If you are experiencing pain in the heel, especially after walking all day long or running long distances, you may be suffering from Plantar Fasciitis. The American Academy of Orthopedic Surgeons reveals that around 2 million people every year are treated for such a condition. A majority of the heel pain is caused due to inflammation of the tissue at the bottom of the foot or Plantar Fasciitis. It is a common type of repetitive injury that affects runners, walkers, and hikers, or anyone who needs to stand for a living, such as cashiers, salesmen, etc. People who work on concrete or walk or run on hard surfaces are more prone to getting Plantar Fasciitis.

Symptoms of Plantar Fasciitis

The plantar tendon runs the length of the foot, spanning the entire area from the base of the toes to the bottom of the heel. Excessive pressure on this part of the foot can result in small tears in the tissue, leading to inflammation, stiffness, and pain. The most common symptom associated with such a problem is pain in the plantar fascia. The focus of such pain is usually centered near the heel where the person can feel as if the tissue is tearing apart. Such pain may gradually develop over time and can turn out to be worse after some rest. Such a condition may worsen after subsequent activity or exercise if proper precautionary measures are not taken. Some people have heel spurs, which are small, bony growths on the bottom of the heel bone. Many people used to believe that heel spurs were the primary reason for the occurrence of plantar fasciitis, but doctors found out that such occurrences were not responsible for the pain associated with plantar fasciitis.

Causes of Plantar Fasciitis

Plantar Fasciitis is an inflammation of the plantar fascia, which connects the heel bone to the base of the toes. It can be caused by any motion of the toes that causes the plantar tendon to pull. Some of the common causes associated with plantar fasciitis include –

  • Walking or running up or down the hills
  • Climbing stairs
  • Walking or running on the toes, especially wearing high heels.
  • Dorsiflexing, which means pointing the toes up as the heel comes down with each stride
  • Heel striking, which is a result of over-striding
  • Tightening of the calves or pulling of the Achilles tendon leading to the weakening of the plantar tendon.

Long-term stretching of the plantar tendon for weeks or months can lead to the accumulation of calcium between the heel bone and the tendon, which builds more bone mass in that specific spot. This can lead to the formation of a heel spur, which is even more painful than plantar fasciitis.

Risk Factors

There is no clearly identifiable reason for the occurrence of plantar fasciitis. However, a number of risk factors can increase the risk of such an occurrence. This includes –

Sudden Weight Gain or Obesity: Excess weight gain can impair the ability of the plantar fascia to absorb shock, which can result in heel pain. There is also a direct link between increased BMI and plantar fasciitis. Pregnancy can also increase the risk of such an occurrence by increasing the weight on the feet.

Aged People: Active men and women are more likely to experience plantar fasciitis problems between the age of 40 to 60 years. However, such conditions are more frequent among women than men.

Excess Pressure on the Heels: Certain occupations that involve spending most of the time walking or standing, such as teachers and factory workers, are more prone to plantar fasciitis problems.

Foot Abnormalities: People with flat feet or overpronation are at an increased risk of getting plantar fasciitis, as their entire soul, touches the ground while standing.

Arthritis and Diabetes: Some types of arthritis, such as psoriatic arthritis, rheumatoid arthritis, reactive arthritis, and ankylosing spondylitis, can cause inflammation of the plantar fascia. However, the exact reason for people with diabetes getting plantar fasciitis is not known.

Wearing Wrong Shoes: Improper footwear can impair walking, thereby putting additional stress on the plantar fascia. This includes worn out and old shoes that do not provide adequate support and protection to the feet.


To find out the tenderness of the foot and flexibility of the plantar fascia, the doctor will conduct a physical examination. This is done to make sure that the pain is not a result of any other foot problem. The doctor may also evaluate the health of the nerves and strength of the muscles by checking the –

  • Muscle tone
  • Reflexes
  • Sense of sight and touch
  • Balance
  • Coordination

An MRI scan or X-ray may be necessary to find out the exact location of the heel pain.

Treatment Options

Home remedies such as rest, icing, and using anti-inflammatory drugs and braces are the primary steps to correct plantar fasciitis problems. If such corrective measures do not ease the discomfort, injecting corticosteroid directly into the affected area of the ligament can help to soothe the pain. The physician may use an ultrasound device to determine the place of injection. Such injection can also be applied on the heel or arch of the foot, and then a painless electrical current passed to let the steroid penetrate deep into the muscles. Physical therapy is another crucial treatment for plantar fasciitis. It can help stretch the Achilles tendons and the plantar fascia. It does so by strengthening the lower leg muscles to stabilize the walk and lessen the workload through proper exercises. If the pain continues even after such measures, the doctor may recommend extracorporeal shock wave therapy, which uses sound waves to heal the ligament. However, such a treatment option can include certain side effects such as swelling, cruises, numbness, and pain. Surgery is the last option when the pain is severe and lasts for almost a year. For people having a hard time flexing their feet even after all possible treatment measures may have to undergo a gastrocnemius, the recession, which is a surgical procedure.

Bottom Line

Most people suffering from plantar fasciitis can get relief from home remedies or medical treatments and physical therapy by a physician. Only some cases would call for a need for surgery. However, the treatment time would depend on the intensity and severity of such a problem.