What is Plantar Fasciitis?
Plantar fasciitis is the most common cause of heel pain. It occurs when the plantar fascia — a thick band of tissue that runs along the bottom of the foot, connecting the heel bone to the toes — becomes inflamed or irritated. This condition typically causes sharp, stabbing pain in the heel, especially with the first steps in the morning or after periods of rest.
Many people with plantar fasciitis also have a heel spur, a small bony growth that forms on the underside of the heel bone where the plantar fascia attaches. However, contrary to popular belief, heel spurs themselves are not the source of pain — it is the inflammation of the surrounding tissue that causes discomfort.
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What Causes Plantar Fasciitis and Heel Spurs?
Heel pain from plantar fasciitis develops when there is excessive strain on the plantar fascia, leading to tiny tears and inflammation. Common causes and risk factors include:
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Tight or inflexible calf muscles.
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Flat feet or high arches.
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Poorly cushioned or unsupportive footwear.
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Sudden increase in activity or prolonged standing.
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Overweight or obesity, which adds extra stress to the feet.
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Repetitive impact from running, jumping, or walking on hard surfaces.
Over time, chronic tension on the plantar fascia can cause the body to lay down extra bone where the tissue attaches to the heel, forming a heel spur visible on an x-ray.
Who Gets Heel Spurs?
Heel spurs are most commonly seen in people who have long-standing plantar fasciitis. They tend to develop gradually over time and are most often found in middle-aged men and women, although they can occur at any age.
While an x-ray may show a bony hook at the bottom of the heel, the presence of a spur does not necessarily mean it’s causing pain. In many cases, heel spurs are painless and discovered incidentally when imaging is performed for another reason.
Symptoms of Plantar Fasciitis
Typical symptoms include:
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Sharp pain in the heel, especially with the first steps in the morning.
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Pain after long periods of standing or sitting.
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Discomfort that worsens after exercise (rather than during).
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Tenderness along the bottom of the foot or near the heel bone.
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Mild swelling or warmth in the heel area.
Pain often improves with rest but tends to return with prolonged walking or activity.
Treatment Options
Non-surgical management
The majority of patients with plantar fasciitis improve with conservative care. Common treatments include:
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Stretching and strengthening exercises to improve flexibility in the calf and foot.
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Supportive footwear or orthotic inserts to reduce strain on the plantar fascia.
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Rest and activity modification to allow inflammation to settle.
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Anti-inflammatory medication or ice therapy to relieve pain and swelling.
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Night splints to keep the foot gently stretched while sleeping.
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Physiotherapy to promote healing and prevent recurrence.
Surgical management
Surgery is rarely needed but may be considered for persistent cases that fail to improve with prolonged non-surgical treatment. Procedures may include releasing part of the plantar fascia or removing a heel spur if it is causing mechanical irritation.
Benefits of Treatment
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Pain relief: Most patients experience significant reduction or complete relief of heel pain.
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Improved mobility: Restores comfort when walking, standing, or exercising.
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Prevention of recurrence: Stretching, proper footwear, and weight management reduce future flare-ups.
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Quick recovery: Most non-surgical treatments begin to show results within weeks, with full recovery over several months.
Risks and Complications
While treatment for plantar fasciitis is usually safe and effective, potential complications may include:
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Ongoing or recurrent pain if the condition becomes chronic.
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Temporary stiffness or soreness from stretching or physical therapy.
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In rare cases, nerve irritation or scar tissue formation following surgery.
With early diagnosis and consistent management, most patients recover without the need for invasive procedures.
Before and After Surgery
Before treatment
We will take a detailed history, examine your foot and ankle, and may order x-rays to identify any heel spurs or rule out other causes of pain.
Treatment process
A combination of stretching, strengthening, footwear adjustments, and physiotherapy is typically prescribed. In some cases, corticosteroid injections or shockwave therapy may be used to reduce persistent inflammation.
Recovery
Pain relief often begins within a few weeks but full healing can take several months, depending on the severity of the inflammation and individual activity levels. Maintaining good foot support and flexibility is key to preventing recurrence.
