Plantar Fasciitis

Plantar fasciitis is pain caused by irritation or strain of the plantar fascia, a thick band of tissue that runs along the bottom of the foot connecting the heel bone to the toes and helping to support the arch. When this tissue is overloaded, small areas of strain and inflammation can develop, usually near where it attaches to the heel.

It is one of the most common causes of heel pain. Although it can be persistent and frustrating, plantar fasciitis is not a serious condition and the great majority of people recover with simple, non-surgical treatment, even if it takes time.

The typical symptom is pain on the bottom of the foot, around the heel and arch. The pain is often sharp and is classically worst with the first few steps after getting out of bed in the morning or after sitting for a while, then easing as the foot warms up with movement.

Pain may return after long periods of standing or activity, and the heel can feel tender to press. It usually affects one foot but can affect both. The pain tends to build gradually rather than coming on suddenly.

Plantar fasciitis is generally caused by repeated strain on the plantar fascia. Things that increase the load on the foot can contribute, such as spending long periods on your feet, a sudden increase in walking, running, or other activity, and exercising on hard surfaces.

Other factors that raise the risk include tight calf muscles or Achilles tendons, unsupportive or worn footwear, high arches or flat feet, and carrying excess weight. It is also more common in middle age. Often a combination of these factors is involved.

Plantar fasciitis is usually diagnosed from the typical pattern of heel pain and a physical examination of the foot, including identifying where the pain is and checking for tenderness and tightness in the foot and calf. The characteristic morning pain near the heel is often enough to make the diagnosis.

Tests are not usually needed. Imaging such as an X-ray or ultrasound may occasionally be used to rule out other causes of heel pain, for example a stress fracture or other foot problems, particularly if the pain is unusual or does not improve as expected.

Most plantar fasciitis improves with simple self-care. Helpful measures include resting the foot and reducing activities that worsen the pain, regularly stretching the calf and the sole of the foot, wearing supportive, well-cushioned shoes, and using cushioning heel pads or insoles. Applying an ice pack and taking over-the-counter pain relief can ease discomfort.

If symptoms persist, a clinician or physiotherapist may suggest a structured exercise programme, tailored insoles, night splints, or other treatments. A small number of people with ongoing pain despite these measures may be offered further options such as a steroid injection or, rarely, other procedures. Recovery often takes several months, and continuing the exercises is important.

Steps that may help prevent plantar fasciitis or stop it returning include wearing supportive footwear and replacing worn-out shoes, keeping calf and foot muscles flexible with regular stretching, increasing activity levels gradually rather than suddenly, and maintaining a healthy weight to reduce load on the feet.

The outlook is good. The large majority of people recover with simple, non-surgical treatment, although it can take several months for the pain to settle fully, so patience and consistency with the recommended measures help. Surgery is rarely needed. If pain continues despite treatment, it is worth seeking further assessment.