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Heel Pain & Plantar Fasciitis

Holding heel and stretching toes

Heel pain is the most common foot pain complaint, and the most common cause of heel pain is plantar fasciitis. Plantar fasciitis can feel like a stabbing pain in your heel, and that pain is generally most severe when you first get out of bed for the day. You may also feel pain in the bottom of your foot. The pain might subside as you move and stretch, but may return after long periods standing—or when you first stand up after you’ve been sitting for a long time.

Plantar fasciitis is often an overuse injury, meaning you’ve stressed a part of your body with a sudden increase in physical activity or intensity. The plantar fascia is a band of tissue that connects your heel to the front of your feet, and damage or stress to the plantar fascia leads to inflammation. That inflamed tissue causes the pain you feel in your heel when you suffer from plantar fasciitis.

Plantar fasciitis diagram, musculature of the foot

Long-term heel pain from plantar fasciitis can also alter the way you walk, shortening your stride or causing you to shift more of your weight away from your heel.

Diagnosing plantar fasciitis is usually as simple as consulting with a doctor in a clinical setting, and it’s rare that imaging studies like an MRI or an X-Ray are necessary.

Plantar fasciitis is common among runners or others who are physically active, or for those with jobs that require them to stand for long stretches of time. Those who are overweight are more likely to experience this painful condition. Plantar fasciitis can also occur during a pregnancy, likely due to the sudden weight gain.

Plantar fasciitis is more common among people who have diabetes, though the connection between the two is unclear.

Wearing shoes without proper support can also cause plantar fasciitis, and it’s more common among folks already dealing with foot problems like flat feet, high arches or a tight Achilles tendon.

Heel spurs may be present among those suffering from heel pain, and for some time doctors thought the spurs themselves caused the pain. While spurs are often found in conjunction with plantar fasciitis, most experts now believe the inflamed plantar fascia is the much more likely cause.

Human foot bones (side view) - Calcaneal spur (heel spur) diagram - dorsal spur, plantar spur

Generally speaking, treating plantar fasciitis often relieves the pain and most doctors will explore that route before recommending surgery to remove a spur. A heel spur that protrudes enough to be felt through the skin and is tender to the touch, however, is a different story and may require correction.

Treating plantar fasciitis usually involves several weeks of resting your feet, balanced with stretching exercises CROSS LINK designed to lengthen the affected tissues. Icing your heels while resting is also helpful.

While recovering from plantar fasciitis you should avoid going barefoot, and you should wear supportive shoes that cup your heels and cushion your feet. If you play sports or do high impact exercises, consider switching to swimming or cycling or other routines with less running and jumping while your plantar fascia recovers.

Pain relievers in the NSAID family, like Advil, Ibuprofen or Motrin—or acetaminophen based pain relievers like Tylenol or Excedrin—may also help.

If these more conservative treatments don’t relieve the pain, a doctor may recommend a night splint to help stretch your plantar fascia and heel cord as you sleep. If the pain persists, your doctor may recommend more robust interventions like steroid injections or a boot.

Most folks recover from plantar fasciitis by following these standard guidelines, and wearing the right shoe can help ease the pain while you recover and protect your plantar fascia from future injuries.