Plantar Fasciitis: Causes, Treatments, and Management
Do you have stabbing heel pain, especially with the first step out of bed in the morning? You are not alone!
Athletic or sedentary, plantar fasciitis can be problematic if not managed properly. Keep reading to know what this condition is, its causes, how it's diagnosed, and how it can be managed.
About Plantar Fasciitis
Plantar fasciitis is one of the most common causes of heel pain, with approximately 2 million diagnosed patients yearly suffering from this condition.
Plantar fasciitis is the inflammation of the plantar fascia ligament, which runs along the bottom of the foot. This tissue attaches the heel bone and base of the toes, helping to support the arch and playing an essential role in how we walk.
Heel pain can become bothersome with everyday activity, especially after a long day at work. Should you worry?
About 90% of those affected tend to feel improvement in their symptoms. That is, within 10 months of making simple changes to treat their pain.
While it's normal for the plantar fascia ligament to become worn down over time, there's a difference between average deterioration and excessive.
The Worst Kind of Pain for Runners: How Painful is Plantar Fasciitis?
Plantar fasciitis is often quickly and effectively treated, but it can still cause severe discomfort. Over 50% of respondents in an APMA survey said that foot pain reduced their daily activity.
With plantar fasciitis, the pain tends to intensify as you stand or start moving about. It can get better with an increasing level of activity during the day. Still, it will worsen again towards the end of the day.
Causes of Plantar Fasciitis
The ligament may lose elasticity and become irritated over time. The usual suspects are continued use and impact, like walking or running. Common causes include:
-Surfaces that you run or walk on
-Increase in activity
-Structure of your foot
Most individuals affected by plantar fasciitis are between the ages of 40-70. But other groups that are at a higher risk of the condition include:
-Those that are overweight or obese
-People who are avid runners, especially long-distance runners
-Individuals with active jobs that require them to stand or move for most of the day
Diagnosing Plantar Fasciitis
Persistent pain, particularly in your heel and/or arch, could mean that you have inflamed tissue there. Plantar fasciitis is likely, but the one who can give a reliable diagnosis is the podiatrist.
For a physical exam, the doctor will look at the following:
-How you walk: If you're walking in a way that avoids putting pressure on the heel, this is a sign of plantar fasciitis.
-Where there's tenderness: They'll check if a region is particularly sensitive.
-Reaction to backward-bending of the foot: Doctors will assess tightness in the Achilles. Pain in the proximal plantar fascia is a sign of the disease too.
If further assessment is required, a doctor may suggest X-ray imaging. This can also help rule out other conditions that often result in heel pain.
Plantar Fasciitis Treatment
A leading cause of plantar fasciitis appears to be the shoes we wear. Shoes could have minimal arch support, a thin sole, and be ill-fitting.
In serious (though rare) cases, surgery may even be needed. Thankfully, simple treatment options are available. This includes switching to shoes that are good for plantar fasciitis.
Stretching
Treating the discomfort associated with plantar fasciitis is possible with stretching. As one of the simplest non-surgical remedies, it can help reduce the tension on the heel and calf.
1. Stretching while seated
For this plantar fasciitis stretch, sit down in a chair and place one heel over the other leg. If you only feel pain in one leg, put that injured leg over the other. Lean down and pull the toes of the injured foot towards you, then hold for 10 seconds.
You should feel this in the plantar fascia ligament. You may try holding the bottom of your foot with the other hand to deepen the stretch. Repeat another 2 or 3 times.
2. Pickup exercise
Picking up small objects with your toes can help stretch the muscles and relieve tension. Sit on a chair with your feet flat on the floor. Place a few small objects in front of you on the floor.
Marbles work exceptionally well for this exercise, but other objects of similar size will do just fine. Use your toes to pick up one object at a time —repeat 15-20 times.
3. Stretch the calves
Your calves can contribute to more pain from plantar fasciitis. So stretching them out and relieving muscle tightness can help reduce the pain in your feet. Facing a wall, put one foot behind the other, leaving about 3 feet of space between them. Lean your hands on the wall and bend the front knee as you do so, leaving the back leg straight.
Make sure both feet are flat on the ground as you lean forward and backward, alternating between bending and straightening the front leg. Repeat on each leg 2-3 times, holding for about 10 seconds each time.
