Plantar fasciitis

The band of tissue supporting your arch becomes irritated. Heel pain has other causes, so an exam helps confirm the problem.

Why it happens
Long hours on your feet, increased activity, and shoes with little support can strain the tissue. Flat feet or high arches may add stress.

What you may notice
Pain under the heel or in the arch, often worst with the first steps after sleep or sitting.

How the diagnosis is checked
Your clinician checks the tender area, foot shape and ankle movement. An x-ray may help rule out a fracture or arthritis. An MRI or ultrasound  are helpful in most cases. 

Treatment and what to expect
Most people improve without surgery. Inserts (orthotics), a night splint or physical therapy may help. Keep using supportive shoes and prescribed stretches after pain improves to reduce repeat problems. Pain may ease after a few steps and return after longer activity. A heel spur seen on an x-ray is not always the cause. Other problems can also cause heel pain.

When to call
Call if the pain worsens or is not improving after several weeks of following your plan.

Your next steps
● Wear shoes with good arch support. Avoid walking barefoot.
● Reduce long periods of standing and activities that trigger pain.
● Do the calf stretches your clinician teaches you. Ask which exercises are safe for your foot.

Choosing activities while you heal
Swimming or cycling while reducing running and jumping. These activities put less impact on the foot.

A physical therapist can teach stretches for both the calf and the tissue under your foot. Replace worn-out shoes that no longer support your feet.

How long may improvement take?
Improvement is usually gradual over months. AAOS reports that more than 9 out of 10 patients improve within 10 months with simple treatment. This is a general estimate, not a deadline. If progress stalls, your clinician can review the diagnosis and plan. Steroid injections are sometimes considered, but they can weaken the tissue and are not right for everyone.

Laser therapy is a progressive and innovative tool to reduce inflammation and start the recovery specifically if symptoms are continuing to be present.