Plantar fasciitis is diagnosed based on your medical history and physical examination. During the exam, your doctor will check for areas of tenderness in your foot. The location of your pain can help determine its cause.
Usually no tests are necessary. Your doctor might suggest an X-ray or magnetic resonance imaging (MRI) to make sure another problem, such as a stress fracture, is not causing you pain.
Sometimes an X-ray shows a piece of bone sticking out (spur) from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed surgically. But many people who have bone spurs on their heels have no heel pain.
Most people who have plantar fasciitis recover in several months with conservative treatment, including resting, icing the painful area and stretching.
Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) may ease the pain and inflammation caused by plantar fasciitis.
Stretching and strengthening exercises or using special devices may relieve symptoms. They include:
- Physical therapy. A physical therapist can show you a series of exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles. A therapist might also teach you to apply athletic taping to support the bottom of your foot.
- Night splints. Your physical therapist or doctor might recommend that you wear a splint that stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight to promote stretching.
- Orthotics. Your doctor might prescribe off-the-shelf or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly.
Surgical or other procedures
If more-conservative measures aren't working after several months, your doctor might recommend:
- Injections. Injecting steroid medication into the tender area can provide temporary pain relief. Multiple shots aren't recommended because they can weaken your plantar fascia and possibly cause it to rupture. Using ultrasound imaging, platelet-rich plasma obtained from the patient's own blood can be injected to promote tissue healing.
- Extracorporeal shock wave therapy. In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It's usually used for chronic plantar fasciitis that hasn't responded to more-conservative treatments. Some studies show promising results, but it hasn't been shown to be consistently effective.
- Ultrasonic tissue repair. This minimally invasive technology was developed in part by Mayo Clinic doctors. It uses ultrasound imaging to guide a needlelike probe into the damaged plantar fascia tissue. Using ultrasound energy, the probe tip vibrates rapidly to break up the damaged tissue, which is then suctioned out.
- Surgery. Few people need surgery to detach the plantar fascia from the heel bone. It is generally an option only when the pain is severe and other treatments have failed. It can be done as an open procedure or through a small incision with local anesthesia.
Lifestyle and home remedies
To reduce the pain of plantar fasciitis, try these self-care tips:
- Maintain a healthy weight. Carrying extra weight can put extra stress on your plantar fascia.
- Choose supportive shoes. Buy shoes with a low to moderate heel, thick soles, good arch support and extra cushioning. Don't walk barefoot.
- Don't wear worn-out athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet.
- Change your sport. Try a low-impact sport, such as swimming or bicycling, instead of walking or jogging.
- Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 minutes three or four times a day. Icing can help reduce pain and inflammation.
- Stretch your arches. Simple home exercises can stretch your plantar fascia, Achilles tendon and calf muscles.
Preparing for your appointment
While you may initially consult your family physician, he or she may refer you to a doctor who specializes in foot disorders or sports medicine.
What you can do
You may want to write a list that includes:
- Your symptoms, and when they started
- Key personal information, including your and your family's medical history and activities you do that could have contributed to your symptoms
- All the medications, vitamins or other supplements you take, including doses
- Questions to ask the doctor
For plantar fasciitis, basic questions to ask your doctor include:
- What's likely causing my symptoms?
- Other than the most likely cause, what are other possible causes for my symptoms?
- What tests do I need?
- Is my condition likely temporary or chronic?
- What's the best course of action?
- What are the alternatives to the primary approach you're suggesting?
- Are there restrictions I need to follow?
- Should I see a specialist?
- Are there brochures or other printed material I can have? What websites do you recommend?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you questions, such as:
- Do your symptoms tend to occur at a particular time of day?
- What types of shoes do you usually wear?
- Are you a runner, or do you participate in any sports that involve running?
- Do you have a physically demanding job?
- Have you had problems with your feet before?
- Do you feel pain anywhere besides your feet?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
Dec. 11, 2019