What is plantar fasciitis?
The plantar fascia is a thick band that fans out from the heel bone toward the toes, supporting the arch and absorbing shock as you walk. When repeated strain causes small tears and degeneration where it attaches to the heel, pain follows. That is plantar fasciitis.
According to press reports citing Korea's Health Insurance Review and Assessment Service, the number of people treated for it rose 2.5-fold in ten years, from about 106,000 in 2011 to about 265,000 in 2021. It is common in people in their 40s to 60s, those who stand for long hours, and those who have gained weight.
Typical symptoms
- Pain with the first steps of the day: A stabbing pain on the inner heel when you first stand up in the morning, easing after a few steps.
- Pain again after rest: The same pain when you stand after sitting for a while.
- Worse after long standing or walking: Often flares again toward the end of the day.
- A tender spot: Pressing the inner underside of the heel hurts.
Plantar fasciitis self-check
If several of these apply, plantar fasciitis is a possibility. This does not replace a diagnosis.
- The first few steps after getting up hurt the most.
- Your heel hurts when you stand after sitting a long time.
- Pressing the inner underside of the heel hurts.
- You recently stepped up walking, hiking or running, or often wear unpadded shoes or slippers.
- Your calves are tight, making it hard to pull your foot up toward you.
How is it different from other heel pain?
| Condition | Where it hurts | Typical features |
|---|---|---|
| Plantar fasciitis | Inner underside of the heel | Worst with the first morning steps, easing as you walk |
| Achilles tendinitis | Back of the heel, the tendon behind the ankle | Hurts on stairs or tiptoe; the tendon may thicken |
| Heel stress fracture | Whole heel; hurts when squeezed from both sides | Keeps getting worse with walking, with swelling. Watch for it if you have osteoporosis |
| Tarsal tunnel syndrome (nerve compression) | Below the inner ankle bone into the sole | Numbness or burning more than pain |
| Heel fat pad atrophy | Center of the heel | Bruise-like pain walking barefoot on hard floors; common with age |
Does it go away on its own?
A review in the American Academy of Orthopaedic Surgeons' journal reports that about 90% of people improve with non-surgical care, most within several months to a year. It also notes that the natural course without any treatment has not been well studied, so it is hard to separate the effect of time from the effect of treatment. Rather than pushing through the pain, the basics are regular stretching and good footwear.
Stretches you can do at home
Stop if you feel sharp pain; stretch only to a gentle pull.
1. Plantar fascia stretch (the best-supported move)
Sit in a chair and rest the painful foot on the opposite knee. With one hand, pull your toes back toward the shin until the sole feels taut, and feel the tight band with your other hand. Hold 10 seconds, repeat 10 times, three times a day. The key is to do it before your first steps in the morning and before standing up after sitting.
In a trial that randomized 101 people with chronic heel pain (DiGiovanni et al., 2003), those doing this stretch had better pain and satisfaction after 8 weeks than those doing only an Achilles stretch. Reviews note, however, that there is not enough evidence to say stretching is clearly better than other treatments.
2. Wall calf stretch
Face a wall with both hands on it, step the painful foot back with the heel flat on the floor, and bend the front knee until the calf stretches. Hold 30 seconds, three times, two or three times a day. Tight calves are thought to increase strain on the plantar fascia.
3. Towel stretch
Sit on the floor with legs straight, loop a towel around the ball of the foot, and pull it toward you with the knee straight for 30 seconds. Easy to do in bed in the morning.
4. Rolling the sole
Sitting down, roll a golf ball or a frozen water bottle under your sole for 1–2 minutes. Many people find it soothing, but few studies have tested it on its own, so treat it as an extra.
Medical treatments and the evidence
| Treatment | What it does and the evidence |
|---|---|
| Insoles and heel cups | Cushion the heel. Many studies find little difference between custom and off-the-shelf insoles, so off-the-shelf ones are a reasonable start. |
| Night splints | Hold the ankle at a right angle overnight to ease morning pain. |
| Anti-inflammatory painkillers | A short-term aid for pain. |
| Steroid injection | Gives short-term relief, but repeated injections risk rupture of the fascia or thinning of the heel fat pad, so the number is limited. |
| Extracorporeal shock wave therapy | Considered for chronic pain lasting more than 6 months. |
| Surgery | Considered in rare cases that do not improve after 6–12 months or more of non-surgical care. |
Plantar fasciitis myths: true or false?
| Claim | What the evidence shows so far |
|---|---|
| A heel spur is stabbing the foot | Heel spurs seen on X-rays are common in people with no pain and are often not the direct cause. The AAOS also explains that removing the spur is not the core of treatment. |
| You must rest completely | Rather than total rest, cut back on what aggravates it (long standing, barefoot on hard floors, sudden increases in exercise) and keep stretching and moving gently. If walking is hard, swimming or a stationary bike keeps you fit. |
| Going barefoot is good for your feet | With plantar fasciitis, walking barefoot on hard floors can make it worse. Wear cushioned slippers indoors too. |
See a doctor right away if
- Pain started suddenly after a fall or twist and you can hardly put weight on the foot
- The heel is swollen, warm or red, or you have a fever
- Your sole is numb or tingling, or the pain continues at night even at rest
- You have diabetes and develop foot pain or a wound
Please keep in mind
- This article is based on information checked as of the date shown at the top. New research or changes in official guidelines may change the details, so please use it as a reference rather than taking it as definitive.
- For an accurate diagnosis and advice about your health, please see a doctor in person.