Understanding Plantar Fasciitis: Causes, Symptoms, Treatment, and Prevention

Plantar fasciitis is a condition characterized by inflammation and pain in the plantar fascia, a thick band of tissue that runs along the bottom of the foot, connecting the heel to the toes.

The typical plantar fasciitis symptoms are as follows:

• Pain in the sole of the foot, which is usually sharp, stabbing, or aching in nature

• Pain with the first steps in the morning or after periods of rest. It can also worsen after prolonged periods of standing or physical activity

• Stiffness, especially after periods of inactivity

• Tenderness and sensitive to touch or pressure

• Gradual onset of symptoms with pain increasing in intensity over weeks or months

It’s important to note that these symptoms are characteristic of plantar fasciitis, but a proper diagnosis by a healthcare professional is crucial to rule out other potential causes of foot pain.

The exact causes of plantar fasciitis are not fully understood, but it is commonly associated with repetitive strain or excessive stress on the plantar fascia. Risk factors include activities that involve running or jumping, prolonged standing or walking on hard surfaces, improper footwear, tight calf muscles or Achilles tendons, obesity, and certain foot mechanics such as high arches or flat feet. These factors can contribute to the development of micro-tears and inflammation in the plantar fascia, leading to plantar fasciitis.

While plantar fasciitis itself does not typically lead to serious complications, it can cause persistent discomfort and affect daily activities if left untreated or not properly managed. Some potential complications of plantar fasciitis if left untreated are:

• Chronic pain: Without appropriate treatment, plantar fasciitis can become a chronic condition, leading to ongoing or recurrent pain in the heel and foot.

• Altered gait: To compensate for the pain, individuals with plantar fasciitis may alter their walking or running mechanics, potentially leading to imbalances and strain on other structures in the feet, legs, or joints.

• Activity limitations: Severe pain and discomfort from plantar fasciitis can limit participation in sports, exercise, or even simple daily activities that involve prolonged standing or walking.

• Impact on quality of life: Persistent foot pain can affect one’s overall quality of life, leading to reduced mobility, increased fatigue, and decreased participation in social or recreational activities.

• Secondary conditions: The altered gait and activity limitations caused by plantar fasciitis may contribute to the development of other conditions, such as knee, hip, or back pain.

Plantar fasciitis treatment and management typically involve a combination of self-care measures, conservative therapies, and, in some cases, medical interventions. Here are some approaches to heal and treat plantar fasciitis:

• Rest and activity modification: Give your feet adequate rest and avoid activities that worsen the pain. Modify or reduce high-impact activities like running or jumping

• Ice therapy: Apply ice packs or use frozen water bottles to ice the affected area for 15–20 minutes several times a day to help reduce inflammation and relieve pain

• Plantar fasciitis exercises: Perform stretching exercises for the calf muscles and plantar fascia to improve flexibility and reduce tension. Examples include calf stretches, Achilles tendon stretches, and plantar fascia stretches

• Supportive footwear: Wear supportive shoes with cushioned insoles and good arch support. Avoid flat or unsupportive footwear that may strain the plantar fascia.

• Orthotic devices: Use shoe inserts or custom orthotics to provide additional support, cushioning, and alignment for the foot

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter pain relievers like ibuprofen or naproxen can help reduce pain and inflammation. Follow the recommended dosage and consult a healthcare professional if needed

• Physical therapy: A physical therapist can provide targeted exercises, manual therapy techniques, and other modalities to alleviate symptoms and promote healing

• Night splints or braces: Using night splints or braces that keep the foot in a slightly stretched position can help alleviate morning pain and promote healing

• Extracorporeal shockwave therapy (ESWT): This non-invasive treatment for plantar fasciitis uses sound waves to stimulate healing and reduce pain in stubborn cases of plantar fasciitis

• Corticosteroid injections: In severe cases, corticosteroid injections may be considered to provide temporary pain relief and reduce inflammation. These should be used judiciously and under medical supervision.

Choose shoes with good arch support, cushioning, and a firm heel counter. Look for shoes with a roomy toe box as well as overall proper fit and support. Avoid high heels and opt for low to moderate heel height.

To prevent plantar fasciitis, wear supportive footwear with good arch support and cushioning. Warm-up before activity with gentle stretching exercises, and gradually increase exercise intensity. It is also important to regularly stretch calf muscles and plantar fascia. Maintain a healthy weight to reduce foot stress and avoid prolonged standing or walking on hard surfaces. Consider using shoe inserts or custom orthotics for added support. Listen to your body and address any foot discomfort promptly and make sure to use supportive footwear or orthotic slippers at home, especially on hard floors. By following these preventive measures, you can reduce the risk of plantar fasciitis and promote overall foot health.

Plantar fasciitis is typically treated by healthcare professionals who specialize in conditions related to the feet, such as podiatrists, orthopedic doctors (specifically foot and ankle specialists), or sports medicine physicians. These specialists have expertise in diagnosing and managing foot and ankle conditions, including plantar fasciitis. They can provide a comprehensive evaluation, recommend appropriate treatments, and guide you through the healing process. 

If you suspect you have plantar fasciitis or are experiencing foot pain, it is advisable to seek care from one of these healthcare professionals to receive an accurate diagnosis and guidance on the most appropriate treatment plan for your specific condition. They can provide personalized recommendations and monitor your progress to ensure effective healing and recovery.

The time it takes to treat plantar fasciitis can vary from person to person and depends on several factors, including the severity of the condition, adherence to treatment, and individual response to therapies. In many cases, with proper and consistent treatment, plantar fasciitis can improve within a few weeks to a few months. However, some individuals may experience more prolonged symptoms and require several months of treatment to achieve significant relief. It is essential to follow the recommended treatment plan, which may include rest, exercises, wearing supportive footwear, and other therapies, to promote healing and improve the chances of a faster recovery.

It’s important to have a podiatrist that will help diagnose your plantar fasciitis as well help you with how to manage and heal it. As part of your care team, Oak Street Health’s podiatrists work closely with your Oak Street Health primary care doctor to diagnose and treat any foot conditions, including plantar fasciitis.