Plantar Fasciitis FAQ: Symptoms, Causes & Modern Treatments
Plantar fasciitis is one of the most common causes of heel pain, especially for adults who spend long hours on their feet or suddenly ramp up their activity. If you’re waking up with that familiar “first-step” jolt of pain, this FAQ breaks down what’s going on and what actually helps.
What exactly is plantar fasciitis?
Plantar fasciitis happens when the thick band of tissue on the bottom of your foot—called the plantar fascia—gets irritated or overstretched. This tissue helps support the arch, so when it’s strained, you feel it right at the heel or along the arch.
What causes plantar fasciitis?
A few patterns show up again and again:
- Standing or walking on hard floors
- Flat feet or very high arches
- Tight calves
- Old or unsupportive shoes
- Sudden increases in activity
- Running, pickleball, hiking, and similar sports
Even people who are normally active can develop symptoms after changing shoes or terrain.
What does the pain feel like?
Most people describe sharp pain under the heel when stepping out of bed or after sitting for a while. Once the foot “warms up,” it may ease, only to flare back up later in the day.
How is plantar fasciitis diagnosed?
A podiatrist typically diagnoses it through a hands-on exam and your symptom history. X-rays or ultrasound might be used to rule out stress fractures or other causes of heel pain, but most cases don’t require extensive imaging.
Do heel spurs cause the pain?
Not usually. Heel spurs often show up on X-rays whether someone has pain or not. The real issue is the irritated fascia—not the spur.
What treatments actually work?
Many people improve with a combination of targeted stretching, supportive footwear, and modifying certain activities. The key is reducing strain on the fascia long enough for it to calm down. Consistency matters more than any single “quick fix.”
How do orthotics help with plantar fasciitis?
Custom orthotics are one of the most reliable tools for long-term relief. They work by:
- Supporting the arch
- Reducing tension through the fascia
- Improving alignment during walking and running
- Providing a stable landing point for the heel
Patients with flat feet, high arches, or recurring symptoms usually see the biggest benefit. Quality over-the-counter inserts may help mild cases, but custom devices tend to provide more precise and longer-lasting support.
Is shockwave therapy a good option?
Yes—extracorporeal shockwave therapy (ESWT) has become a highly effective treatment for stubborn plantar fasciitis. It stimulates blood flow and helps the tissue heal in chronic cases where the fascia has stopped responding to stretches and basic treatments.
Most patients describe the sessions as tolerable, and there’s no downtime afterward. Many see improvement over several weeks as the tissue gradually responds.
Shockwave therapy is especially helpful for:
- Long-standing heel pain
- Patients who’ve tried injections or physical therapy without progress
- Athletes wanting a non-surgical option
How long does it take to get better?
Some people notice improvement within a few weeks, while others take a couple of months. Chronic cases can take longer, but with the right combination—stretching, supportive shoes, orthotics, and possibly shockwave therapy—most patients return to normal activity.
Should I stop working out?
You don’t have to quit exercising, but you may need to adjust your routine. High-impact activities can irritate the fascia, but low-impact options like biking, swimming, or rowing usually feel fine. A foot specialist can help tailor activity recommendations to your goals.
When is surgery considered?
Surgery is rarely needed. It’s typically reserved for cases that haven’t improved with several months of conservative care, including structured stretching, orthotics, and advanced treatments like shockwave.
Can plantar fasciitis come back?
Yes, and it often does when stretching and supportive footwear fall by the wayside. Keeping the calves flexible, replacing worn shoes, and using orthotics when needed can go a long way toward preventing flare-ups.
© Colorado Center for Podiatric Sports Medicine | Privacy Policy
