Heel and Foot Pain including Plantar Fasciitis


Heel and foot pain are very common. The most common cause is plantar fasciitis which causes a pain under the heel. It usually goes away with time but various treatments may help.

Heel and foot pain are very common

Heel and foot pain are very common

Spare a thought for your feet - they have to bear the weight of your whole body. There are many bones in each foot (see the images below) and these can briefly be divided into three parts:

  • Forefoot: made up of the toes (phalanges) and the five long bones (metatarsals). These are named from first to fifth. The first metatarsal bone is the largest and is the bone that joins to your big toe. Each toe has three phalanges, except the big toe which has only two. This means there are three joints in the toes (two in the big toe).
  • Hindfoot: the ankle joint and the tarsal bones, including the biggest, the heel bone (calcaneum).

What is the Achilles tendon?

Your Achilles tendon is an important part of your leg. It is found just behind and above your heel. It joins your heel bone (calcaneum) to your calf muscles. The function of your Achilles tendon is to help in bending your foot downwards at the ankle, as iyou do when you're pointing your toes. (This movement is called plantar flexion.)

Foot - Achilles Tendon

What is the plantar fascia?


There are also many other tendons, as well as muscles and ligaments, within your foot. The bones, ligaments and tendons within your foot form the foot arches. These arches are called the longitudinal and transverse arches. It is your foot arches that allow your foot to hold up the weight of your body. Nerves provide sensation to the skin of your foot.

What causes foot pain?

Dr Sarah Jarvis MBE

Do you have painful feet? You're not alone - plantar fasciitis is a really common cause of pain under the heel (calcaneum). While plantar fasciitis is one of the most common causes of heel and foot pain, it is not the only reason:

Common causes of heel and foot pain

There are also many conditions that can cause problems elsewhere in the body, as well as in the feet - for example:

Flat feet can cause pain anywhere in the foot

Flat feet can cause pain anywhere in the foot

The rest of this leaflet is about plantar fasciitis.

What is heel pain?

Dr Sarah Jarvis MBE

Plantar fasciitis means inflammation of your plantar fascia. 

It is a condition that affects around one in ten people at some point in their lives. It's also known as 'jogger's heel' - although you don't have to be a runner to develop it. Luckily, it usually gets better in time, but treatment may speed up your recovery. So, what can you do about it? Useful treatment includes rest, good footwear, heel pads, painkillers and exercises. A steroid injection or other treatments may be used in more severe cases.


What makes it likely for someone to develop plantar fasciitis?


  • If you are on your feet for a lot of the time, or if you do lots of walking, running, standing, etc, when you are not used to it or have previously had a more sedentary lifestyle.
  • If there is overuse or sudden stretching of your sole. For example - athletes who increase running intensity or distance; poor technique starting 'off the blocks', etc.
  • If you have a tight Achilles tendon (the big tendon at the bottom of your calf muscles above your heel). This can affect your ability to flex your ankle and may make you more likely to damage your plantar fascia.

Plantar fasciitis may be confused with 'policeman's heel' but they are different. Policeman's heel is called plantar calcaneal bursitis - inflammation of the sack of fluid (bursa) under the heel bone (calcaneum). This is not as common as plantar fasciitis.

Often there is no apparent cause for plantar fasciitis, particularly in older people. A common wrong belief is that the pain is due to a bony growth, or 'spur', coming from the heel bone. Many people have a bony spur of the heel bone but not everyone with this develops plantar fasciitis.

Plantar fasciitis is common. Around 1 in 10 people will develop plantar fasciitis at some time in their lives. It is most common in people between the ages of 40 to 60 years. However, it can occur at any age. It is twice as common in women as it is in men. It is also common in athletes.

Pain is the main symptom and this can be anywhere on the underside of your heel. However, commonly, one particular area is found as the main source of pain. 

Where is the plantar fascia?

Heel - plantar fascia

This diagram shows the position of the plantar fascia in relation to the bones in the foot. Inflammation of this band of tissue causes the symptoms of plantar fasciitis. ('-itis' is the medical term for inflammation).

What symptoms does inflammation of the plantar fascia cause?

Pain is the main symptom. You can imagine how the inflamed plantar fascia can hurt when you put pressure on the foot while walking. This pain can be anywhere on the underside of your heel. However, commonly, one spot is found as the main source of pain. This is often about 4 cm forward from your heel and may be tender to touch.

The pain is often worst when you take your first steps on getting up in the morning, or after long periods of rest where no weight is placed on your foot. Often, it's described as a stabbing or aching pain. Gentle exercise may ease things a little as the day goes by. However, a long walk or being on your feet for a long time often makes the pain worse. Resting your foot usually eases the pain - this can be very frustrating for people who are trying to improve their fitness levels by taking up running!



Usually, the pain will ease in time. 'Fascia' tissue, like 'ligament' tissue, heals quite slowly. It may take several months or more to go. However, there is a variety of treatments that may help to speed recovery. A combination of different treatments may help. These vary from rest and simple exercises (most common) to surgery (rare).

Collectively, these initial treatments are known as 'conservative' treatments for plantar fasciitis:

Rest your foot




Heel pads and arch supports


Pain relief





Watch our physiotherapist taking you through all the exercises for plantar fasciitis in our video.

Exercises (done with or without shoes on) to help treat plantar fasciitis

Choosing the correct footwear can help to reduce pain

Choosing the correct footwear can help to reduce pain





Plantar Fasciitis Management Options

Each treatment option for Plantar Fasciitis has various benefits, risks and consequences. In collaboration with health.org.uk, we've put together a summary decision aid that encourages patients and doctors to discuss and assess what's available.


Steroid injections


Extracorporeal shock-wave therapy

In extracorporeal shock-wave therapy, a machine is used to deliver high-energy sound waves through your skin to the painful area on your foot. It is not known exactly how it works but it is thought that it might stimulate healing of your plantar fascia. One or more sessions of treatment may be needed.



Other possible treatments






  • Regularly changing training shoes used for running or walking.
  • Losing weight if you are overweight.
  • Avoiding exercising on hard surfaces.

Are you protected against flu?


Check now

Further reading and references