HealthInfo Aoraki South Canterbury
Heel & foot pain (plantar fasciitis)
Mamae ā-waewae me rekereke
Plantar fasciitis (pronounced plarn-tar-fash-ee-eye-tis) is the most common cause of pain under one of your heels.
The plantar fascia is a strong flat band of connective tissue (like a ligament). It acts like a bow string and supports the arch of your foot by connecting your heel bone to the ends of your metatarsal bones.
Plantar fasciitis affects around one in 10 people and is more common in women than in men. You are more likely to get plantar fasciitis if you:
- are on your feet a lot (for example, nurses and retail staff)
- do a lot of walking, running or standing when you are not used to it
- wear unsupportive footwear with poor cushioning for walking, running or standing
- are overweight (this puts strain through the arch of your foot)
- quickly increase how much you exercise or how intensely you exercise, leading to overuse
- have a tight Achilles tendon.
Symptoms of plantar fasciitis
When the arch of your foot is under increased stress, it can cause tiny tears in your plantar fascia, usually where it connects to your heel bone. This causes inflammation and pain under or around your heel when you are standing or walking. Sometimes it might even be painful when you are resting.
Other symptoms of plantar fasciitis include:
- "first-step pain" – a feeling on your heel or the base of your foot like stepping on a stone after getting out of bed or sitting for a long time
- pain after driving
- deep aching pain in your foot
- pain that is worse when you are barefoot or walking up stairs.
Your general practice team, podiatrist or physiotherapist will probably be able to diagnose plantar fasciitis after talking to you and examining your foot. They might order an X-ray or ultrasound scan if they are not certain of the diagnosis.
Reducing heal & foot pain
Plantar fasciitis usually gets better by itself, but it can sometimes take years. You can do several things to help make yourself more comfortable and speed up your recovery.
- Wear appropriate supportive shoes.
- Do not overtrain in sports.
- Warm up and cool down with activity and include flexibility in your exercise programme. The Long calf stretch, Short calf stretch and Static isotonic hold can be very helpful in treating heel pain.
- Manage your weight. If you are overweight, losing some weight can help to decrease your pain.
- Apply ice to the painful area for 20 minutes a day. Put the ice in a bag or a cloth. Do not hold it directly against your skin. If you have peripheral neuropathy or nerve damage, do not use ice on your feet.
- Avoid walking or running on hard surfaces, particularly in bare feet.
- Massage your plantar fascia from the ball of your foot back to your heel. You can do this by rolling your foot over a tennis ball (or something similar) on the floor.
It could be worth talking to your general practice team or other health provider to see if taking some anti-inflammatory pain relief (NSAIDs) would be suitable for you.
NSAIDs can have some serious side effects, especially if you take them for a long time. Two serious side effects are stomach pain and bleeding from a stomach ulcer. Some people with asthma, high blood pressure, kidney failure and heart failure might not be able to take them even for a short time. If you are not sure if you can take NSAIDs, check with your general practice team or pharmacist.
Getting help for plantar fasciitis
If you have tried all these steps and your pain is not getting better, you may need to see a podiatrist or physiotherapist to help your treatment.
A podiatrist can look at what is causing your pain. They can make sure the way you are walking is not causing more foot problems. They can also work out if you would benefit from strapping your feet, using special insoles (called orthotics), wearing different shoes or doing some stretches. They can refer you to have further tests or assessments if necessary.
If you need to find a podiatrist, you can search on the Podiatry NZ's website.
In most cases you will have to pay privately to see a podiatrist, although ACC may cover treatment for some pain caused by an injury.
A physiotherapist can help with massage and joint mobilisation. They can suggest ways to decrease the load you put on your foot. They can also give you exercises that will help strengthen your foot, ease your pain and help to prevent future pain. If you need help finding a physiotherapist, you can search on the Physiotherapy NZ's website.
Written by Podiatry NZ. Adapted by HealthInfo clinical advisers. Last reviewed April 2023.
Sources
Review key: HICCA-28239