4. Roll a ball
Like a foam roll exercise targeting only your feet, this is a great way to loosen the muscles in the foot and decrease discomfort. Take any small, rolling object (a tennis ball is perfect for this) and place it under your foot.
Doing this exercise seated is best because it offers more control. If you prefer, you can also do it while standing and grasping onto something for balance. Roll the object underneath your foot, back and forth, for approximately 2 minutes on each foot.
5. Follow the RICE method
While not a stretch in the strictest sense, the RICE method is helpful. Here's what RICE stands for:
R: Rest the affected area, at least for a few days
I: Ice it to reduce inflammation, keeping the ice on for 15-20 minutes at a time
C: Compression; put a soft compress around the area, like a bandage, to keep swelling at a minimum
E: Elevate your foot, such as resting it on a couple of cushions
Non-Surgical Medical TreatmentPhysical therapy
Doctors may recommend undergoing physical therapy. Stretching will probably be introduced here. Your therapist can guide you and set the best course of treatment based on your symptoms.
A PT can administer deep myofascial massage and iontophoresis, too. Iontophoresis refers to a procedure wherein an electrical current is passed through skin soaked in tap water.
Anti-inflammatory medication
Nonsteroidal anti-inflammatory drugs, or NSAIDs, reduce inflammation in the plantar fascia ligament that causes pain. Ibuprofen and naproxen are two examples of these that are often easy to find.
However, you should consult with a doctor before use. Follow-up if there is no change in symptoms after one month.
Night splints
As we sleep, our foot points downward and contracts the plantar fascia ligament. Your foot becomes used to that position and those first few steps in the morning put new pressure on it. This is often why the discomfort from plantar fasciitis is more severe in the morning.
Night splints help maintain a neutral position during sleep. They are effective but can often disrupt sleep or lead to discomfort over the longer term.
Treating Chronic Heel Pain
In some cases, heel pain can be acute or chronic. Here, less conservative remedies may be necessary. Before pursuing any of these, you must consult with your doctor first.
Injections
Cortisol injections are among the most common treatment options for chronic or acute heel pain.
Cortisone is a steroid with powerful anti-inflammatory properties. It gets injected directly into the plantar fascia ligament to reduce swelling and pain. However, there is a risk that the injections can lead to a rupture in the ligament.
Platelet-rich plasma injections, meanwhile, have fewer risks of causing a rupture. Here, your own blood is put through a centrifuge. The resulting plasma becomes rich with platelets. These platelets, in turn, encourage faster healing of the plantar fascia.
This approach is experimental, though, and expensive, making it an unpopular choice for plantar fasciitis.
Shock therapy
For chronic heel pain that results in symptoms lasting longer than six months, extracorporeal shockwave therapy (ESWT) could be a viable treatment option. Using high-energy shockwaves, medical professionals target the damaged plantar fascia. This helps stimulate new blood vessels to grow.
As a last resort before surgery, ESWT still has the benefit of being non-invasive. However, it can be painful, lead to numbness, and cause bruising (ecchymosis).
Surgery
Surgery is not needed in about 90% of patients with plantar fasciitis. But this could be the best option for those who haven't had symptomatic relief for over a year.
An endoscopic plantar fasciotomy has an average success rate of 90%. It releases the plantar fascia tension and diminishes chronic pain as well.
It's a minimally invasive procedure that involves 1-2 incisions, each approximately ½-inch long. From that incision, the surgeon releases the tension that's causing discomfort.
Supportive Shoes for Plantar Fasciitis
Getting doctor-recommended shoes is one of the most affordable and straightforward treatments. Wearing the best walking shoes for plantar fasciitis ensures your feet are supported all day long. The best shoes for plantar fasciitis have shock absorption capabilities.
This ensures that the ligament can be protected, and the micro-tears that cause heel pain can also be reduced.
Taos® has everything from dress shoes to comfortable sneakers to supportive sandals and slippers. Every pair in the plantar fasciitis collection has a structured, cushioned footbed and superior heel support.
Takeaway
Plantar fasciitis can lead to severe discomfort and pain. The longer the duration of symptoms, the longer the treatment period. Wearing plantar fasciitis shoes is one of the best non-surgical treatments.
Recommended by podiatrists, Taos® has a selection of stylish footwear for women and men with plantar fasciitis. You may be surprised that they feel even better than your custom orthotics.
