Plantar Fasciitis

Plantar fasciitis is inflammation of the plantar fascia — the thick band of tissue that runs across the bottom of your foot, connecting your heel bone to your toes. It's the most common cause of heel pain. **Key Facts:** - **Location:** Bottom of heel, sometimes extending to arch - **Classic symptom:** Sharp heel pain with first steps in the morning - **Cause:** Repetitive strain and microtears in the plantar fascia - **Recovery:** Usually 6-12 months with conservative treatment - **Common in:** Runners, overweight individuals, those on feet all day **How It Differs from Heel Spur:** - **Plantar fasciitis:** Soft tissue inflammation (the fascia) - **Heel spur:** Bony growth on the heel bone - Many people with heel spurs have no pain - See our [plantar fasciitis vs heel spur comparison](/compare/plantar-fasciitis-vs-heel-spur) **Related Conditions:** - [Heel spur](/condition/heel-spur) — often found alongside plantar fasciitis - [Achilles tendinitis](/condition/achilles-tendinitis) — tendon pain at back of heel - [Arthritis](/condition/arthritis) — can affect foot joints - [Flat feet](/condition/flat-feet) — increases plantar fasciitis risk - [Obesity](/condition/obesity) — excess weight strains feet **Risk Factors:** - Age 40-60 - Running and high-impact activities - [Obesity](/condition/obesity) - Jobs requiring standing all day - Tight calf muscles - Flat feet or high arches

**How Plantar Fasciitis Develops:** **The Plantar Fascia:** Your plantar fascia is a thick, fibrous band of tissue that supports the arch of your foot and acts as a shock absorber when you walk. It connects your heel bone to the base of your toes. **1. Repetitive Stress:** Every step puts tension on your plantar fascia. Over time, repetitive stretching and stress can cause small tears in the tissue. **2. Inflammation:** These microtears trigger inflammation, causing pain and stiffness. The body tries to heal, but continued stress prevents full recovery. **3. Morning Pain:** Overnight, the plantar fascia contracts. When you take your first steps, it's suddenly stretched, causing that characteristic sharp morning pain. **Why Some People Get It:** - **Foot mechanics:** [Flat feet](/condition/flat-feet) or high arches alter stress distribution - **Tight muscles:** Tight calves and [Achilles tendon](/condition/achilles-tendinitis) increase fascia strain - **Weight:** Extra pounds from [obesity](/condition/obesity) increase load on feet - **Activity:** Runners, dancers, and those on feet all day stress the fascia - **Age:** Tissue becomes less flexible after 40 - **Footwear:** Poor arch support or worn-out shoes **Connection to Heel Spurs:** Long-standing plantar fasciitis can lead to [heel spur](/condition/heel-spur) formation — a bony growth where the fascia attaches. However, the spur itself often isn't the pain source.

**Conservative Treatment (First Line):** **Rest and Activity Modification:** - Reduce activities that worsen pain - Avoid high-impact exercise temporarily - Cross-train with swimming or cycling **Stretching (Most Important):** - Plantar fascia stretches (towel stretch, wall stretch) - Calf stretches (gastrocnemius and soleus) - Stretch before getting out of bed - Stretch 3-4 times daily **Ice Therapy:** - Ice massage with frozen water bottle - 15-20 minutes after activity - Reduces inflammation **Supportive Footwear:** - Good arch support - Cushioned heel - Avoid flat shoes and barefoot walking - OTC or custom orthotics **NSAIDs:** - Ibuprofen or naproxen for pain and inflammation - Short-term use (2-4 weeks) **Night Splints:** - Keep foot flexed overnight - Reduce morning pain - 1-3 month trial recommended **If Conservative Treatment Fails:** **Physical Therapy:** - Stretching and strengthening exercises - Manual therapy - Taping techniques - Gait analysis **Injections:** - Corticosteroid injections (limited use) - Platelet-rich plasma (PRP) — emerging treatment **Surgery (Last Resort):** - Rarely needed (< 5% of cases) - Plantar fascia release - After 6-12 months of failed conservative treatment **Prognosis:** - 90% improve with conservative care - Most resolve within 10-12 months - Recurrence possible without preventive measures