Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain, occurring when the thick band of tissue (plantar fascia) that runs across the bottom of your foot becomes inflamed. This ligament acts as a shock absorber, and repetitive stress can cause tiny tears, leading to pain and stiffness.

According to the American Academy of Orthopaedic Surgeons, plantar fasciitis is one of the most common orthopedic complaints, affecting approximately 2 million people each year. At Mountain Spine & Orthopedics, our foot and ankle specialists use precise diagnostics to create evidence-based treatment plans that relieve your discomfort and help you stay active.

Patients typically report a sharp, stabbing pain at the bottom of the heel that is most intense with the first steps in the morning or after long periods of rest. The pain may improve with movement but often returns after prolonged standing.

• Morning heel pain that improves after a few minutes of walking
• Pain that worsens after prolonged standing or activity
• Tenderness when pressing on the inside of the heel
• Stiffness and tightness in the arch of the foot
• Pain that increases when climbing stairs or standing on tiptoes

• Foot structure: Flat feet or high arches alter weight distribution
• Tight calf muscles: Increase tension on the plantar fascia
• Sudden activity increase: Training errors in runners and athletes
• Obesity: Excess weight increases heel loading
• Occupations: Jobs requiring prolonged standing on hard surfaces
• Improper footwear: Worn-out shoes or inadequate arch support
• Age: Most common between 40-60 years old

Diagnosis is primarily clinical, based on your history and a physical exam demonstrating point tenderness at the plantar fascia's origin on the heel bone. We may use a complimentary ultrasound or MRI review to assess fascia thickness and rule out alternative diagnoses in atypical or refractory cases.

We differentiate plantar fasciitis from other causes of heel pain including heel spurs, Achilles tendonitis, stress fractures, and nerve entrapment to ensure you receive the correct treatment.

Most patients improve with conservative care within 6-12 months.

Non-Surgical Treatment

• Stretching exercises: Specific stretches for the plantar fascia and calf muscles
• Orthotics: Custom or over-the-counter arch supports
• Night splints: Maintain stretch while sleeping
• Supportive footwear: Shoes with good arch support and cushioning
• NSAIDs: Anti-inflammatory medications for pain and swelling

Interventional Options

• Corticosteroid injections: Image-guided injections for targeted relief
• PRP injections: Platelet-rich plasma to promote tissue healing
• ESWT: Extracorporeal shockwave therapy to stimulate healing

Surgical Treatment

When conservative care fails after 6-12 months, plantar fascia release surgery may be recommended.

The pain arises from both the mechanical overload of the fascia and the inflammatory response to micro-tearing. The hallmark morning pain is due to the fascia tightening overnight and then being suddenly stretched with your first steps.

Without treatment, chronic plantar fasciitis can lead to compensatory changes in walking that cause back pain, hip pain, or knee problems.

Reducing your risk of plantar fasciitis starts with smart footwear choices and consistent stretching habits.

• Stretch daily: Calf and plantar fascia stretches, especially before getting out of bed
• Wear supportive shoes: Replace athletic shoes every 300-500 miles
• Maintain healthy weight: Reduces stress on the plantar fascia
• Increase activity gradually: Avoid sudden training intensity increases
• Use orthotics: Especially if you have flat feet or high arches
• Avoid barefoot walking: On hard surfaces
• Strengthen foot muscles: Towel curls and marble pickups

If you are experiencing stabbing heel pain, schedule a consultation with Mountain Spine & Orthopedics today. Benefit from our complimentary MRI review and free second opinion as we create a personalized plan to relieve your plantar fasciitis.