Plantar fasciitis can cause pain, swelling, and stiffness in one or both heels. You can often treat this condition at home with ice, rest, supportive braces, and over-the-counter pain relief. If your pain doesn’t improve, a doctor can offer more guidance.

Illustration of where on the heel plantar fasciitis occursShare on Pinterest
Inflammation from plantar fasciitis typically occurs at the bottom of the foot near the heel. Illustration by Yaja’ Mulcare.

Plantar fasciitis causes pain in the bottom of the heel. The plantar fascia is a thick, weblike ligament that connects the heel to the front of the foot. It acts as a shock absorber and supports the arch of the foot, helping you walk.

Plantar fasciitis is one of the most common orthopedic complaints. Your plantar fascia ligaments experience a lot of wear and tear in your daily life. Too much pressure on your feet can damage or tear the ligaments. The plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness.

The cause of plantar fasciitis discomfort is still unclear. Depending on the cause and extent of the inflammation, nonsurgical treatment may provide relief, but in severe cases, a surgical procedure may be considered.

In this article, we examine plantar fasciitis, its symptoms and causes, treatment options, and recovery time.

The major complaint of those with plantar fasciitis is pain at the bottom of the heel or sometimes at the bottom mid-foot area. It usually affects just one foot, but it can affect both feet.

Plantar fasciitis pain develops gradually over time. It can be dull or sharp. Some people feel a burning or ache on the bottom of the foot extending outward from the heel.

The pain is usually worse in the morning when you take your first steps out of bed or if you’ve been sitting or lying down for a while. Due to heel stiffness, climbing stairs can be tough.

After prolonged activity, the pain can flare up due to increased irritation or inflammation. People with plantar fasciitis usually feel pain not during activity but after stopping.

Doctors used to believe that heel spurs caused pain in people with plantar fasciitis. These are hooks of bone that can form on the foot’s heel bone or calcaneus. Like plantar fasciitis, it can develop from long-term stress on your feet.

However, plantar fasciitis isn’t actually caused by heel spurs. It tends to develop due to the overstretching or overuse of this ligament, although a tear or small tears in the fascia tissue can also cause pain. Your foot structure can also predispose you to developing plantar fasciitis.

Plantar fasciitis is commonly found in runners and older adults. About half of patients diagnosed with plantar fasciitis also have heel spurs, but the presence of spurs doesn’t cause the condition.

Other risk factors include:

  • being overweight or having obesity
  • having an active job where you are often on your feet
  • carrying excess weight
  • having tight Achilles tendons
  • wearing shoes with soft soles and insufficient arch support.

Another risk factor is ankle dorsiflexion, which is when you bend your foot backward at the ankle.

In children

Like adults, children may develop plantar fasciitis from overuse of the ligament or from wearing old or unsupportive shoes.

It tends to develop among children who play sports that involve a lot of running, jumping, and inclines. It can also occur together with Sever’s disease, but it can also happen on its own.

Your doctor will perform a physical exam to check for tenderness in your foot and the exact location of the pain. This is to ensure that the pain isn’t the result of a different foot problem.

During the evaluation, they may ask you to flex your foot while they push on the plantar fascia to see if the pain worsens as you flex and better as you point your toe. They’ll also note if you have mild skin discoloration or swelling.

Your doctor will also evaluate the strength of your muscles and the health of your nerves by checking your:

  • reflexes
  • muscle tone
  • sense of touch and sight
  • coordination
  • balance

Your doctor can usually diagnose plantar fasciitis based on this exam. They may also order an X-ray or an MRI to rule out another cause of pain, such as a fracture. An ultrasound may also be useful to see if there is any thickening, calcifications, or other issues.

There isn’t one treatment that can heal planta fasciitis immediately. That said, home treatments like rest, icing, and anti-inflammatory drugs like NSAIDs or lidocaine patches are often the first steps in treating plantar fasciitis.

If these options don’t ease the pain, a corticosteroid injection directly into the damaged section of the ligament can help. Your doctor can do this in their office. But, if your pain is acute or your condition is chronic, these shots are usually effective for only short-term relief.

Other things your doctor may recommend include wearing night splints, braces, or supportive shoes.

Home remedies

Additional options you may consider include:

  • Essential oils: Some research suggests certain oils, such as vanilla, eucalyptus, and menthol, may help reduce pain and inflammation. Before applying, dilute them with a carrier oil, like coconut oil, and stop using them if you experience skin irritation or allergy symptoms.
  • CBD: Numerous studies have found that Cannabidiol (CBD) may be effective in relieving various types of pain, including one 2018 review. But, more research is needed to examine the effect on plantar fasciitis pain specifically.
  • Nutrition: More research is needed on using nutrition to improve or prevent plantar fasciitis, but eating a balanced diet can help you ensure you get nutrients that may help with tissue repair and healing. If you do decide to take supplements, always check with your doctor first.
  • Stretches: These can help stretch your calves, Achilles tendon, and plantar fascia to help relieve and even prevent plantar fasciitis. Examples include toe curls or extensions.

Other medical treatments

More advanced treatments include:

Note that the evidence for the effectiveness of corticosteroid injections, prolotherapy, extracorporeal shockwave therapy, and botox is a bit more robust than the evidence for the efficacy of plasma injections, though more research is beneficial in all of these treatment modalities.

If home and medical treatments don’t cure your plantar fasciitis, you may consider surgery.

Learn more: All about plantar fasciitis surgery and home remedies for plantar fasciitis.

Does plantar fasciitis ever go away?

For most people, plantar fasciitis improves within a few weeks to a few months of treatment.

You can develop chronic heel pain if you ignore the condition. This can change the way you walk and cause injury to your:

  • legs
  • knees
  • hips
  • back

Without proper treatment, plantar fasciitis can lead to rupture or damage to ligaments, loss of fat tissue in the foot, and decreased arch support.

Note that rupture is particularly likely if you do steroid injections because this can weaken the ligament. Since these injections are more effective in the short term, speak with your doctor to determine the best treatment or combination of treatments long term.

Surgery also carries the risks of bleeding, infection, and reactions to anesthesia. Plantar fascia detachment can also cause changes in your foot and nerve damage. Gastrocnemius recession surgery can also cause nerve damage.

Most people don’t need surgery to relieve pain from plantar fasciitis. Instead, their condition improves through physical therapy, home treatments, and medical treatments.

However, treatment can take weeks to months to improve your symptoms. In some cases, surgery may become an option that you might need to consider.

Regardless of what treatment you choose, don’t ignore your symptoms. Untreated plantar fasciitis can lead to more painful complications.