If the first steps out of bed cause sharp heel and foot pain, you may have plantar fasciitis. This overuse injury affects the sole of the foot. It involves inflammation of the fascia, the tissue connecting your heel bone to your toes. Typically, morning pain lessens throughout the day as you walk, but the pain may worsen in severe cases or for those who stand all day.

Causes of plantar fasciitis

Plantar fasciitis often affects those who:

• Stand, walk, or run for extended periods (especially on hard surfaces)
• Have flat feet or high arches
• Wear non-supportive shoes
• Are middle-aged or overweight

Increasing the intensity of your exercise program, or having tight Achilles tendons or calf muscles, can increase your risk of developing plantar fasciitis.

Treatment options

• Rest - Try to keep weight off your foot and cut back on weight-bearing activities until the symptoms of pain and swelling resolve. Continuing to exercise and push through pain will make this condition worse.
• Ice - Apply ice to the sore area for 20 minutes several times a day to relieve inflammation.
• Footwear - Avoid walking barefoot and consider supportive shoes or orthotics.
• Stretching - Once the swelling subsides, stretching can help reduce the pain. You can also try self-massage by rolling the bottom of your foot on a tennis ball, golf ball, or a frozen bottle of water.
• Medical Intervention - If your symptoms are severe and you are not responding to treatment in 1 to 2 weeks, contact your medical provider for additional therapies or treatments. Those may include physical therapy, a cam walker, a night splint, a cortisone injection, or shockwave therapy. Your care provider may prescribe a non-steroidal anti-inflammatory medication to help with the swelling.

Most people have their symptoms resolve within 6 to 8 weeks. This hopeful outlook can provide reassurance and comfort during the recovery process.

Preventing plantar fasciitis

• Wear supportive shoes. Orthotics may give arch support and alleviate the symptoms. Your podiatric physician can fit you for devices that fit into your shoes.
• Over-the-counter heel cushions or heel lifts may help those on their feet all day. • If you stand in one place for long periods, especially on a hard surface like concrete, a foam mat can help provide support.
• Your podiatric physician may recommend using a night splint, or sock brace that locks your ankle at 90 degrees and keeps your foot stretched overnight or at times of rest.

Recognize the symptoms early, practice self-care, and reduce activities that trigger pain. Regular stretching and ice can help prevent worsening symptoms and speed up recovery. If pain lasts more than a few weeks, consult your medical provider, as other conditions (like stress fractures, arthritis, tarsal tunnel syndrome, tendinitis, sciatica, or nerve irritation) can mimic plantar fasciitis.

This article was reviewed by Lindsay Johnson, DPM, FACFAS, Chief of Podiatry at Atrius Health.