Plantar fasciitis symptoms & treatment

When you have intense pain in the heel of your foot, you may have plantar fasciitis. It may start gradually or suddenly. The pain may make you start limiting activities you used to enjoy.

Podiatrists are doctors who specialize in treating plantar fasciitis. If you are experiencing symptoms of plantar fasciitis, you should see a podiatrist first because they can provide the most conventional and least invasive treatments.

If treatment doesn't work and surgery is required, you may need to see an orthopedist who specializes in foot and ankle disorders. At Advocate Health Care, we offer a variety of noninvasive and minimally invasive plantar fasciitis treatments.

What is plantar fasciitis?

Plantar fasciitis happens when the plantar fascia – a thick band of connective tissue that reaches from the heel all the way to the ball of the foot – is damaged.

The plantar fascia is supposed to flex and stretch when you walk or run. It acts as a sort of shock absorber for your foot. You’ll start to have pain when the tissues can’t stretch enough to allow you to move the way you need to.

Pain and symptoms of plantar fasciitis usually start as a shooting or aching pain in the heel, beginning at the point where the plantar fascia attach to the heel bone. It may be the most painful when you stand up after sitting for a long time or for the first time in the morning.

What causes plantar fasciitis?

Plantar fasciitis pain often develops with no clear cause. There are some risk factors that make it more likely.

• Having a job that keeps you on your feet, like factory work or working in a restaurant
• When your calf muscles or Achilles tendons are tight and they make it hard to flex your foot
• Wearing unsupportive shoes
• Changing the brand or style of shoes you wear
• Running or other sports that cause repetitive impact
• Increasing the mileage that you run or walk
• Changing to a new sport or physical activity
• Having poor running form
• Being overweight or obese
• Having either very high arches or flat feet
• Being an active person between 40 and 70 years old

Plantar fasciitis symptoms

The shooting pain associated with symptoms of plantar fasciitis usually begins at the heel and travels to the center of your foot. You may have stiffness in the heel that makes it hard to flex your foot or walk. Symptoms of plantar fasciitis and pain may occur:

• During and after standing for a long time
• When you take your first steps in the morning or after prolonged sitting
• After exercise

Home treatment for plantar fasciitis

It’s very important to rest your foot. If you notice something that seems to contribute to the pain or plantar fasciitis symptoms, try changing your routine to avoid that activity.

In addition, you may be able to ease your pain by:

• Stretching the calf muscles and bottom of your foot several times a day
• Rolling a tennis ball or a cold water bottle under the arch of your foot while sitting down (three to four times a day) – this helps massage and stretch the plantar fascia
• Using an over-the-counter anti-inflammatory medicine like ibuprofen, naproxen or aspirin to control pain and inflammation (Consult with your doctor before starting these or any other medications)
• Resting your feet when the pain is the worst
• Using arch supports, heel cushions or custom foot orthotics (inserts) in your shoes
• Decreasing the mileage you run or stopping running altogether
• Switching to no-impact or low-impact workouts
• Putting ice or cold packs on the heel and arch for 10 to 20 minutes after painful activities

If your pain doesn’t improve with these measures or gets worse, see your doctor. The sooner you have treatment, the more quickly the pain will go away. Delaying plantar fasciitis treatment will make it take longer to treat.

Diagnosing plantar fasciitis

Your sports medicine or orthopedic doctor will take your medical history and perform a physical exam. They’ll ask about your pain and possible plantar fasciitis symptoms, and whether you have an idea about what caused it. They’ll also do simple tests to check what movements cause pain and how your foot moves.

They may do X-rays to check for bone fractures or bone spurs (bony growths on the heel bone that often occur along with plantar fasciitis).

They may also order an MRI to help rule out other causes for your pain such as a compressed or pinched nerve.

Plantar fasciitis treatments

Plantar fasciitis treatments often include noninvasive medical treatments such as these:

• Custom bracing or splinting (night splints) to wear while you sleep that hold your foot flexed in the best position to heal
• Orthopedic physical therapy to build flexibility and strength in the foot and calf as well as improve mobility
• Integrated medicine practices like massage, chiropractic and acupuncture to relieve pain naturally
• Assessing your running form to identify and adjust any problems with your biomechanics
• Injections for joint pain (cortisone shots) to relieve pain while your foot heals
• Using heel cushions, arch supports or custom orthotics in your shoes

If nonsurgical methods don’t work your doctor might recommend surgery. We perform tendon procedures to break up and remove the scar tissue around heel spurs that can occur with plantar fasciitis. Because doctors do these plantar fasciitis treatments through a tiny incision, most people return to normal activities within a few weeks.