Other non-surgical treatment options can be employed on top of changing your footwear. Consult a podiatrist to be assessed and get the best results.
About Plantar Fasciitis
What is Plantar Fasciitis?
Plantar fasciitis is one of the most common causes of heel pain, with approximately 2 million diagnosed patients yearly suffering from this condition.
Plantar fasciitis is the inflammation of the plantar fascia ligament, which runs along the bottom of the foot. This tissue attaches the heel bone and base of the toes, helping to support the arch and playing an essential role in how we walk.
Heel pain can become bothersome with everyday activity, especially after a long day at work. Should you worry?
About 90% of those affected tend to feel improvement in their symptoms. That is, within 10 months of making simple changes to treat their pain.
While it's normal for the plantar fascia ligament to become worn down over time, there's a difference between average deterioration and excessive.
The Worst Kind of Pain for Runners: How Painful is Plantar Fasciitis?
Plantar fasciitis is often quickly and effectively treated, but it can still cause severe discomfort. Over 50% of respondents in an APMA survey said that foot pain reduced their daily activity.
With plantar fasciitis, the pain tends to intensify as you stand or start moving about. It can get better with an increasing level of activity during the day. Still, it will worsen again towards the end of the day.
Causes and Symptoms
Causes of Plantar Fasciitis
The ligament may lose elasticity and become irritated over time. The usual suspects are continued use and impact, like walking or running. Common causes include:
-Surfaces that you run or walk on
-Increase in activity
-Structure of your foot
Most individuals affected by plantar fasciitis are between the ages of 40-70. But other groups that are at a higher risk of the condition include:
-Those that are overweight or obese
-People who are avid runners, especially long-distance runners
-Individuals with active jobs that require them to stand or move for most of the day
Diagnosis
Diagnosing Plantar Fasciitis
Persistent pain, particularly in your heel and/or arch, could mean that you have inflamed tissue there. Plantar fasciitis is likely, but the one who can give a reliable diagnosis is the podiatrist.
For a physical exam, the doctor will look at the following:
-How you walk: If you're walking in a way that avoids putting pressure on the heel, this is a sign of plantar fasciitis.
-Where there's tenderness: They'll check if a region is particularly sensitive.
-Reaction to backward-bending of the foot: Doctors will assess tightness in the Achilles. Pain in the proximal plantar fascia is a sign of the disease too.
If further assessment is required, a doctor may suggest X-ray imaging. This can also help rule out other conditions that often result in heel pain.
Treatment
Plantar Fasciitis Treatment
A leading cause of plantar fasciitis appears to be the shoes we wear. Shoes could have minimal arch support, a thin sole, and be ill-fitting.
In serious (though rare) cases, surgery may even be needed. Thankfully, simple treatment options are available. This includes switching to shoes that are good for plantar fasciitis.
Stretching
Treating the discomfort associated with plantar fasciitis is possible with stretching. As one of the simplest non-surgical remedies, it can help reduce the tension on the heel and calf.
1. Stretching while seated
For this plantar fasciitis stretch, sit down in a chair and place one heel over the other leg. If you only feel pain in one leg, put that injured leg over the other. Lean down and pull the toes of the injured foot towards you, then hold for 10 seconds.
You should feel this in the plantar fascia ligament. You may try holding the bottom of your foot with the other hand to deepen the stretch. Repeat another 2 or 3 times.
2. Pickup exercise
Picking up small objects with your toes can help stretch the muscles and relieve tension. Sit on a chair with your feet flat on the floor. Place a few small objects in front of you on the floor.
Marbles work exceptionally well for this exercise, but other objects of similar size will do just fine. Use your toes to pick up one object at a time —repeat 15-20 times.
3. Stretch the calves
Your calves can contribute to more pain from plantar fasciitis. So stretching them out and relieving muscle tightness can help reduce the pain in your feet. Facing a wall, put one foot behind the other, leaving about 3 feet of space between them. Lean your hands on the wall and bend the front knee as you do so, leaving the back leg straight.
Make sure both feet are flat on the ground as you lean forward and backward, alternating between bending and straightening the front leg. Repeat on each leg 2-3 times, holding for about 10 seconds each time.
4. Roll a ball
Like a foam roll exercise targeting only your feet, this is a great way to loosen the muscles in the foot and decrease discomfort. Take any small, rolling object (a tennis ball is perfect for this) and place it under your foot.
