Plantar Fasciitis Treatment

Quick Summary

Plantar fasciitis is a common cause of heel pain that occurs when the thick band of tissue supporting the foot becomes irritated. Symptoms may include sharp heel pain, tenderness, and stiffness, especially after rest. Risk factors include running, prolonged standing, flat feet, excess weight, and unsupportive footwear. Treatment often begins with stretching, icing, supportive shoes, orthotics, and activity changes. Persistent cases may require additional treatment, including shock wave therapy, laser therapy, surgery, or minimally invasive plantar fasciitis embolization.

Plantar fasciitis is one of the most common causes of heel pain and can make walking, running, or standing uncomfortable. It occurs when the thick band of tissue supporting the foot becomes irritated or inflamed. While many cases improve with conservative care, persistent symptoms may require additional treatment. Understanding the symptoms, causes, diagnosis, and available options can help you take the next step toward relief.

What is plantar fasciitis?

The fascia within the foot is a thick band of tissue connecting the heel bone to the toes and supporting the arch of the foot. When this tissue becomes inflamed, the condition is known as plantar fasciitis. It is the most common type of heel pain, and it can be very painful.

Plantar fasciitis often develops gradually rather than from one specific injury. The pain may be most noticeable after getting out of bed in the morning or after sitting for an extended period.

Symptoms of Plantar Fasciitis

The symptoms of plantar fasciitis can vary from person to person, but common signs include:

Sharp or stabbing pain near the heel
Pain that is worse with the first steps after waking up
Heel pain after sitting or resting
Pain that increases after prolonged standing or walking
Tenderness along the bottom of the foot
Stiffness in the heel or arch

For some people, the pain improves as they move around but may return after prolonged activity or rest. Persistent or worsening heel pain should be evaluated by a healthcare professional to identify the cause.

What Causes Plantar Fasciitis

The majority of people with plantar fasciitis are women between the ages of 40 and 60, and it is commonly experienced by runners. In fact, it is believed to be caused by repetitive microtrauma to the heel, which occurs among runners, those who are overweight, those with flat feet and those with jobs that require prolonged standing. It is also common among those with Type II diabetes.

Several factors can place additional stress on the plantar fascia, including:

Running or other repetitive activities
Prolonged standing or walking
Being overweight
Flat feet or high arches
Tight calf muscles
Changes in activity level
Poorly supportive footwear

Having one or more of these risk factors does not mean you will develop plantar fasciitis. A proper evaluation can help determine what may be contributing to your heel pain.

How Is Plantar Fasciitis Diagnosed?

A healthcare provider will typically begin with a discussion of your symptoms and medical history, followed by an examination of your foot. The location of your pain, tenderness, flexibility, and foot structure can help identify plantar fasciitis.

Imaging may be recommended when your symptoms are unusual, persistent, or when another condition needs to be ruled out. Depending on your symptoms, your provider may use X-rays, ultrasound, or other imaging studies to evaluate the foot.

Treatment Options

Most cases of plantar fasciitis will resolve on their own; conservative treatments such as medication, icing, taping, stretching or wearing orthotics can help manage the pain during the healing process. Unfortunately, the condition can take up to 12 months to heal, if it heals at all. Approximately 20% of those with plantar fasciitis will require additional, more aggressive treatment.

Conservative Treatment

Initial treatment often focuses on reducing stress on the plantar fascia and managing pain. Depending on your condition, this may include:

Stretching exercises for the foot and calf
Icing the affected area
Supportive footwear or orthotics
Activity modification
Taping
Medications when recommended by your healthcare provider

Surgery

In such cases, surgery is often recommended to “release” the fascia. For many, this can relieve the pain and inflammation. However, up to 44% of those who have this surgery will experience swelling and tenderness for up to 10 years after surgery.¹ Others may experience complications such as continued pain, nerve injury and instability.

Shock Wave and Laser Therapy

In recent years, extracorporeal shock wave therapy (ESWT) and laser therapy have evolved as less invasive options to treat plantar fasciitis. Regrettably, these require multiple treatment sessions and their success rates hover between 51-76%.^2,3 What’s more, the use of anti-inflammatory medications can slow the healing process from these procedures, and those who have had recent corticosteroid injections or have implanted devices or hormones are not eligible for ESWT.

Plantar Fasciitis Embolization

A new treatment option called plantar fasciitis embolization (PFE) is gaining popularity nationwide. It has been clinically proven as a safe and effective treatment. PFE is a minimally invasive, outpatient approach that may be considered when plantar fasciitis symptoms persist despite conservative treatment.

You can learn more about this minimally invasive, outpatient treatment option offered by NG Vascular & Vein Center doctors by clicking here.

Frequently Asked Questions About Plantar Fasciitis

Plantar fasciitis commonly causes sharp or stabbing pain near the heel. Pain may be strongest with the first steps after waking up or after sitting for a long time.

Recovery varies between individuals. Many cases improve with conservative treatment, but symptoms can persist for months. Persistent pain may require additional evaluation and treatment options.

Walking does not necessarily worsen plantar fasciitis, but excessive activity can increase stress on the plantar fascia. Modifying activities and wearing supportive footwear may help reduce symptoms.

Consider an evaluation if heel pain is persistent, severe, affects your daily activities, or does not improve with conservative measures. A provider can determine the underlying cause.

Yes. Plantar fasciitis can recur, particularly when factors such as repetitive activity, poor footwear, tight muscles, or sudden changes in exercise continue to place stress on the foot.

Plantar fasciitis embolization is a minimally invasive outpatient treatment designed for persistent plantar fasciitis. It may be considered when conservative treatment has not provided adequate relief.

No. PFE is a minimally invasive procedure rather than open surgery. Your doctor can evaluate your symptoms and medical history to determine if this treatment may be appropriate.

PFE may be considered when plantar fasciitis symptoms continue despite conservative care. A specialist can review your condition and discuss whether this minimally invasive treatment fits your needs.