Chiodo CP, Price MD, Sangeorzan AP. Foot and ankle pain. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelly's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 52. Show Grear BJ. Disorders of tendons and fascia and adolescent and adult pes planus. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 83. Hickey B, Mason L, Perera A. Forefoot problems in sport. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 121. Kadakia AR, Aiyer AA. Heel pain and plantar fasciitis: hindfoot conditions. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 120. Rothenberg P, Swanton E, Molloy A, Aiyer AA, Kaplan JR. Ligamentous injuries of the foot and ankle. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 117. Last reviewed on: 6/8/2022 Reviewed by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Plantar fasciitis is one of the most common causes of pain in the bottom of the heel, the arch or both areas. The plantar fascia is a thick, fibrous, ligamentlike band on the bottom of the foot. It is attached to the heel, runs forward along the foot and attaches again at the ball of the foot. When the plantar fascia becomes irritated and swollen, the condition is called plantar fasciitis. What causes plantar fasciitis?With every step we take, our body weight comes to rest first on the heel and then gradually over the length of the foot. As the foot begins to bear weight, it flattens. This puts pressure on the plantar fascia, which has very little stretch. As we walk, the plantar fascia pulls on its attachment at the heel. If the foot is properly aligned, this pull causes no problems. If the foot is pronated — meaning it rolls outward at the ankle — the arch falls too much and there is an abnormal amount of pull on the fairly rigid plantar fascia. This causes an abnormally strong pull on the heel where the plantar fascia attaches. Something similar happens when the foot has supination, meaning it rolls inward. These type of feet are relatively inflexible, usually have a high arch and a short or unusually tight plantar fascia. Plantar fasciitis can be caused by:
It's not always possible to identify the cause. Plantar fasciitis tends to develop as we get older and the fascia become less elastic. Women tend to get this condition more than men. What are the symptoms of plantar fasciitis?When you have plantar fasciitis, you usually feel pain in the bottom of the heel or the arch of the foot. Some people describe the pain as feeling like a bruise or an ache. The pain tends to gradually go away once you begin walking around. With continued walking, the pain may return, but usually goes away after rest. If the swollen plantar fascia irritated a nerve in the foot, pain may radiate into the ankle. In the early stages of plantar fasciitis, the pain may go away quickly once you take weight off the foot. Over time, however, it may take longer and longer for the pain to go away. Without treatment, the plantar fascia will eventually tear partially away from the heel. The body fills the torn area in with calcium. This eventually becomes a bone and is called a heel spur. How is plantar fasciitis diagnosed?This condition is usually diagnosed on the basis of your description of your symptoms. Your doctor may examine your foot and its structure or look at your shoes to see how they are wearing. (Feet that pronate tend to break down the inner side of the shoe; feet that supinate tend to break down the outer side of the shoe.) How is plantar fasciitis treated?Depending on the individual, different treatments may be more effective than others. Approaches include:
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