Doing this exercise seated is best because it offers more control. If you prefer, you can also do it while standing and grasping onto something for balance. Roll the object underneath your foot, back and forth, for approximately 2 minutes on each foot.
5. Follow the RICE method
While not a stretch in the strictest sense, the RICE method is helpful. Here's what RICE stands for:
R: Rest the affected area, at least for a few days
I: Ice it to reduce inflammation, keeping the ice on for 15-20 minutes at a time
C: Compression; put a soft compress around the area, like a bandage, to keep swelling at a minimum
E: Elevate your foot, such as resting it on a couple of cushions
Non-Surgical Medical TreatmentPhysical therapy
Doctors may recommend undergoing physical therapy. Stretching will probably be introduced here. Your therapist can guide you and set the best course of treatment based on your symptoms.
A PT can administer deep myofascial massage and iontophoresis, too. Iontophoresis refers to a procedure wherein an electrical current is passed through skin soaked in tap water.
Anti-inflammatory medication
Nonsteroidal anti-inflammatory drugs, or NSAIDs, reduce inflammation in the plantar fascia ligament that causes pain. Ibuprofen and naproxen are two examples of these that are often easy to find.
However, you should consult with a doctor before use. Follow-up if there is no change in symptoms after one month.
Night splints
As we sleep, our foot points downward and contracts the plantar fascia ligament. Your foot becomes used to that position and those first few steps in the morning put new pressure on it. This is often why the discomfort from plantar fasciitis is more severe in the morning.
Night splints help maintain a neutral position during sleep. They are effective but can often disrupt sleep or lead to discomfort over the longer term.
Treating Chronic Heel Pain
In some cases, heel pain can be acute or chronic. Here, less conservative remedies may be necessary. Before pursuing any of these, you must consult with your doctor first.
Injections
Cortisol injections are among the most common treatment options for chronic or acute heel pain.
Cortisone is a steroid with powerful anti-inflammatory properties. It gets injected directly into the plantar fascia ligament to reduce swelling and pain. However, there is a risk that the injections can lead to a rupture in the ligament.
Platelet-rich plasma injections, meanwhile, have fewer risks of causing a rupture. Here, your own blood is put through a centrifuge. The resulting plasma becomes rich with platelets. These platelets, in turn, encourage faster healing of the plantar fascia.
This approach is experimental, though, and expensive, making it an unpopular choice for plantar fasciitis.
Shock therapy
For chronic heel pain that results in symptoms lasting longer than six months, extracorporeal shockwave therapy (ESWT) could be a viable treatment option. Using high-energy shockwaves, medical professionals target the damaged plantar fascia. This helps stimulate new blood vessels to grow.
As a last resort before surgery, ESWT still has the benefit of being non-invasive. However, it can be painful, lead to numbness, and cause bruising (ecchymosis).
Surgery
Surgery is not needed in about 90% of patients with plantar fasciitis. But this could be the best option for those who haven't had symptomatic relief for over a year.
An endoscopic plantar fasciotomy has an average success rate of 90%. It releases the plantar fascia tension and diminishes chronic pain as well.
It's a minimally invasive procedure that involves 1-2 incisions, each approximately ½-inch long. From that incision, the surgeon releases the tension that's causing discomfort.
Supportive Shoes for Plantar Fasciitis
Getting doctor-recommended shoes is one of the most affordable and straightforward treatments. Wearing the best walking shoes for plantar fasciitis ensures your feet are supported all day long. The best shoes for plantar fasciitis have shock absorption capabilities.
This ensures that the ligament can be protected, and the micro-tears that cause heel pain can also be reduced.
Taos® has everything from dress shoes to comfortable sneakers to supportive sandals and slippers. Every pair in the plantar fasciitis collection has a structured, cushioned footbed and superior heel support.
Takeaway
Plantar fasciitis can lead to severe discomfort and pain. The longer the duration of symptoms, the longer the treatment period. Wearing plantar fasciitis shoes is one of the best non-surgical treatments.
Recommended by podiatrists, Taos® has a selection of stylish footwear for women and men with plantar fasciitis. You may be surprised that they feel even better than your custom orthotics.
Other non-surgical treatment options can be employed on top of changing your footwear. Consult a podiatrist to be assessed and get the best results.
