Plantar heel pain

Plantar heel pain is a common foot problem, felt in the heel at the sole of the foot. Doctors call it plantar fasciopathy, and you may have heard the older name, plantar fasciitis.

You'll usually notice the pain most first thing in the morning, or when you take your first step after a spell of sitting or lying still. Symptoms tend to build up gradually and get worse over time.

The plantar fascia is a tough, flexible band of tissue that runs under the sole of your foot. It connects the heel bone to your toes and works as a shock absorber for the foot.

Sudden or repeated stress can make the plantar fascia thicken, and that is what causes plantar heel pain. The muscles around it and the heel bone can be involved too.

You're unlikely to need an x-ray or scan, unless your doctor wants to rule out another condition.

Doctors often call plantar heel pain a self limiting condition. That simply means it can get better by itself over time. There are also things you can do at home that may ease the pain and help you recover faster.

Stretching exercises for both your calf muscles and your plantar fascia should help ease the pain and make the affected foot more flexible.

While you recover from plantar heel pain, try to stay as active as you can. A little activity is better than none. Stay within acceptable pain limits, but remember you don't need to be pain free. Aim to do a little bit more each day, or every few days.

The guide below can help you see if you're pacing your daily activities at the right level as you build your movement up. It also shows how much pain or discomfort is acceptable.

It can help to rate your pain out of 10 (0 being no pain, 10 being the worst pain you've ever had), for example:

• 0 to 3: minimal pain
• 4 to 5: acceptable pain
• 6 to 10: excessive pain

Try to keep your pain within a rating of 0 to 5. If it goes above that level, you can change how much you are doing by:

• reducing the number of times you do a movement
• reducing the pace of an activity
• increasing rest time between activities

Being active shouldn't make your existing heel pain worse overall. If you do more than you have been doing, you may feel some extra discomfort while your body gets used to returning to your usual activity levels. This kind of pain should ease quickly, and you should be no worse the morning after.

Pain medicine can help you move more comfortably, and that in turn can help manage your symptoms. More about taking painkillers.

Using ice on your plantar heel pain can help reduce symptoms. Take care to protect your skin from a burn by putting a barrier, like a towel, between it and the ice. Never place heat or ice directly on your skin. Apply for no longer than 20 minutes at a time and leave a few hours between treatments.

Stop putting ice on the area if you notice the skin getting redder, changing colour or starting to blister.

Read more about burns and scalds

If you have any problem with circulation or sensation in your foot, don't use ice to treat plantar heel pain.

Try not to wear hard, flat-soled shoes that don't support your feet. They give your heel very little support, and that could make your plantar heel pain worse.

Choose shoes that fit you well and both support and cushion your feet. Running shoes are particularly useful.

Supportive devices, such as insoles, can be used if other treatments haven't worked. They can help some people with plantar heel pain, but not everyone benefits from them.

A healthcare professional can suggest which devices would suit you.

For a short-term alternative to insoles, you can have your heel strapped with sports strapping tape (zinc oxide). This helps relieve pressure on your heel. Some people have an allergic reaction to this tape, so if you know you are sensitive to it, or if you notice any skin reaction, stop using it immediately.

If painkillers aren't controlling the pain, your doctor may talk to you about a corticosteroid injection into your heel for plantar heel pain.

Corticosteroids are medicines that help reduce pain and inflammation. They may also be given together with a local anaesthetic.

The injections won't cure your condition. They're used to help with the symptoms.

With plantar heel pain, you may sometimes need to take some time off work so that you can recover. How long you stay off depends on your condition and on what your job involves.

You don't have to be free of symptoms before you think about going back. Carrying on at work, or returning as soon as you're able to, will help your recovery.

Getting back to your normal daily activities bit by bit can also build up your strength and stamina.

If you follow this advice for plantar heel pain, you should slowly get better over time.

Talk to a doctor if:

• your symptoms haven't improved within 12 weeks of following this advice
• your symptoms get worse

Find out about access to MSK services in your area.

With any health problem, look after your mental wellbeing too, because it can affect your recovery.

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