Plantar Fasciitis – Heel Pain: Causes and Treatment
Plantar fasciitis is one of the most common causes of heel pain. It affects the plantar fascia – the strong band under the foot – and typically causes sharp pain with the first steps in the morning.
What plantar fasciitis is
The plantar fascia is a strong band of tissue that attaches to the heel and spreads towards the base of the toes. It supports the arch of the foot and absorbs the shock of every step. With long or excessive loading it develops tiny tears and irritation, which cause pain at the underside of the heel.
It is common in runners, in people who spend long hours on their feet, with flat feet or a very high arch, and with tight calf muscles. Typically the pain is worst with the first steps after getting up or after sitting for a while, and eases somewhat once you are walking.
Most people improve within a few months with conservative treatment – stretching, strengthening, suitable footwear and physiotherapy. In stubborn cases shockwave therapy is a well-studied and widely used option.
Common causes
- prolonged standing or walking on hard surfaces
- running and sudden increases in training load
- tight calf muscles and Achilles tendon
- flat feet or a very high arch
- unsuitable or worn-out shoes
- excess weight
How it feels
- sharp heel pain with the first steps in the morning
- pain after sitting for a long time
- pain on the underside and inner side of the heel
- worse after long walks or runs
- stiffness in the foot
- sometimes mild swelling around the heel
How we can help
We start by assessing your foot, calf and the way you walk and run. We combine shockwave therapy, laser, manual and soft-tissue therapy, chosen stretching and strengthening exercises, and kinesiology taping where needed. We also give clear guidance on footwear and loading so the pain does not return.
When to see a doctor
See a doctor for sudden severe pain after an injury, being unable to put weight on the foot, swelling with blue-red discolouration, numbness or burning in the foot, or if the pain does not ease despite several weeks of rest and care.
This page is for information only and does not replace an assessment by a specialist.