Plantar fasciitis is a condition in which the tissue that runs across the bottom of the foot, the plantar fascia, becomes inflamed. It is associated with symptoms like pain, discomfort or a burning sensation in the bottom of the foot, especially after waking up or following physical activity, like walking or running.

The plantar fascia is responsible for supporting the arch of the foot and for absorbing the impact when walking. Plantar fasciitis is more common in people who practice long-distance running or use ill-fitting sneakers. However, it can also develop in people who have flat feet.

Treatment of plantar fasciitis is guided by an orthopedic surgeon, who may prescribe anti-inflammatories, orthopedic insoles, physiotherapy and, in more severe cases, surgery.

Common symptoms

The main symptoms of plantar fasciitis include:

Pain in the middle of the heel, which worsens in the morning when weight-bearing
Pain that worsens with prolonged standing
A burning sensation on the bottom of the foot
A sensation of 'sand' when pressing on the sole of the foot.

Symptoms of plantar fasciitis are related to the thickening of the fascia caused by inflammation, as well a fibrosis and calcification in this tissue.

Confirming a diagnosis

A plantar fasciitis diagnosis is typically confirmed by an orthopedic surgeon, who will first assess your symptoms and health history and then physically examine the foot.

The doctor may request an X-ray or MRI to confirm the diagnosis and rule out other conditions that can present with similar symptoms, like a stress fracture or tarsal tunnel syndrome (TTS).

Possible causes

Plantar fasciitis is caused by repetitive strain or excessive tension of the plantar fascia that results in microtraumas.

Some factors that can increase the risk for developing plantar fasciitis include:

Age, being more common after the age of 40
Flat feet or pes cavus
Limited ankle movement
Practicing sports like long-distance running, jumping rope, aerobic dancing or ballet
Use of ill-fitting shoes;
Being overweight or obese
Heel atrophy

A combination of these factors can also contribute to inflammation of the plantar fascia. If left untreated, it can cause intense pain and interfere with activities of daily living. Learn more about what can cause pain on the bottom of the foot.

Treatment options

Treatment for plantar fasciitis should be guided by an orthopedic surgeon. It is aimed at reducing inflammation of the plantar fascia and relieving symptoms.

The main treatment options used for the management of plantar fasciitis include:

Ice packs, applied for 15 minutes to the soles of the feet, about twice a day;
Non-steroidal anti-inflammatory drugs, in the form of tablets or ointments, such as ibuprofen, naproxen or diclofenac
Orthopedic insoles or night splints;
Physiotherapy, with stretching exercises for the plantar fascia or the use of equipment like ultrasound and shock waves
Corticosteroid injections administered by a doctor directly into the plantar fascia

In more severe cases with very intense pain and swelling that does not resolve with conservative measures, the doctor may advise surgery.

Is plantar fasciitis curable?

In most cases, plantar fasciitis can be cured when treatment is guided by a doctor. However, treatment can be lengthy, and total symptom relief can take 6 to 12 months.

How to prevent

To prevent the onset of plantar fasciitis, it is recommended to:

Maintain an optimal weight based on your frame, which can be achieved through diet and exercise
Wear comfortable shoes that adequately support the feet, and avoid the use of hard shoes
Reevaluating your sports hobbies, and opting instead for low-impact activities, like cycling or swimming
Performing foot stretches before and after working out

You should also wear shoes that fit properly and are adequate for your type of footstep. You should avoid using shoes for prolonged periods of time