Plantar Fasciitis
Also known as: Heel spur syndrome، Runner's heel، Policeman's heel
Plantar fasciitis is inflammation of the thick band of tissue running along the bottom of the foot. It's the most common cause of heel pain in adults, affecting roughly 1 in 10 people in their lifetime.
Common Symptoms
- Stabbing pain in the heel with the first morning steps
- Pain that eases after walking but returns with prolonged standing
- Tenderness when pressing the bottom of the heel
- Heel pain after exercise (rarely during)
- Mild swelling at the heel
- Pain that worsens after sitting for long periods (then standing)
- Discomfort when climbing stairs
Causes & Risk Factors
- Sudden increase in walking or running activity
- Standing for long hours on hard surfaces
- Flat feet or very high arches
- Tight calf muscles or Achilles tendon
- Obesity — every step puts 1-2× body weight on the heel
- Inappropriate footwear (worn-out shoes, no arch support, high heels)
- Age 40-60 most common
Treatment Options
Morning stretches before getting out of bed
Pull toes toward shin for 30 seconds × 3, then calf stretches × 30 seconds each side. Pre-loads the fascia gently. Major reduction in first-step pain within 2-3 weeks.
Supportive shoes with arch support
Stop walking barefoot at home. Wear supportive shoes with built-in arch support all day. Avoid flat shoes, flip-flops, and slippers. Custom or quality OTC orthotics transform recovery.
Ice massage
Freeze a small water bottle and roll it under the foot for 5-10 minutes after activity. Cold reduces inflammation; rolling massages out adhesions. Twice daily during flare-ups.
Night splints
Holds the foot in a neutral position during sleep, keeping the fascia gently stretched. Most patients see substantial reduction in morning pain within 2-3 weeks of consistent use.
Cortisone injection
Short-term relief for severe pain. Limited to 2-3 per year per foot — repeated use can weaken the plantar fascia and risk rupture. Best after 3+ months of conservative care.
Extracorporeal shockwave therapy (ESWT)
For chronic cases (>6 months) not responding to other treatment. 3-5 sessions over weeks. About 70-80% of patients see meaningful improvement.
When to See a Doctor
- Heel pain persisting more than 6 weeks despite home treatment
- Pain interfering with work or daily activities
- Heel pain combined with numbness or tingling (rule out nerve issue)
- Pain pattern not matching the morning-first-step classic (different diagnosis possible)
- Severe pain that prevents weight-bearing
Frequently Asked Questions
Why is plantar fasciitis worse in the morning?
Overnight, the plantar fascia contracts and tightens. The first weight-bearing steps suddenly stretch the inflamed tissue, causing sharp pain that eases as you walk and the fascia warms up.
How long does plantar fasciitis take to heal?
With consistent conservative treatment, most cases improve significantly within 2-3 months and resolve completely within 6-12 months. Untreated cases can persist for years.
Can I run with plantar fasciitis?
Reduce running volume and intensity rather than stopping completely. Switch to softer surfaces, supportive shoes with arch support, and consider low-impact alternatives (swimming, cycling) during flare-ups.
Do I need an MRI for heel pain?
Most plantar fasciitis is diagnosed clinically — no MRI needed. We order MRI only if pain is unusually severe, doesn't respond to 3-6 months of treatment, or we suspect a different diagnosis (stress fracture, nerve entrapment).
Are cortisone injections safe for plantar fasciitis?
Cortisone injections work for short-term relief but are limited to 2-3 per year per foot. Repeated injections can weaken the plantar fascia and increase rupture risk. Reserved for cases not responding to conservative care.