Heel Pain and Plantar Fasciitis

Plantar fasciitis is irritation or inflammation of the thick band of tissue that runs under the foot from the heel to the front of the foot, and it is one of the most common causes of heel pain. This page by Dr. Emeel Hourani explains its symptoms, causes, diagnosis and treatment options in general terms.

Note: This is general information and cannot tell you whether you have this condition. Heel pain has many possible causes and needs an in-person examination.

Symptoms

Pain linked to this condition may include:

  • Pain under the heel or along the sole of the foot
  • Pain that is worst with the first steps in the morning or after sitting for a while
  • Pain that builds after long standing or running
  • A feeling of tightness or stabbing in the sole
  • Tenderness when pressing on the heel area

Causes

The plantar fascia is placed under repeated strain, which can be linked to several factors:

  • Long periods of standing or walking
  • Running or a sudden increase in sporting activity
  • Unsuitable or poorly supportive shoes
  • Extra body weight
  • Tightness in the calf muscles and Achilles tendon
  • Foot shape, such as flat feet or a high arch

Diagnosis

The doctor asks about the pain, when it appears and your daily activity, then examines the foot to find where it hurts and how the ankle moves. An X-ray may be requested to rule out other causes of heel pain, and ultrasound or MRI may be used in some cases.

An accurate diagnosis matters because heel pain can also come from the bone, nerves or tendons. For more on symptoms, see the heel pain guide.

Treatment options

Non-surgical treatment

Many cases improve with non-surgical care. The doctor sets the right plan after examination.

  • Rest and reducing activities that aggravate the pain
  • Cold packs wrapped in a cloth
  • Supportive shoes and shoe inserts when needed
  • Stretching exercises for the plantar fascia and calf muscles
  • Physiotherapy
  • Gradual adjustment of weight and sporting activity
  • Injections in selected cases, as decided by the doctor

Surgical treatment

Surgery is rarely the first choice. It may be discussed only if severe pain continues despite a sufficient period of non-surgical treatment. After examination, the doctor decides whether it is needed and which procedure suits you.

Recovery and rehabilitation

Recovery time varies from person to person and is set by the surgeon after assessment. Sticking with the plan and being patient matter, because this condition can improve slowly.

  1. Easing the pain and reducing pressure on the heel
  2. Continuing stretching exercises
  3. Strengthening the foot and calf muscles
  4. A gradual return to walking and sport
  5. Keeping suitable footwear to lower the chance of the pain coming back

When to see the doctor

See a doctor if you notice any of the following:

  • Heel pain that persists and does not improve with rest
  • Severe pain that stops you walking or standing
  • Swelling, redness or warmth around the heel
  • Numbness or burning in the foot
  • Pain after an injury or a fall
  • Pain that wakes you at night

Frequently asked questions

Why is heel pain worse in the morning?

After rest or sleep the fascia tightens, then is stretched with the first steps, so the pain peaks. This is a general description, and an examination is needed to confirm the cause.

Does heel pain go away on its own?

Some pain eases with rest and activity changes, but it can take a long time. If it continues, it is better to have a doctor examine you.

Do shoe inserts help?

Some inserts may help relieve pressure on the heel in some people. The doctor decides whether they suit you after examining the foot.

Will I need surgery?

In most cases treatment starts without surgery. Surgery is a rare option, considered only after the condition has been assessed.

Book your appointment

The clinic of Dr. Emeel Hourani in Amman, Ibn Khaldoun Street (Al-Khalidi Street), Panorama Hattar Building No. 22, 3rd floor.

Phone: +962 6 562 2482WhatsApp: +962 79 658 5724