Heel Pain and Plantar Fasciitis: Stepping into Trouble

A Painful Start to the Day

Do you wake up and feel a sharp pain in your heel when you take your first few steps? You’re not alone. This is one of the classic signs of plantar fasciitis, a common cause of heel pain. It affects about 1 in 10 people at some point in their life, especially runners, people who are on their feet all day, and those who are overweight. Heel pain can make simple activities like walking, shopping, or exercising very difficult — and it leads to millions in lost workdays and health costs each year.

What Is Plantar Fasciitis?

The plantar fascia is a thick band of tissue that runs from your heel to the ball of your foot. It helps support your arch and absorb shock when you walk or run. When this tissue is overloaded, small tears can occur, leading to pain and inflammation — usually at the front of the heel. Pain is often worst in the morning or after rest, and eases as you move around. Over time, though, it can become more constant and interfere with daily life.

What Actually Helps?

Most cases of plantar fasciitis improve with non-surgical treatment, especially physiotherapy. A typical plan includes:

• Stretching the plantar fascia and calf muscles
• Strengthening the foot and ankle muscles
• Taping or orthotics to support the arch
• Ice massage or rolling the foot on a frozen water bottle
• Activity changes to reduce overload (e.g. limiting running or walking on hard surfaces)

Supportive shoes with good arch support and cushioning are essential. Many people start to feel relief within 4–6 weeks, but full recovery can take 3–6 months.

What Doesn’t Help Much

Cortisone injections may reduce pain in the short term, but they carry a risk of weakening the tissue and increasing the chance of rupture. Passive treatments like ultrasound, laser, or acupuncture lack strong evidence. Surgery is a last resort, used in less than 5% of cases.

Heel spurs — which are often seen on X-rays — aren’t usually the cause of pain. Treating the fascia, not the spur, is the focus.

What’s Coming in the Future?

There’s increasing interest in shockwave therapy, which may help chronic cases that don’t improve with exercise. Blood flow restriction training, foot-strengthening programs, and mobile apps for tracking and guiding home rehab are also being explored. Research continues into how load management, footwear design, and individual foot shape affect recovery outcomes.

How to Prevent Heel Pain

• Wear supportive footwear, especially if you stand for long periods
• Stretch your calves and arches regularly
• Avoid sudden increases in walking or running distances
• Keep your weight within a healthy range to reduce pressure on the feet
• Strengthen your foot and ankle muscles