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Heel pain is a common complaint that has many causes. One cause of heel pain is inflammation of the tissue on the bottom of the foot. This is called plantar fasciitis.
The plantar (foot) fascia (connective tissue) stretches under the skin across the arch of the foot from the heel to the base of the toes. When this tissue is torn, overused, or stretched, it can become inflamed (fasciitis). Soreness, tenderness, and pain result.
Some causes of plantar fasciitis are standing too long, being overweight, having arches that are either too flat or too high, or wearing nonsupportive hard-soled shoes. Although many people with plantar fasciitis have heel spurs (outgrowths of bone in the heel), spurs are not the cause of plantar fasciitis. This Patient Page is based on one previously published in the September 17, 2003, issue of JAMA.
Heel pain, especially in the early morning or after a period of rest
Increasing pain with standing
Pain in the heel after exercising
Arch supports or heel pads (sometimes called orthotics) to be worn in shoes
Stretching the calf muscles and Achilles tendon (see illustration)
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
Reducing excess body weight
Corticosteroid injections may be used in select cases.
Surgery may be helpful if other treatments are not successful.
It is important to understand that all heel pain is not from plantar fasciitis. Other medical problems can cause foot and heel pain. Diabetes and blood vessel disease, both serious medical problems, can cause heel pain. Arthritis, traumatic injury and bruising, gout, stress fractures (caused by repeated stress on bone), and other diseases can also cause heel pain. Rarely, tumors (either benign or cancerous) or infections can cause heel pain. If you develop persistent heel pain, see your doctor for an evaluation.
American Academy of Physical Medicine and Rehabilitation www.aapmr.org
American Academy of Orthopaedic Surgeons www.aaos.org
American College of Foot and Ankle Surgeons www.acfas.org
American Podiatric Medical Association www.apma.org
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA 's Web site at www.jama.com. Many are available in English and Spanish.
Sources: American Academy of Orthopaedic Surgeons, American College of Foot and Ankle Surgeons, American Podiatric Medical Association
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
This article was corrected for an error on December 20, 2011.
Torpy JM, Lynm C, Golub RM. Plantar Fasciitis. JAMA. 2011;306(17):1940. doi:10.1001/jama.306.17.1940
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