Plantar Fasciitis Cause of Heel Pain

Causes and Treatment

plantar fasciitis
Plantar fasciitis is a common cause of heel pain.. Jan-Otto / Getty Images

Plantar fasciitis is a common, painful foot condition. Patients, and sometimes doctors often confuse the terms plantar fasciitis and heel spurs.

  • Plantar fasciitis refers to the condition of inflammation of the tight band of tissue that forms the arch of the foot
  • A heel spur is a hook of bone that can form on the heel bone (calcaneus). About 70% of patients with plantar fasciitis are found to have a heel spur that can be seen on x-ray.

    Plantar fasciitis is most often seen in middle-aged men and women, but can be found in all age groups. The condition is diagnosed by the typical symptom of focal pain deep in the heel area of the bottom of the foot. Often the pain from plantar fasciitis is most severe when you first stand on your feet in the morning. Pain often subsides quite quickly, but then returns after prolonged standing or walking.

    Plantar fasciitis is sometimes, but not always, associated with a rapid gain of weight. It is also sometimes seen in recreational athletes, especially runners. In these athletes, it is thought that the repetitive nature of the sports causes the damage to the plantar fascia that forms the arch of the foot.

    Cause of Plantar Fasciitis

    Plantar fasciitis occurs because of irritation to the thick tissue that forms the arch of the foot. This strong and tight tissue is called the plantar fascia. It is also one of the major transmitters of weight across the foot as you walk or run.

    Therefore, the stress placed on the this tissue is tremendous.

    When a patient has plantar fasciitis, the connective tissue that forms the arch of the foot becomes inflamed (tendonitis) and degenerative (tendinosis). These abnormalities cause plantar fasciitis and can make normal activities quite painful.

    Symptoms of plantar fasciitis are typically worsened early in the morning after sleep. At that time, the arch tissue is tight and simple movements stretch the contracted tissue. As you begin to loosen the foot, the pain usually subsides, but often returns with prolonged standing or walking.

    Other Causes of Heel Pain

    Plantar fasciitis can be confused with a condition called tarsal tunnel syndrome. In tarsal tunnel syndrome, an important nerve in the foot, the tibial nerve, is pinched as it passes by the ankle joint.  There are also other less common problems causes of heel pain such as nerve problems, stress fractures, and fat pad necrosis, all of which can cause foot pain. Finally, several rheumatologic conditions can cause heel pain. These syndromes such as Reiter's syndrome and ankylosing spondylitis can cause heel pain similar to plantar fasciitis. If your symptoms are not typical for plantar fasciitis, or if your symptoms do not resolve with treatment, your doctor will consider these possible diagnoses.

    Treatment of Plantar Fasciitis

    Treatment of heel pain caused by plantar fasciitis begins with simple steps.  There are a number of options for treatment of plantar fasciitis, and almost always some focused effort with nonsurgical treatments can provide excellent relief.  In rare circumstances, simple steps are not adequate at providing relief, and more invasive treatments may be recommended.  Typically, patients progress from simple steps, and gradually more invasive treatments, and only rarely is surgery required.


    Neufeld SK and Cerrato R "Plantar fasciitis: evaluation and treatment" J Am Acad Orthop Surg. 2008 Jun;16(6):338-46.

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