Ouch, my heel hurts! What to know about plantar fasciitis

You wake up, get out of bed and feel a stabbing pain in your heel. Sound familiar? If so, you may be dealing with plantar fasciitis.

Plantar fasciitis is one of the most common causes of heel pain. It’s caused by inflammation in the plantar fascia, the thick band of tissue that runs across the bottom of your foot, connecting your toes to your heel.

Joshua Porter, MPAS, PA-C

Joshua Porter, MPAS, PA-C

Now that we’ve established the basics of this common condition, let’s take a look at the answers to some commonly asked questions:

Q: If I have plantar fasciitis, what exactly will the pain feel like?

A: When you have the condition, the pain usually starts out as a mild pain around the heel that may be most noticeable after exercise. Over time, the pain may worsen, and you will likely notice it immediately after getting up in the morning and anytime you get up after sitting for a while.

If plantar fasciitis isn’t treated, it can become chronic. Because the condition may force you to change how you walk to alleviate the pain, it may lead to pain in other areas of the lower body, including the hips, knees and feet.

The pain itself is usually referenced as “stabbing,” so it’s an intense sensation. It’s important to note that the pain occurs after physical activity, not during it.

Q: Why does plantar fasciitis occur?

A: It’s an overuse injury. While the plantar fascia is designed to withstand a lot of pressure — since we’re on our feet for long periods of time each day — we can still put too much pressure on the heel.

When that happens, the tissue is damaged or tears, which leads to inflammation. That causes the pain and stiffness associated with plantar fasciitis.

Q: Are certain people more likely to get plantar fasciitis?

A: Yes — the condition is more common among runners, those who are overweight or obese, and those who frequently wear shoes without proper support.

Anyone, though, can get plantar fasciitis, and there are certain things that may make you more likely to develop the condition. These include:

  • Frequently participating in physical activity that puts a lot of pressure on the heel, like jumping, ballet dancing and aerobic dance, in addition to running
  • Having certain foot mechanics, like flat feet, high arches or an abnormal pattern of walking that places pressure on the heel
  • Working in an occupation that requires long hours on your feet walking or standing
  • Having tight calf muscles that make it harder to flex the foot

Plantar fasciitis may also develop after a person has picked up a new activity or has increased his or her activity level.

Q: If I have plantar fasciitis, how is it treated?

A: A plantar fasciitis diagnosis is made after a medical examination in which the doctor checks the foot for areas of tenderness.

If you’ve been diagnosed with the condition, your doctor will likely recommend conservative treatments to help resolve the pain. Treatment options may include over-the-counter or prescription anti-inflammatory or pain medications, stretching, icing the affected foot, physical therapy, splinting, and orthotic arch supports.

If you don’t find relief with these options, your doctor may suggest other treatments, such as steroid injections or even surgery. Your doctor may recommend additional studies if you don’t experience relief with conservative treatment. These studies may include an MRI of the foot as well as a nerve conduction study to rule out nerve entrapment, which can also be associated with plantar fasciitis. It should be noted, though, that surgery is rarely necessary for plantar fasciitis. It’s really only an option when pain is severe and all other treatment options are ineffective, because it can weaken the arch in your foot.

Joshua Porter, MPAS, PA-C, graduated from Southern Illinois University. He specializes in foot and ankle surgery at Erlanger Orthopaedics Foot & Ankle Institute.

Dealing with heel pain or some other type of orthopedic issue? Our Orthopaedic Institute offers a Walk-in Clinic to provide fast, convenient care when you need it most, open Monday through Thursday with extended hours and Friday until noon. No appointment is necessary.