The plantar fascia is the ligament that runs across the bottom of the foot, connecting the heel bone to the ball of your foot. This ligament acts as a shock absorber and supports the arch. When there is repetitive stress and tearing, this thick band of tissue becomes inflamed causing stabbing pain and tenderness in the heel area, making it difficult to bear weight and walk.
Plantar fasciitis is normally a chronic condition that can be triggered by wearing unsupportive footwear, running or sometimes no specific reason. Contributing factors include:
The main symptom of plantar fasciitis is intense pain in the heel area that is often worse in the morning and improves throughout the day. The pain is generally concentrated where the ligament meets the base of the heel.
An ultrasound, X-ray or MRI may be necessary to diagnosis the condition and rule out other possibilities, such as a stress fracture or a heel spur.
Plantar fasciitis is sometimes confused with a heel spur, which is a bone spur on the bottom of the calcaneus (heelbone). Although the two conditions can both be present and connected, they can also occur independently. In other words, one person may have plantar fasciitis despite having no heel spur, while another may have a heel spur but have no inflammation of the fascia or any heel pain.
The initial treatment for plantar fasciitis involves rest, ice, stretching and nonsteroidal anti-inflammatories (NSAIDs) like naproxen or ibuprofen. The use of massage and stretching of the foot, Achilles tendon and calf muscle helps relieve the tension and provide relief. Many patients find it helpful to roll a frozen water bottle under the foot.
If the plantar fasciitis persists or worsens, a foot specialist might recommend:
Most people with plantar fasciitis (roughly 95%) do not need surgery. It could take months or years to treat it successfully using nonsurgical means, and even then, it could possibly reoccur. For those with a very serious case, there are several surgical procedures that could reduce tension on the ligament:
Like with any surgery, there are risks involved that your surgeon should go over before making the decision to have plantar fasciitis surgery. Recovery depends on the type of surgical procedure, but can take up to 6-10 weeks and 3 months for rigorous activity.
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