Written By: Chloe Wilson BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board
Plantar fasciitis symptoms of pain and tenderness under the heel are a common problem.
Plantar fasciitis is a common cause of foot arch and heel pain and affects approximately 1-in-10 people.
It develops when there is damage and inflammation of the plantar fascia, the thick band of tissue on the sole of your foot.
Plantar fasciitis usually develops due to overuse and is a common problem for runners and people who spend long periods on their feet.
But exactly what is plantar
fasciitis? Here we will look at the causes, symptoms and treatment options as
well as how to prevent this common cause of foot arch pain.
The plantar fascia is a thick, tough, fibrous band made up of collagen fibres, which runs along the sole of your foot.
It originates from the heel bone (calcaneus), extends along the bottom of the foot and attaches to the bottom of the toes. It helps to support the arch of your foot and transfers forces across your foot when you walk or run.
There are three parts to the plantar fascia. The central portion is the largest with smaller bands coming out of each side known as the medial and lateral portions.
Plantar fasciitis symptoms develop if too much strain is placed on the plantar fascia, usually from overuse or repetitive actions, causing small tears to develop in the collagen fibres. This results in swelling and inflammation. If the problem continues, it may develop into plantar fasciosis, which means there is chronic degeneration of the tendon rather than inflammation.
In approximately two-thirds of cases, plantar fasciitis symptoms are accompanied by the presence of a bone spur.
When there is repeated tension on the plantar fascia, it pulls on the
area of bone where the tendon attaches to the heel bone, known as the
The body responds by laying done excess bone, known as a heel bone spur, to try and protect itself from injury.
This bone spur then further irritates the plantar fascia making the problem worse.
People often mistakenly think it is the bone spur that causes the plantar fasciitis, but in actual fact, the bone spur develops as a result of the condition.
Plantar fasciitis symptoms often develop for the following reasons:
The most common of plantar fasciitis symptoms is pain that is worse after rest, either first thing in the morning or after sitting for long periods. In fact, plantar fasciitis is the most common cause of morning foot pain.
This is because the fascia tightens slightly. As you walk around, it then stretches out slightly and symptoms often improve. However, if you are on your feet too much, the plantar fasciitis symptoms return.
Pain from plantar fasciitis is usually felt underneath the heel where the tendon arises from the heel bone, approximately four centimetres forwards from the back of the heel. It is usually tender to touch and there may be a hard lump under foot.
Plantar fasciitis symptoms are often worse when the foot and toes are pulled up (known as dorsiflexion) as this increases the tension on the tendon. Other activities where the plantar fascia is stretched e.g. standing on your tip toes or walking up stairs also tend to increase the pain.
Your doctor can usually diagnose the condition from talking to you about your plantar fasciitis symptoms and examining your foot. Occasionally, they may carry out other tests such as x-rays or ultrasound scan to rule out other causes of pain.
Plantar fasciitis treatment usually involves a combination of things including:
If conservative treatment fails to resolve the symptoms of plantar fasciitis, then surgery may be recommended.
Studies have shown that the sooner plantar fasciitis treatment is started after symptoms develop, the quicker the recovery process. Plantar fasciitis symptoms usually resolve but they can take months.
You can find out all about how to treat plantar fasciitis and stop it from coming back in the plantar fasciitis treatment section.
There are a number of other conditions that present with similar symptoms to plantar fasciitis such as:
You can find out more about each of these conditions in the foot arch pain section.
In order to prevent the onset or recurrence of plantar fasciitis symptoms, there are a number of things you can do:
You can find out more about the best ways to treat and prevent plantar fasciitis in the plantar fasciitis treatment section including the most effective exercises, which shoe insoles work best, injections and when surgery is indicated.
If these plantar fasciitis symptoms aren't sounding quite like your problem, visit the foot pain diagnosis or foot arch pain sections for help working out what is wrong.
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Page Last Updated: 05/11/23
Next Review Due: 05/11/25
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