Symptoms:

The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn.

The pain is usually worse:

• In the morning when you take your first steps
• After standing or sitting for a while
• When climbing stairs
• After intense activity

The pain may develop slowly over time, or suddenly after intense activity.

Signs and tests:

The doctor will perform a physical exam. This may show:

• Tenderness on the bottom of your foot
• Flat feet or high arches
• Mild foot swelling or redness
• Stiffness or tightness of the arch in the bottom of your foot.

X-rays may be taken to rule out other problems, but having a heel spur is not significant.

Treatment:

Your doctor will usually first recommend:

• Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation
• Heel stretching exercises
• Resting as much as possible for at least a week
• Wearing shoes with good support and cushions

Other steps to relieve pain include:

• Apply ice to the painful area. Do this at least twice a day for 10 - 15 minutes, more often in the first couple of days.
• Try wearing a heel cup, felt pads in the heel area, or shoe inserts.
• Use night splints to stretch the injured fascia and allow it to heal.

If these treatments do not work, your doctor may recommend:

• Wearing a boot cast, which looks like a ski boot, for 3-6 weeks. It can be removed for bathing.
• Custom-made shoe inserts (orthotics)
• Steroid shots or injections into the heel

In a few patients, nonsurgical treatment does not work. Surgery to release the tight tissue becomes necessary.

Expectations (prognosis):

Nonsurgical treatments almost always improve the pain. Treatment can last from several months to 2 years before symptoms get better. Most patients feel better in 9 months. Some people need surgery to relieve the pain.

Complications:

Pain may continue despite treatment. Some people may need surgery. Surgery has its own risks. Talk to your doctor about the risks of surgery.

Calling your health care provider:

Contact your health care provider if you have symptoms of plantar fasciitis.

Prevention:

Making sure your ankle, Achilles tendon, and calf muscles are flexible can help prevent plantar fasciitis.