Heel Pain and Plantar Fasciitis

What is plantar fasciitis?

Plantar fasciitis is irritation of the strong band of tissue that supports the bottom of the foot. It is one of the most common causes of heel pain. The discomfort is often strongest with the first few steps after getting out of bed or after sitting for a while.

Common symptoms

• Sharp or aching pain under the heel
• Pain with the first steps in the morning
• Discomfort after standing, walking, or exercise
• Tightness through the arch or calf

Heel pain can also come from a stress fracture, tendon problem, arthritis, nerve irritation, or another condition. A careful exam helps identify the real source.

Why it happens

The plantar fascia can become overloaded when activity changes quickly, shoes lack support, the calf is tight, or the foot places extra stress on the heel. Flat feet, high arches, long hours of standing, and some sports can increase strain.

How we evaluate heel pain

We ask when the pain started, where it is most tender, and what makes it better or worse. The exam includes foot structure, flexibility, walking pattern, and areas of tenderness. X-rays or other imaging may be recommended when the symptoms or exam suggest another cause.

Treatment options

Most people begin with nonsurgical care. Your plan may include:

• Activity changes while the tissue settles
• Stretching for the calf and plantar fascia
• Supportive shoes, taping, or a brace
• Custom orthotics when foot mechanics contribute to pain
• Medication or an injection when appropriate
• Shockwave therapy for selected ongoing cases

Surgery is considered only when a well directed nonsurgical plan has not provided enough relief.

When to schedule an appointment

Schedule an evaluation if heel pain is limiting walking, keeps returning, or has not improved with simple changes. Seek prompt care for severe swelling, sudden pain after an injury, numbness, or an inability to bear weight.

Frequently asked questions

Is a heel spur the same as plantar fasciitis?

No. A heel spur is a bony finding that may be visible on an X-ray. Many people have a spur without pain. The painful tissue is often the plantar fascia or another nearby structure.

Should I keep exercising?

That depends on the cause and severity of your pain. Low impact activity may be reasonable, but running through sharp heel pain can delay recovery. We can help you choose safe modifications.

Do custom orthotics help everyone?

Not everyone needs them. They may help when foot structure or walking mechanics continue to place stress on the heel.

How to prepare for your appointment

Bring your usual walking or athletic shoes and any prior imaging. Note where the pain begins, which activities affect it, whether an injury occurred, and what treatments you have already tried.

Related care

You may also want to explore diagnostic ultrasound, bracing and walking boots, and shockwave therapy.

Foot and ankle care close to home

Signature Foot and Ankle provides personalized care at our Boynton Beach and Loxahatchee offices. Call 561 203 9285 or request an appointment online.