Heel pain · Foot & ankle care
Plantar fasciitis.
Pain with your first steps can make the whole day feel harder. Understand this common cause of heel pain—and the options for getting back to comfortable movement.
Understanding the problem
Why those first
steps can hurt.
The plantar fascia is a strong band of tissue along the bottom of the foot, connecting the heel to the front of the foot and supporting the arch. When it becomes irritated, pain often develops near the heel.
Changes in activity, long periods on your feet, calf tightness, foot structure, and footwear can contribute. There isn’t always one clear trigger.
At your appointment
Confirm the cause.
Choose a direction.
Bring the shoes you wear most and any relevant outside imaging. Tell us about changes in activity, what you have tried, and how the pain affects your day.
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Listen to your history
Where you hurt and when the pain appears help guide the examination.
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Examine the foot & ankle
Your physician checks tenderness, movement, and possible sources of strain, while considering other causes of heel pain.
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Consider imaging when useful
X-rays may help assess bones or rule out other problems. MRI or ultrasound is not routinely needed for a typical presentation.
Treatment choices
Start with a plan.
Adjust as you improve.
Most people improve without surgery. Treatment usually starts with a consistent combination of activity changes, support, and exercises suited to your condition.
A practical starting plan
- Adjust activities that repeatedly aggravate the heel.
- Choose supportive footwear and reduce barefoot walking on hard surfaces.
- Use a guided calf and plantar fascia stretching program; physical therapy may help.
- Consider heel cushioning, taping, or shoe inserts when appropriate.
The combination should fit your symptoms and daily needs. Ask your clinician or pharmacist whether a pain medicine is suitable for you.
If symptoms persist
A follow-up visit is a chance to reassess the diagnosis, your activity load, and how the initial plan is working. Additional support may include a night splint, physical therapy, or a short period in a protective boot when appropriate.
Persistent pain should lead to a review of the plan rather than simply repeating a treatment indefinitely.
Understanding injection options
Cortisone
A steroid injection may reduce pain in selected cases. It does not replace the rest of your care plan. Risks include plantar fascia tearing and thinning of the heel’s cushioning fat pad, particularly with repeated injections.
Platelet-rich plasma (PRP)
PRP may be discussed for persistent symptoms. Results vary, and research is still developing. Ask about the evidence, expected benefit, cost, and alternatives before choosing it.
When surgery is considered
Surgery is generally reserved for ongoing, limiting pain after an appropriate course of nonsurgical care and confirmation of the diagnosis.
Depending on the findings, options may include a partial plantar fascia release or a calf-lengthening procedure. Your surgeon will explain the expected benefit, risks, alternatives, and recovery for the specific procedure.
Common questions
A little clarity
before your visit.
Does a heel spur need to be removed?
Usually not. A spur on an X-ray does not establish the source of heel pain, and plantar fasciitis can often be treated without removing it.
Do I need custom orthotics?
Not everyone does. Some people benefit from an over-the-counter insert; others may need custom support. Fit, comfort, symptoms, and foot structure help guide that choice.
Should I keep exercising through the pain?
Reduce activities that clearly worsen symptoms and ask about suitable alternatives. Lower-impact activity may be an option while you recover. Your plan should help you stay active without repeatedly aggravating the heel.
Is heel pain in children the same thing?
Not necessarily. Growing children and teens can have heel pain related to the growth plate, such as Sever’s disease. Other causes are possible too, so a child’s heel pain deserves its own evaluation.
Your next step
Make those first
steps count.
Schedule a visit online, or contact our team for help arranging an appointment.
Online scheduling is provided through athenahealth. To change an existing appointment, please contact our team.