impact. But sometimes, too much pressure can cause damage or tears to this tissue . When this happens, the plantar fascia becomes inflamed and irritated, causing pain in the bottom of your heel or arch when you walk or do exercise.

Plantar fasciitis is sometimes known as plantar fasciosis.

It’s a common condition, especially for walkers and runners, but it isn’t usually serious and gets better with time, rest and treatment.

Plantar fasciitis symptoms

Although the main symptom of plantar fasciitis is heel pain, you may experience the pain differently – for example, the pain may feel like a sharp, burning pain or a more constant pain. The pain may also come and go depending on your activity level.

Symptoms can include:

  • a gradual feeling of pain building up in your heel
  • heel pain that may feel worse when you start walking first thing in the morning or after sitting for a while, but then it may go away – this is because plantar tissue can tighten when you rest
  • finding it hard to lift your toes off the ground
  • heel pain that gets better during exercise, but gets bad again later in the day or after standing or walking for a long time

When to see a doctor about plantar fasciitis

The plantar fascia has a weak blood supply, so it can take a long time to heal. Ignoring it and not treating it could lead to long-term heel pain that doesn’t go away or keeps coming back. If you have heel pain that doesn’t get better after you treat it at home for 2 weeks, by resting, icing and massaging it, for example, it’s best to get it checked by a doctor.

See a doctor if:

  • the heel pain feels so bad that it’s stopping you doing your normal activities
  • the pain stops you from sleeping or makes it difficult to move or look after yourself
  • you have diabetes – foot injuries can be more serious if you have diabetes
  • the pain gets worse or keeps coming back
  • the pain isn’t getting better after 2 weeks of treating it at home

Sometimes, more serious conditions can be mistaken for plantar fasciitis. Go to the hospital or emergency department immediately if you have these symptoms:

  • really bad or worsening heel pain that makes you feel faint, dizzy or sick, or stops you from walking
  • your leg, ankle or foot made a snapping sound when you injured it
  • really bad swelling or bruising over your ankle or foot that appears suddenly or gets worse
  • a change in the shape, colour or temperature (warm or cold) of your foot
  • lower leg, ankle or foot weakness or numbness
  • difficulty moving or putting any weight on your ankle or foot at all
  • a fever or feeling unwell
  • a break in the skin around the painful heel

Plantar fasciitis causes

Plantar fasciitis is a common cause of foot pain, but it’s not clear what exactly causes it.

It’s thought that certain factors can raise your risk of getting plantar fasciitis. These include:

  • being overweight or obese
  • being 40 to 60 years old
  • having high arches or flat feet
  • a tight Achilles tendon (the tissue that attaches the heel to the calf) or a tight calf muscle
  • wearing shoes that don’t fit or support your foot properly, or wearing high heels
  • standing or walking for a long time
  • running
  • having legs that are different lengths
  • overstretching the soles of your feet during exercise
  • recently starting exercises, like running on hard ground

Arthritis can trigger or worsen plantar fasciitis. Pregnancy may also increase your chance of getting it because of weight gain and hormonal changes, which may affect the ligaments in your feet.

How is plantar fasciitis diagnosed?

A doctor will usually suspect you have plantar fasciitis based on your symptoms and a physical exam.

You may also need an X-ray to rule out other causes of your heel pain, such as a broken bone or arthritis.

In some cases, an MRI or ultrasound scan may be needed if treatment isn’t working.

What can you expect if you have plantar fasciitis?

Plantar fasciitis usually gets better in a few weeks if you treat it yourself by resting, icing and massaging it, for example. If the pain doesn’t improve in 2 weeks, then see a doctor. When it’s more serious, most people find that their symptoms are completely gone within 1 year of starting simple treatment methods.

Plantar fasciitis treatment

To treat plantar fasciitis, a doctor may ask you to do some simple self-care at home, such as:

  • resting your foot and raising it up on a chair when you can
  • applying an ice pack (in a towel) to the foot every few hours for up to 20 minutes
  • taking simple painkillers, like paracetamol, and anti-inflammatories – speak to your pharmacist or doctor for further guidance on how to safely get and use these medicines
  • doing exercise that doesn’t put weight through your foot, like swimming
  • wearing comfortable, low-heeled shoes that support your foot properly
  • putting insoles or heel pads into your shoes
  • not walking barefoot
  • massaging your foot
  • doing simple exercises to help stretch your foot and calf and relieve the pain
  • wearing a splint on your foot at night to stretch your calf and foot muscles

If self-care isn’t helping your symptoms, a doctor might refer you to a foot specialist, like a podiatrist, or to a physiotherapist.

If your symptoms are very bad, a doctor may suggest a steroid injection into your foot.

In very rare cases, surgery may be needed, but that’s only if the pain won’t go away after you’ve been treated by a podiatrist or physiotherapist.

Can you prevent plantar fasciitis?

There are some steps you can take to prevent plantar fasciitis or stop it from coming back, including:

  • wearing shoes that support your foot/heel, or using insoles to support your arches
  • replacing the old shoes you use for exercising. Read more about choosing the right sports shoes and trainers
  • keeping a healthy weight
  • stretching your foot and your Achilles tendon often
  • exercising on soft ground

Many people may get plantar fasciitis and Achilles tendinopathy mixed up as they both cause pain in similar areas of your foot. But there are some very obvious differences, so it’s important to understand what makes them different and how to treat them differently.

Your questions answered

Can plantar fasciitis go away on its own?

Yes, plantar fasciitis can clear up on its own and usually it gets better in a few weeks when you treat it. But, because the plantar fascia has a poor blood supply, if it doesn’t get the treatment it needs, it may take up to a year to get better. Plantar fasciitis is painful, so it’s important to seek treatment early, so that it doesn’t become a long-term painful problem that stops you from doing your daily activities or getting the exercise you need.

Should I stay off my feet with plantar fasciitis?

To treat plantar fasciitis, a doctor will usually advise you to rest your foot and avoid putting weight on the foot for long periods. However, doing stretches and exercises that don’t put any stress on your feet, such as swimming, are often recommended too. Speak to a doctor or physiotherapist for guidance on the best kinds of exercise and stretching.

How do I know if I have plantar fasciitis or heel spurs?

“Plantar fasciitis and heel spurs are often confused because some of their symptoms can be similar. Heel spurs are bony lumps caused by a calcium deposit growing between the heel and arch of the foot – they’re often found in people who have plantar fasciitis. While plantar fasciitis is always painful, heel spurs often aren’t painful. But, heel spurs can cause symptoms like a sharp pain in the heel when standing up in the morning; a dull ache in the heel during the day; swelling or inflammation of the heel; the heel feeling hot to the touch; or a small, bone-like growth under the heel that can be seen. The only way to know if you have plantar fasciitis or a heel spur is to see a doctor – you may need an X-ray or another scan, like an MRI, to find out if it’s a heel spur or something else.” – Answered by Dr Ann Nainan from the Healthily Medical Team

Key takeaways

  • heel pain is the main symptom of plantar fasciitis
  • there are things you can do to prevent plantar fasciitis, like wearing supportive shoes or maintaining a healthy weight
  • it’s important to get treatment for plantar fasciitis to avoid long-term pain that keeps on coming back
  • you can treat plantar fasciitis with self-care practices at home, including resting your foot, and gently stretching and exercising it
  • it can take up to 1 year for your heel to heal from plantar fasciitis, but simple treatments can speed up your recovery
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