Plantar fasciitis is irritation of the thick band of tissue under your foot, and it is one of the most common causes of heel pain. A foot you cannot put weight on, or serious pain after an injury, needs care right away. Heel pain that keeps coming back can be looked at during a comprehensive evaluation at our Towson clinic.
Why the First Steps of the Day Hurt Most
Many people know the pattern before they know the name. The morning's first steps are the worst. The pain settles as you walk, then returns after a long stand or when you get up from a chair.
How you sleep is part of the reason. Most people sleep with their feet pointed down, which relaxes the tissue under the foot and helps explain the morning pain.
Understanding Plantar Fasciitis
Plantar fasciitis is irritation or inflammation of the plantar fascia, a strong band of tissue along the bottom of the foot. It runs from the heel bone toward the toes and supports the arch. It tends to cause pain near the heel, and it is most common between ages 40 and 60.
Sometimes it shows up for no clear reason. When a cause can be traced, the sequence usually looks like this.
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The band takes on more load
The plantar fascia absorbs shock with every step. Long hours on your feet, running or jumping all add stress.
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Small tears form
Too much tension can leave small tears in the tissue.
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The tissue becomes inflamed
Repeated stretching and tearing can irritate the band. That inflammation is the heel pain you feel.
Other causes of heel pain
- A stress fracture of the heel bone
- Achilles tendinitis at the back of the heel
- A trapped nerve in the foot
- Arthritis
The American Academy of Orthopaedic Surgeons' guide to plantar fasciitis and bone spurs puts the number treated at about 2 million patients a year.
Left alone, heel pain can change the way you walk, which can lead to problems in the foot, knee, hip or back.
Signs of Plantar Fasciitis
- Sharp or stabbing pain under the heel
- Pain at its worst on the first steps of the morning
- Pain after a long car ride or other long rest
- Pain that eases after a few minutes of walking
- More soreness after exercise than during it
- A tender spot just in front of the heel bone
- Pain after standing for a long time
- Limited upward motion at the ankle
What Puts Strain on the Plantar Fascia
Repeated impact
Running, ballet and high-intensity workouts all load the heel and arch. So do basketball, tennis and other sports with jumping or quick moves.
Long hours on hard floors
Teachers, factory workers and health care workers are on their feet for much of the day, often on hard surfaces. Long periods of sitting at a desk can raise the risk too.
New or increased activity
A sudden jump in how much you walk, run or train can bring it on.
Foot shape and tight calves
Flat feet or high arches change how weight spreads across the foot. Tight calf muscles add tension to the band.
Worn or poorly matched shoes
Old shoes lose their support. Shoes made for one sport may also suit another poorly, such as running shoes on a tennis court.
Extra body weight
More weight means more pressure on the heel with each step.
How We Treat Plantar Fasciitis in Towson
Care starts with finding out whether plantar fasciitis is what you have, since other problems can hurt in the same place. After our comprehensive evaluation, a service like this may be recommended, depending on your condition.
Class IV Laser Therapy
This clinic offers a Class IV cold laser, a noninvasive handheld device that emits light. It may be considered for plantar fasciitis.
Other Ways Heel Pain Is Managed
This is not a full list, and most of these happen outside our clinic. A podiatrist or your own doctor can cover the rest.
| Option | What it involves | Who provides it |
|---|---|---|
| Rest and changed activity | Cutting back on what hurts and choosing low-impact exercise, such as cycling or swimming. | You, with advice from your doctor |
| Stretching | Stretches for the calf and for the band under the foot. | You at home, or a therapist your doctor refers you to |
| Ice and pain relievers | Ice on the heel, or pain relievers you can buy without a prescription. | You, with advice from your doctor or pharmacist |
| Shoes, heel pads and arch supports | Thick soles, extra cushioning, soft heel pads, or store-bought or custom inserts. | A shoe store, or a podiatrist for custom inserts |
| Night splints | A splint that holds the foot in a stretched position during sleep. | Your doctor or a podiatrist |
| Class IV laser therapy | Light from a handheld device. | This clinic, if recommended |
| Surgery | Mayo Clinic says surgery is rarely needed and may be considered only when pain is serious and other treatments have not helped. | A foot and ankle surgeon |
When to See a Podiatrist
A podiatrist is a doctor who specializes in the foot and ankle, and your doctor may refer you to one or to a sports medicine specialist. Foot pain that makes it hard to use your feet is reason enough to go.
A podiatrist is the right call if you need custom inserts, a brace or cast, a prescription or a talk about surgery. The same goes for heel pain that treatment has not helped. If an evaluation here points to a problem this team cannot help with, you may be referred to another provider.
Cleveland Clinic's description of what a podiatrist does includes ordering tests, prescribing medicine and operating on the foot and ankle.
When Foot Pain Needs Care Right Away
Get medical attention right away for
- A foot you cannot walk on or put weight on
- Serious pain or swelling, especially after an injury
- A wound that is open or oozing pus
- Signs of infection, such as warmth, tenderness, a change in skin color or a fever over 100 F
- Diabetes with a foot wound that is deep, swollen, warm or slow to heal
Make an office visit for
- Burning pain, numbness or tingling, especially across most of the sole
- Swelling that has not improved after 2 to 5 days of home care
- Pain that has not improved after several weeks
Mayo Clinic's advice on foot pain is to see a health care professional before home remedies if the cause is unknown or both feet hurt. That is especially true with diabetes.
Ankle and Foot Pain
Our Towson clinic also sees ankle and foot pain, and those problems often have nothing to do with the plantar fascia. A sprained ankle is a stretched or torn ligament. It usually affects the outer side of the ankle, after the foot rolls inward. Severe sprains can tear the ligament completely.
Other common sources of foot pain
- Achilles tendinitis
- A stress fracture or broken bone
- Arthritis or gout
- Bunions or corns
- Nerve problems, including diabetic neuropathy
Get an ankle looked at for
- Trouble putting weight on it, which needs care right away
- Swelling or pain that lasts several weeks despite home care
- A feeling that the ankle keeps giving out
The same academy's page on ankle sprains says a severe sprain can look and hurt much like a broken bone, so it needs prompt medical evaluation.
What a First Evaluation May Cover
Heel pain is one of the problems we see at our Towson clinic. New patients may start with a detailed intake, and the evaluation may add a physical assessment. Please tell us about any podiatrist or doctor you already see, since care here may be combined with other medical treatment.
Around Prince Rd and Goucher Blvd
West of the clinic along E Joppa Rd, Prince Rd comes up in about 0.15 miles and Goucher Blvd in about 0.4 miles. Campus Hills is nearby too, and Towson Town Center lies about 1.2 miles to the northwest.
Book a Heel Pain Evaluation
Bring any shoe inserts you wear, along with a list of your medicines and supplements. It also helps to note when the pain began and how long you spend on your feet each day. Questions about cost or coverage are easiest to answer by phone.