If your first steps out of bed bring a sharp pain in the heel, you are not alone. One of the most common causes of this pattern is plantar fasciitis, an irritation of the tissue that supports the arch of your foot.
What is plantar fasciitis?
The plantar fascia is a band of tissue along the bottom of the foot that supports the arch. When it becomes irritated and inflamed, the result is heel pain. Repeated stress can damage or tear the tissue, and in most cases no single cause is ever identified.
Common signs
- Pain on the bottom of the foot near the heel
- Pain with the first few steps after getting out of bed or after a long period of rest, which usually eases after a few minutes of walking
- Pain that is often greater after exercise or activity than during it
Who is more likely to get it?
The American Academy of Orthopaedic Surgeons (AAOS) lists several risk factors:
- New or increased activity
- Repetitive high-impact activity such as running or dancing
- Long periods of standing on hard surfaces
- Flat feet or high arches
- Tight calf muscles
- Excess body weight
- Age, with the condition most common between 40 and 60
What can help
The good news is that most people improve without surgery. According to the AAOS, more than 90% of patients with plantar fasciitis improve within 10 months with nonsurgical care. Common options include:
- Rest, lower-impact activity and regular stretching of the calves and the plantar fascia
- Ice for about 20 minutes, three to four times a day
- Anti-inflammatory medicine for short periods. The AAOS advises talking to your primary care doctor before using these for more than a month
- Physical therapy
- Supportive shoes, heel pads or orthotics
- Night splints
If pain continues for several months, other treatments such as injections or shockwave therapy may be discussed. Surgery is generally saved for people who have not improved after about 12 months of aggressive nonsurgical treatment.
When to have your heel checked
Heel pain can have causes other than plantar fasciitis. If your pain keeps returning or is not improving with simple self-care, an exam can confirm the cause. A foot and ankle specialist may use X-rays, and sometimes an MRI, to rule out other problems and build a treatment plan that fits your feet, your shoes and your activity.
Sources
This article is for general education and is not a substitute for an exam or personal medical advice. If you have foot or ankle pain, an injury, or any of the warning signs above, request an appointment or call 407-360-9990 to be seen at our Orlando or DeLand office.
Learn more about our podiatry services and the conditions we treat.