What is plantar fasciitis (plantar fasciopathy)?
The plantar fascia is a strong band of tissue linking the heel to the front of the foot. It supports the arch and cushions every step. When it is loaded beyond what it tolerates, its attachment under the heel becomes painful: this is plantar fasciitis.
Heel pain in the morning: how to recognise it
According to the NHS, plantar fasciitis is more likely if:
- the pain, under the heel and arch, is much worse with the first steps after sleeping or resting;
- it gradually eases as you move around, then gets worse after standing, walking or running for a long time;
- stretching the sole of your foot hurts, for example when you raise your toes or walk up stairs.
Pain at the back of the heel, above the shoe, points rather to the Achilles tendon, which is a different situation.
Heel spur: should you worry?
A heel spur is a small spur-shaped bony growth under the heel bone. It shows up on an X-ray.
Plantar fasciitis is diagnosed first from your symptoms and a clinical examination; if you have had an X-ray, discuss the result with your doctor. The load on the foot often deserves more attention than the image.
Why the heel becomes painful
Plantar fasciitis comes from straining the plantar fascia, and it is not always clear why this happens. According to the Swiss League against Rheumatism and the NHS, several factors can contribute:
- a tight calf or heel;
- shoes with poor cushioning or support;
- a lot of standing, walking or running, or a recent increase in these;
- weight gain, which increases the load on the foot.
The NHS also notes that it is more common between 40 and 60. Heel pain is not just a runner's problem.
Warning signs: when to seek care without waiting
The vast majority of heel pain is benign. The following signs, however, call for a prompt or urgent medical opinion:
Seek care immediately (emergency department) if you have:
- a swollen, warm, painful calf, especially on one side (possible blood clot in a vein);
- sudden pain at the back of the heel with a feeling of a kick or snap, and difficulty walking (possible Achilles tendon rupture);
- a red, hot, swollen foot or heel with fever;
- a fall or injury after which you cannot bear weight.
See your doctor promptly if:
- tingling, burning or numbness appears under the foot;
- the pain is present at rest and at night;
- other joints are swollen or stiff;
- you have diabetes and a wound or redness on the foot.
In the vast majority of cases, none of these signs is present.
What to do day to day
For heel spurs and sole pain, the Swiss League against Rheumatism lists better shoes, orthopaedic insoles if needed, stretching and strengthening of the plantar fascia and the foot and calf muscles, then, depending on the case, a corticosteroid injection or shockwave therapy. The NHS suggests similar steps: shoes with cushioned heels and good arch support, insoles or heel pads, regular gentle stretches, activities that do not load the feet such as swimming, and avoiding long periods of standing or walking barefoot on hard floors.
In practice:
- Before getting up, move your ankle and toes a few times.
- Choose well-cushioned shoes, including at home, rather than walking barefoot on hard floors.
- Stretch regularly your calf and the sole of your foot, without pushing into pain.
- Dose the load: temporarily cut back long walks or running, then build up gradually.
What does the research say?
The Swiss League against Rheumatism and the NHS put simple measures first: suitable shoes, insoles if needed, stretches and exercises guided by a physiotherapist. Injections and shockwave therapy come next and should be discussed with your doctor. For alternatives to cortisone, read Tendinopathy without cortisone.
The first consultation lasts 1.5 to 2 hours (CHF 182). Bring your medical file, your test results (X-ray, ultrasound, reports) and a list of your medications. We review your situation and build your plan together. Follow-up is then adapted to your progress. We work alongside your GP and the other professionals caring for you, including your physiotherapist or podiatrist.
Which approaches may have a place at Centre Algos?
Depending on your situation, several approaches can be combined, alongside your medical care:
- Naturopathy: sleep, diet, stress management and metabolic balance, to work on the lifestyle habits that can influence pain.
- Cupping: applied to the calf, it can help release muscle tension.
- Percutaneous hydrotomy: subcutaneous micro-injections; it may be considered when the situation is suitable, after assessment, once warning signs have been ruled out and in agreement with your medical care. Price on quotation, set at the first consultation according to your situation.
Everyone responds differently: the aim is to regain comfort when walking day to day, without promising a result.
When to seek care
What is happening in your case
This text describes general mechanisms. What keeps your heel pain going, in your particular situation, deserves a real conversation rather than a generic answer.
A question before you decide? Book a free 10-minute call to see whether our approach suits you.
