Plantar fasciitis is inflammation of the plantar fascia, the thick band of tissue that runs along the bottom of your foot from the heel to the toes. It is the most common cause of heel pain, producing a sharp, stabbing ache that is usually worst with your first steps in the morning. The good news: the large majority of cases improve with simple, nonsurgical care — especially when you start treatment early.
If you have ever stepped out of bed and felt a jolt of pain shoot through your heel, you are far from alone. Plantar fasciitis is one of the most frequent reasons patients come through our doors in Farmington and South Ogden. Below, our podiatrists walk through what causes it, how to recognize it, and the full range of treatment options — from at-home stretches to advanced in-office procedures.
What is plantar fasciitis?
Plantar fasciitis develops when the plantar fascia — a strong, fibrous band that supports your arch and the surrounding muscles — is repeatedly overstretched or develops small tears. The fascia is a weight-bearing structure that absorbs shock with every step, so when it is strained beyond what it can tolerate, it becomes irritated and inflamed.
Because that tension concentrates where the fascia attaches to the heel bone, chronic irritation can also contribute to a heel spur — a small bony growth. Many people with heel spurs feel no pain at all, and treating the underlying plantar fasciitis usually resolves the symptoms.
What are the symptoms of plantar fasciitis?
The hallmark symptom is a stabbing pain in the bottom of the heel that is sharpest with your first steps after waking or after sitting for a while, then often eases as you keep moving. Common signs include:
- Stabbing pain on the heel, near the heel, or on the bottom of the foot
- "First-step pain" — a sharp jolt when you stand up after sleeping or resting
- Pain that flares after exercise rather than during it
- Discomfort following prolonged standing, walking, or sitting
- Heel tenderness that improves with gentle movement but returns after rest
What causes plantar fasciitis, and who is at risk?
Plantar fasciitis is caused by repeated strain that irritates and slightly tears the fascia. Runners and athletic people are at higher risk because of repeated impact, but the condition is also very common in people who are overweight or who spend long hours on their feet — because the plantar fascia is a weight-bearing part of the body, extra load matters. Contributing factors include:
- Tight Achilles tendons or calf muscles that increase pull on the heel
- Flat feet or high arches that change how weight loads the fascia
- Frequently wearing high heels or worn-out, unsupportive shoes
- Being overweight, which adds strain to the arch
- Being age 40 or older
- Jobs that require extended standing or walking on hard surfaces
Plantar fasciitis is more common in women than in men. Because tight calf muscles and poor arch support are frequent contributors, Achilles tendon problems often go hand in hand with it.
How is plantar fasciitis treated?
The great majority of cases resolve without surgery, so we start with the most conservative options and advance only if pain persists. A typical plan combines at-home measures with in-office therapies tailored to how long you have had symptoms and how active you are.
Nonsurgical treatment
- Rest, ice, and activity changes to calm the initial inflammation
- Stretching and physical therapy for the plantar fascia and calf
- NSAIDs and other medications to reduce pain and swelling
- Custom orthotics and supportive footwear to offload the arch — see our custom orthotics options
- Night splints that keep the fascia gently stretched while you sleep
- Corticosteroid injections for stubborn, focused pain
In-office & minimally invasive options
For heel pain that has not responded to first-line care, advanced in-office treatments can help you avoid open surgery. These include extracorporeal shock wave therapy (ESWT), which uses sound-wave energy to stimulate healing without incisions, and the Tenex procedure, a minimally invasive, ultrasound-guided technique that removes damaged tissue through a tiny opening under local anesthesia.
Surgery
Surgery is rarely needed and is reserved for the small number of cases that do not improve after an extended course of conservative care. When appropriate, the procedure involves partially releasing the plantar fascia from the heel bone to relieve tension. Our physicians always exhaust nonsurgical options first.
Why you shouldn't wait to treat heel pain
Early treatment is more effective and can prevent a short-term problem from becoming a chronic one. When heel pain lingers, people often change how they walk to avoid it — and that altered gait can lead to new problems in the knees, hips, back, and the opposite foot.
See a podiatrist if your heel pain lasts more than a week or two of home care, keeps you from your normal activities, or returns each morning. Seek care sooner if you have severe pain, swelling, numbness or tingling, or heel pain following an injury, as these may point to a different condition. People with diabetes or poor circulation should have any new foot pain evaluated promptly. When you are ready, you can request an appointment at either of our Northern Utah offices.
Medically reviewed by the physicians at Wasatch Foot & Ankle Institute. Our board-certified, fellowship-trained podiatrists provide foot and ankle care in Farmington and South Ogden, Utah. This article is for general education and is not a substitute for an in-person evaluation.