Understanding Plantar Fasciitis: Foot Pain Causes, Treatment, and Prevention

David S. Klein, MD FACA FACPM
Sep 26, 2025
4 min read

As a physician, I often see patients who struggle with foot pain, especially in the heel. One of the most common culprits is plantar fasciitis, a condition that affects people of all ages but is especially noticeable among those who are on their feet a lot, athletes, and individuals with certain risk factors. Let’s break down what it is, what causes it, how it’s treated, and—most importantly—how you can prevent it.

Plantar Fascia and Plantar Fasciitis — The Plantar Fascia is a tough band of muscles and tendons on the bottom (Plantar Aspect) of the Foot

What Is Plantar Fasciitis and Why does it Cause Foot Pain?

The plantar fascia is a thick band of tissue that runs along the bottom of your foot, connecting your heel bone to your toes. Its job is to support the arch of your foot and absorb shock when you walk or run. When this tissue becomes irritated or inflamed, it leads to plantar fasciitis. The hallmark symptom is sharp heel and foot pain, especially when taking the first steps in the morning or after sitting for a while.

The plantar fascia is a tough band of tissue that stretches from the forefoot to the heel, and is responsible for maintenance of arch integrity.

Plantar Fasciitis is worse in the morning when you awaken

Causes and Risk Factors

Plantar fasciitis usually develops from repeated stress on the plantar fascia. Several factors increase the likelihood of developing it:

Foot mechanics: Flat feet, high arches, or an abnormal walking pattern can place extra stress on the fascia.
Overuse: Long-distance running, dancing, or prolonged standing can strain the heel.
Improper footwear: Shoes without proper arch support or cushioning can worsen the problem.
Age and weight: It’s more common in people between ages 40–60 and in those carrying excess weight, which increases pressure on the fore-foot.

Plantar Fasciitis Pain from Walking and Climbing — The Plantar Fascia is under maximal tension when weight is on the forefoot.

Due to persistent mechanical stress resulting from prolonged walking, standing and stretching, the plantar fascia withstands remarkable mechanical challenges during routine activity. As a result of microtrauma subsequent to jumping, jogging, and running, the plantar fascia can develop small areas where it is torn from the attachment on the heel. Foot and Hell Pain are a direct result.

Symptoms

The classic sign is a sharp, stabbing pain at the bottom of the heel. The pain is usually worse in the morning or after periods of rest, but may improve with movement. Over time, the discomfort can become constant if untreated.

The pain of plantar fasciitis is usually stabbing or burning pain in nature, usually worse in the morning. The pain seems to be worse when your feet hit the floor after sleep, and the pain eases with motion and mobility. The pain will come and go, worse with certain types of shoes and with pressure on localized areas.

Treatment Options

The good news is that most cases of plantar fasciitis improve with conservative treatment:

Rest and activity modification: Reducing high-impact activities gives the fascia time to heal.
Ice and anti-inflammatory measures: Applying ice or taking non-steroidal anti-inflammatory drugs (NSAIDs) can reduce pain and swelling.
Stretching and physical therapy: Gentle calf stretches, plantar fascia stretches, and strengthening exercises for the foot and ankle can help.
Supportive footwear and orthotics: Shoes with good arch support, cushioned soles, or custom orthotic inserts take stress off the fascia.
Night splints: Wearing a splint that keeps the foot flexed overnight can stretch the fascia and lessen morning pain.

In more severe or persistent cases, other treatments such as steroid injections, shockwave therapy, or surgery may be considered, but these are reserved for people who do not respond to conservative measures.

Prevention Strategies

Preventing plantar fasciitis often comes down to protecting your feet from stress:

Wear shoes with good cushioning and arch support.
Replace athletic shoes regularly, especially if you run or walk often.
Stretch your calves and feet before and after exercise.
Maintain a healthy weight to reduce pressure on your feet.
Avoid walking barefoot on hard surfaces for prolonged periods.

Final Thoughts

Plantar fasciitis can be frustrating, but with the right approach, it is manageable and often curable without invasive treatment. By paying attention to your footwear, body mechanics, and activity habits, you can both recover from plantar fasciitis and reduce the risk of it coming back.