Plantar Fasciitis and Heel Spurs

The plantar fascia is a fibrous membrane that extends from the heel to the base of the toes, and helps to maintain the arch of the foot. The fascia can become swollen, resulting in pain. This condition is known as plantar fasciitis.

When plantar fasciitis becomes chronic, meaning that the issue persists over an extended period of time, a heel spur may develop. A heel spur is a small piece of bone that forms under the foot where the fascia meets the heel.

Plantar fasciitis, with or without a heel spur, causes heel pain. The pain is more intense first thing in the morning or after an extended period of inactivity and tends to lessen over the course of the day. The pain may recur as soon as one engages in certain physical activities.

Causes and triggers

Plantar fasciitis and heel spurs are usually the result of excess weight on the feet. That said, the most common risk factors are:

• Sports (e.g., running, tennis, aerobics)
• Walking or standing on hard surfaces for extended periods
• A foot injury such as landing on one's heels
• Flat feet or high arches
• Obesity or rapid weight gain (e.g., pregnancy)
• Inadequate, unsupportive or ill-fitting footwear, and high heels

Treatment

To reduce the pain associated with plantar fasciitis and accelerate healing, try to:

• Rest the feet
• Take a break from the activity that is causing the pain
• Avoid walking bare foot
• Wear shoes that support the arches and heel
• Use an orthotic, whether it be an arch support or a heel cushion, for shock absorption and to elevate the heel
• Massage the feet before doing any physical activity
• Apply ice on the heel for about 20 minutes, 4 times a day
• Stretch the feet and calf muscles

For pain relief, use acetaminophen (e.g., Tylenol) or an anti-inflammatory such as ibuprofen (e.g., Advil or Motrin). Speak to your healthcare professional to see which product is right for you.

If these measures do not offer sufficient relief, cortisone injections can be administered. In rare cases where patients do not respond to any treatment, surgery may be considered.

When should I see a healthcare professional?

See your healthcare provider (e.g., podiatrist) if none of the recommended measures relieve your pain.