Plantar fasciitis is a common cause of pain under the heel and along the arch of the foot. It involves irritation and small scale damage where the plantar fascia, a strong band of tissue supporting the arch, attaches to the heel bone.
Symptoms
Pain is usually strongest during the first steps after getting out of bed or after sitting for a long time. It may ease as the foot warms up and return after prolonged standing, walking or running. Pressing the inner underside of the heel can feel tender.
Sudden pain after an injury, marked swelling, numbness or an inability to bear weight is less typical and needs assessment for another cause.
What is a heel spur?
A heel spur is a bony projection that can appear where the plantar fascia attaches to the heel. It is visible on an X ray, but many people with a heel spur have no pain. The spur is usually a result of long term tension rather than the direct cause of symptoms, so removing it is rarely necessary.
Risk factors
Plantar fasciitis can follow a rapid increase in running, walking or time spent standing. Tight calf muscles, footwear with poor support, higher body weight and some foot shapes may increase strain. It can affect active and less active people.
Diagnosis
A clinician usually makes the diagnosis from the pattern of pain and an examination of the foot and ankle. Imaging is not routinely required. An X ray, ultrasound or MRI may be considered when symptoms are unusual, severe, linked to trauma or not improving as expected.
Self care and treatment
- Temporarily reduce activities that repeatedly aggravate the pain, while remaining active in ways that are tolerable.
- Wear supportive, cushioned shoes and avoid walking barefoot on hard floors.
- Use a cold pack wrapped in cloth for short periods after activity.
- Stretch the calf and plantar fascia regularly, without forcing through sharp pain.
- Return to running or high impact exercise gradually as symptoms improve.
Heel pads or insoles may help some people, particularly when combined with stretching and suitable footwear. A physiotherapist or podiatrist can assess movement, footwear and an appropriate strengthening programme.
Pain medicines can have important risks and interactions. Ask a pharmacist or clinician what is suitable if you have stomach ulcers, kidney disease, heart disease, take anticoagulants or are pregnant.
Persistent symptoms
Recovery is often gradual and may take several months. A clinician may consider night splints, a more structured rehabilitation programme, shockwave therapy or an injection for persistent pain. Steroid injections can offer short term relief but may weaken or rupture the fascia, so benefits and risks require careful discussion.
Surgery is rarely needed and is usually considered only after prolonged symptoms despite appropriate non surgical treatment.
See our Pain guide for general information about pain assessment and safe management.
When to seek medical help
Arrange an assessment if pain is severe, keeps returning, affects normal activities, causes tingling or loss of sensation, or does not improve after about two weeks of consistent self care. Seek earlier advice if you have diabetes or poor circulation.
Seek urgent care after a significant injury if you cannot bear weight, the foot looks deformed, or there is severe swelling. A hot, red, swollen foot with fever, an open wound or rapidly worsening pain also needs urgent assessment.
Sources
- NHS: Plantar fasciitis
- American Academy of Orthopaedic Surgeons: Plantar fasciitis and bone spurs
- Royal Orthopaedic Hospital: Plantar fasciitis
Using this information
This information supports, but does not replace, an individual assessment. Heel pain has several possible causes, and treatment should reflect symptoms, examination findings and general health.
Reviewed: 28 August 2026