Plantar Fasciitis: Heel Pain Symptoms and Treatment

04 April 2019

Do you experience pain in your heel when you’re awake and even after a long night of rest? Heel pain is a very common foot problem.
It is usually felt on the underside or the back of the heel. Most cases of heel pain are caused when a band of tissue in the foot, called the plantar fascia, becomes damaged and thickens.

What is Plantar Fasciitis?

Plantar fasciitis sufferers usually feel stabbing pain within the first few steps after waking up. The pain and stiffness usually decrease after a while, but it gets worse again after walking or standing for a long time.

Why Does It Happen? Common Causes of Plantar Fasciitis

The role of plantar fascia is to support the arch of our foot and acts as a shock-absorber in our foot.

Plantar fasciitis happens when the thick band of tissue on the bottom of the foot is overstretched or overused.
The likelihood of injuring the plantar fascia increases if you:

walk, run or stand for a long period of time
wear shoes with poor cushioning or poor arch support
are overweight or have gained weight suddenly
have foot arch problems, e.g. flat feet and high arches
have tight calf muscles or Achilles tendon

How Do I Know If I Have Plantar Fasciitis?

The symptoms of plantar fasciitis are pain and stiffness:

on the bottom of the heel
in the arch of the foot
that is usually worse upon waking up
that increases over a period of months

How Is It Diagnosed?

Seeing a specialist called the Foot & Ankle Surgeon is important in getting the right diagnosis. Plantar fasciitis is usually diagnosed simply through physical examination. Sometimes, X-rays or ultrasounds of the fascia may be obtained to rule out other possible causes of heel pain.

Treatment for Plantar Fasciitis

The Foot & Ankle Surgeon will first recommend some non-surgical treatments which include:

Heel, foot & calf muscle stretching exercises
Avoid going barefoot
Ice/cold therapy
Limit activities for at least a week
Shoe modifications, e.g. heel pads and medial arch support
Pain-relief medications
Reduce body weight
Timely injection of platelet-rich plasma (PRP) according to doctor’s recommendation

Is Plantar Fasciitis Surgery Necessary?

Most patients respond to non-surgical treatments and recover. If pain persists after six months, the doctor may consider endoscopic plantar fascia release surgery.

Is Prevention Key To Pain-Free Heels?

For long-term care of your heel, preventive measures may be the way to help keep the condition from getting worse:

Lose weight if you are overweight or obese
Always stretch the plantar fascia and Achilles tendon, especially before exercise
Avoid exercising on hard surfaces
If you run or do any sports, change your training or sports shoes regularly
Wear shoes with good support in the arch and cushioning in the heels

Quick Facts

There are 26 bones in the human foot, of which the heel is the largest.
Heel pain is usually felt under the heel or just behind it.
Plantar fasciitis is estimated to account for 8% of all running-related injuries.
In most cases, the pain is under the foot, towards the front of the heel.
Home care such as rest, ice, proper fitting footwear and supports can help ease heel pain.