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What to Know About Plantar Fasciitis

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What to Know About Plantar Fasciitis

If you’ve been diligently walking, hiking, or jogging and you’re waking up in the morning with a sharp pain in the heel of your foot, you might have plantar fasciitis. This painful condition can affect anyone who is frequently on their feet — waitstaff, teachers, factory workers, and athletes included. What is plantar fasciitis? Does having diabetes play a role? And how can you get relief if you have it?

What is plantar fasciitis?

You may never have heard of or had this condition, but plantar fasciitis is the most common cause of pain on the bottom of the heel, says the American Academy of Orthopaedic Surgeons. About two million people are treated for this condition every year.

The plantar fascia is a tough, fibrous band of tissue, or ligament, that runs along the bottom of each foot, connecting the heel bone to the toes. It supports the arch of the foot and it plays a key role in enabling you to propel your foot forward when walking or running. Plantar fasciitis means that this ligament becomes inflamed, and this creates a lot of pain, especially when you put weight on your foot or start walking.


What causes plantar fasciitis?

There are a number of factors that lead to plantar fasciitis. You may be more likely to get (or have) this condition if you:

  • Have either high arches or flat feet
  • Have pronated ankles that turn inward when walking
  • Wear unsupportive shoes, especially for long periods of time
  • Stand, walk, or run on a hard surface
  • Run or jump a lot
  • Are an athlete
  • Are overweight, obese or pregnant

Also, people (especially women) between the ages of 40 and 60 are more likely to have plantar fasciitis.

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How might diabetes play a role in plantar fasciitis?

If you have diabetes, you likely have a higher risk of plantar fasciitis. A study in the Journal of Diabetes Complications published in 2019 found that the incidence of plantar fasciitis was higher in people with diabetes (type 1 or type 2) than people who don’t have diabetes. It’s thought that certain metabolic factors that occur in diabetes may increase the likelihood of plantar fasciitis. For example, advanced glycation end-products (AGEs) can disrupt the organization of collagen, and research indicates that AGEs are increased with diabetes.

Hyperglycemia (high blood sugars), neuropathy, being overweight, high cholesterol, and high uric acid levels are other mechanisms that may play a role in plantar fasciitis, according to a study published in 2013 in the journal Rheumatology. These factors can lead to a number of issues, including inflammation, that set the stage for plantar fasciitis to occur.

What are the symptoms of plantar fasciitis?

Typically, pain in the heel is the hallmark of this condition. Pain may start out gradually and sharpen over time. Some people have a dull pain, while others have a stabbing pain. Other indicators of plantar fasciitis include:

  • Increased pain after exercising
  • Pain that is worse in the morning after getting out of bed or when standing after sitting for a long time (the pain usually decreases as you continue to move, but it can return after long periods of standing or after exercising)
  • Pain in the arch of the foot
  • Swelling in the heel
  • Pain that continues for months

Some people may find that they also have pain in the ankle, calf, and possibly their toes, but these are not the most common symptoms. Also, you may find that you develop knee, back, or hip pain as a result of walking differently to avoid or lessen the pain in your heel.

How is plantar fasciitis diagnosed?

Your health care provider will check your medical history and examine your foot to rule out other conditions that can cause heel pain, such as a stress fracture or a compressed nerve. According to the American Academy of Orthopaedic Surgeons, things that might point to plantar fasciitis are:

  • A high arch
  • Tenderness on the bottom of the foot in front of the heel bone
  • Pain that worsens when you flex your foot and your provider pushes on the plantar fascia; the pain will improve when you point your toes down

You likely won’t need any imaging tests, although your provider may order an X-ray or an MRI to make sure that another issue isn’t causing the symptoms.

How is plantar fasciitis treated?

More than 90% of people with plantar fasciitis will improve within 10 months of starting simple types of treatment. But, the longer you have symptoms and worse the pain, the longer the treatment may take.


Treatment options include:

  • Rest. The first step is to decrease or even stop doing activities that make the pain worse in order to heal the plantar fascia.
  • Ice. Putting ice on the affected area three to four times daily for 10 to 15 minutes at a time.
  • Stretching. Calf stretches and stretches for the plantar fasciia are highly effective for relieving pain. You may need a referral to a physical therapist.
  • Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS). These can help reduce both pain and inflammation.
  • Shoes and orthotics. Wearing supportive, cushioned shoes can help, rather than shoes or sandals without arch supports. You might need orthotics, arch supports, or shoe inserts, as well.
  • Athletic tape. Applying athletic tape can support the muscles and ligaments in your foot. You may need a physical therapist to show you how to do this.
  • Night splint. While not exactly easy to sleep with, this stretches the plantar fascia while you sleep.
  • Cortisone injections. Cortisone, a type of steroid, can reduce inflammation and it can be injected directly into the plantar fascia. However, you will likely be limited as to the number of injections you can get, as there is risk of the plantar fascia tearing.
  • Extracorporeal shock wave therapy. This treatment involves the use of high-energy shock waves directed to the area of pain. But because this procedure isn’t always effective, it’s not used that often.

If plantar fasciitis doesn’t improve after 6 to 12 months of the above therapies, surgery might be recommended. Surgery might involve gastrocnemius recession, in which the calf muscles are lengthened, or plantar fascia release, in which the plantar fascia is cut to relieve tension.

How you can prevent plantar fasciitis?

There are steps that you can take to reduce the chances of getting this painful condition. These tips can help:

  • Lose weight if you are overweight.
  • Wear supportive shoes and sneakers. Replace sneakers before they stop providing support.
  • Change up your exercise to include low-impact exercises, such as swimming or bicycling.
  • Ice your foot several times a day to reduce any pain or inflammation.
  • Do stretches for your plantar fascia, Achilles tendon, and calf muscles.
  • Take care of your diabetes!

Want to learn more about keeping your feet healthy with diabetes? Read “Tips for Healthy Feet With Diabetes,” “Caring for Your Feet When You Have Diabetes,” and “How to Choose Footwear.”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter,, and

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