This content was reviewed and approved by a medical professional.
Dr. Vivek David is a licensed orthopedic surgeon who specializes in joint replacement and lower limb reconstruction surgeries. With a rich experience of over 10 years in orthopedics, he has an excellent reputation of handling complex lower limb joint reconstruction and robotic surgeries.
Reviews of the Best Shoes for Plantar Fasciitis
From our sneakers to wool clogs, Taos® is among the industry’s top brands for men’s and women’s plantar fasciitis shoes. Here’s what some of our customers are saying:
Comfy, Stylish Boots
"I have chronic Plantar Fasciitis and I can actually wear these boots comfortably. They are so comfy and stylish. I’d love them in every color!"
On Crave
Great for problem feet
"I have battled plantar fasciitis for over a year. I am wearing these as my house shoes, and the [plantar fasciitis] is significantly improved."
Very comfortable
"These are comfortable and warm! The arch support is great. Making sure to wear these or my other Taos slippers around the house has made a noticeable difference in my plantar fasciitis pain."
On Good Wool
So comfortable and stylish
"Footwear has come so long since the days of orthotic shoes in the '80s. I have collapsed arches, heel spurs and plantar fasciitis. These shoes are so comfortable I can wear them all day without issues."
Amazing Interior Support
“I’ve been looking for cute sneakers with actual arch support for so long. I have extremely flat feet and always wind up in pain if I stand for any sort of extended period of time. These shoes are great! 10/10 would recommend to my fellow people cursed with bad feet.”
On Moc Star
Elegance paired with comfort!
“A godsend sandal for someone with foot issues such as plantar fasciitis and bunions! Such comfort and elegant styling is challenging to find in a sandal! It covers my bunions and my feet are just in heaven with the footbed!”
On Gift 2
Footbeds for Plantar Fasciitis
Footbeds for Plantar Fasciitis
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European Wool
Boots
Sandals
OUR MISSION:
Wellness for your feet.
Structured Footbeds
Anatomically engineered to hug the contours of your feet and provide shock absorption in every step.
Quality Materials
Better-grade components without compromise. Each pair is built to wander far and well.
Craft & Care
Our passion to make great shoes guides everything we do. We’re proud to offer a broad range for every aspect of your life.
FAQs about Plantar Fasciitis
Check out below a few of the most frequently asked questions about this condition:
The big difference between plantar fasciitis and heel spurs is this pain. Only 1 in 20 people with heel spurs feel foot pain. For plantar fasciitis, pain is the identifying symptom.
You may have it if you're feeling discomfort on the bottom of your feet. This is usually at the beginning of the day when you first get out of bed or after prolonged rest periods. The pain could worsen over the day. Still, go to a podiatrist for a proper assessment.
Washington University Orthopedists suggest making an appointment with a doctor if your symptoms don't improve after a week of resting and icing. This is only the case if your condition doesn't come from a specific injury or episode, like tripping or a sports injury.
It's all about looking out for your feet. This means getting rid of worn-out shoes. Stick to pairs with support or get orthotic inserts.
A supportive footbed, or orthotic, is essential in a shoe for heel pain relief. Pain happens when the heel strikes the ground, puts tension on the fascia, and causes micro-tears. A cushioned, shock-absorbing footbed in a täōs shoe reduces the impact of every step. This leads to less pain and chronic inflammation over time.
Stretching every day helps, too. And maintain a healthy weight that puts less stress on your feet.
If your job requires you're on your feet for much of the day, seek the best work shoes. The best pair has plenty of arch support, cushioning, and shock absorption.
Of the available treatments, wearing the proper footwear is something everyone agrees with. The NHS recommends wearing shoes with arch support and heel cushioning, such as täōs. It is a brand dedicated to creating stylish, durable, and doctor-recommended shoes for plantar fasciitis.
All täōs closed-toe shoes, which are virtually everything except sandals, feature removable supportive footbeds. With orthotic-friendly shoes, the insole can be removed to accommodate your custom orthotic or medical device.
With proper treatment, most patients can cure their plantar fasciitis symptoms. Some may develop chronic or acute conditions, but this is rare.
Most patients can feel complete relief from symptoms in about a year, though it can vary. But the sooner you start wearing proper supportive shoes, the quicker you can recover.