Plantar fasciitis (sometimes called jogger’s heel, tennis heel, or policeman’s heel, or incorrectly referred to as heel spurs) is a common condition of inflammation and pain in the heel area caused by irritation at the insertion of the fascia, a thick band of fibrous connective tissue at the bottom of the foot that runs from the heel to the toes.
20 Plantar Fasciitis Home Remedies & Treatments
Plantar fasciitis does go away in most cases, but it usually won’t go away on its own without conservative measures, such as:
- Rest
- Stopping or limiting athletic activities where there is repetitive heel impact
- Stretching exercises
- Icing the area for 20 minutes up to four times daily, to help relieve pain
- Over-the-counter (OTC) pain medications
- Wearing protective footwear for temporary pain relief
- Athletic shoes
- Arch-supporting shoes
- Shoes with rigid shanks
- Cushion-soled shoes with gel pad inserts or heel cups
- Orthotics to properly support the foot may help
- Taping the foot with a technique called "low-dye taping" may help
- Splints worn overnight may be helpful to provide pain relief and a gentle stretch
- Avoid wearing slippers or going barefoot
- Even with rest and conservative treatments, it can still take up to a year for plantar fasciitis to go away. If conservative measures fail to relieve the pain caused by plantar fasciitis, other treatments include:
- Physical therapy can help with long-term pain relief
- Contrast baths, ultrasonography, and iontophoresis may be used along with PT
- Steroid injections in the foot to relieve pain
- The effect may wear off in a few weeks
- Botulinum toxin type A injection may help with pain relief and overall foot function
- Walking cast
- Surgery is rarely needed for plantar fasciitis and is only recommended when all other treatments have failed symptoms persist for at least 6 to 12 months
- Autologous blood injection, platelet-rich plasma (PRP) injection, nitroglycerin patches, and extracorporeal shock-wave therapy (ESWT) are treatments designed to create an acute inflammatory reaction and restart the healing process
- Extracorporeal shock wave therapy (ESWT) has not yet been shown to be effective, but it is approved by the Food and Drug Administration (FDA) to treat plantar fasciitis and may be recommended by some clinicians
What Are Symptoms of Plantar Fasciitis?
The main symptom of plantar fasciitis is pain beneath the heel on the sole of the foot. Pain may be present in one or both feet.
- It is usually worse in the morning or after sitting for long periods
- The pain may be sharp and severe
- Patients may limp
- Pain tends to improve with activity but will worsen again after long periods on your feet
What Causes Plantar Fasciitis?
Plantar fasciitis occurs when the plantar fascia — a thick band of fibrous connective tissue at the bottom of the foot that runs from the heel to the toes — is overly stretched and tears.
Risk factors for stretching and tearing the plantar fascia include:
- Participating in activities that cause repetitive impact to the heel such as running or dancing.
- Plantar fasciitis is very common in runners and it may be due to:
- Overtraining or sudden increases in distance
- Running on hard surfaces (concrete is harder than pavement, which is harder than dirt)
- Poorly fitted running shoes/worn out shoes (runners should replace shoes every 250-500 miles)
- Flat feet
- High arches
- Plantar fasciitis is very common in runners and it may be due to:
- Improper athletic training
- Obesity
- Being female
- Wearing high heels
- Limited ankle flexibility
- Tight hamstrings or glutes
- Occupations requiring prolonged standing and weight-bearing
- Structural problems with the foot/ankle: high or low arches, overpronation, leg-length discrepancy, excessive lateral tibial torsion, and excessive femoral anteversion
- Aging and heel fat pad atrophy
- Rheumatic disorders such as ankylosing spondylitis or psoriatic arthritis.
How Is Plantar Fasciitis Diagnosed?
A doctor will take a medical history and perform a physical exam of the feet. No specific lab tests or imaging studies are needed to diagnose plantar fasciitis but they may be used to rule out other causes of heel pain such as fractures, tumors, or arthritis.
Imaging tests may include:
- X-rays
- Ultrasound
- Magnetic resonance imaging (MRI)
- Bone scan
- CT scan
- Electromyography (EMG)
Blood tests may include:
- Complete blood count (CBC)
- Erythrocyte sedimentation rate (ESR)
- Complete metabolic panel
- Rheumatoid factor studies
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