Plantar Fasciitis: If You Have It, Do Not Leave It Untreated—Seek Treatment Before Chronic Foot Pain Develops

SONGWUT THITIBOONSUWAN,M.D.

Good foot health is an essential foundation of daily life, because every step begins with the feet. However, when pain occurs in the heel or sole of the foot, even slightly, it can unexpectedly affect walking, work, and quality of life each day.

Plantar fasciitis is one of the common causes of foot pain, especially among working-age individuals, those who stand for long periods, walk a lot, exercise heavily, or are overweight. However, many patients tend to overlook the early symptoms, thinking it is only general soreness, resulting in not receiving proper care from the beginning, until the condition progresses into chronic foot pain, which takes a long time to treat and affects long-term living.

Key Takeaways

Plantar fasciitis is caused by inflammation or degeneration of the plantar fascia from repetitive use over a long period, resulting in cumulative injury even without severe trauma.
Symptoms of plantar fasciitis may vary in each individual, but the most common characteristic is heel pain in the first step after waking up or after prolonged sitting. The pain usually improves after walking for a while, but will return again if standing or walking for a long time.
In most cases, plantar fasciitis can be treated without surgery if properly managed from the early stage. The key to treatment is behavior modification, reducing excessive foot use, choosing appropriate footwear, and regularly stretching and strengthening the plantar fascia.
Paying attention to symptoms from the early stage and starting proper care will help reduce the risk of chronic foot pain and help return to normal mobility again.

What Causes Plantar Fasciitis? Understanding the Causes That Lead to Plantar Fasciitis

Plantar fasciitis is caused by repeated injury of the plantar fascia, which is an important structure that supports the arch of the foot and helps distribute body weight while standing, walking, and running. When this ligament is subjected to excessive impact or tension over a long period, inflammation or degeneration will follow.

When the plantar fascia cannot maintain normal elasticity and strength, the weight distribution system between the ligament and foot bones becomes imbalanced, resulting in pain in the heel and sole of the foot, especially when bearing weight. Symptoms of plantar fasciitis usually gradually increase over time, not occurring suddenly.

If not properly diagnosed and treated from the early stage, accumulated inflammation may develop into chronic pain, making walking difficult, inability to stand for long periods, and affecting work and daily life in the long term.

Do You Have These Symptoms…? You May Be at Risk of Plantar Fasciitis!

Patients with plantar fasciitis may have different symptoms depending on severity and stage of the condition. Some may have intermittent pain in the early stage, while others may have continuous pain that interferes with daily life. Common symptoms that should be observed include:

Heel or sole pain in the first step after waking up or after prolonged sitting, and the symptoms gradually improve after walking for a while.
Pain becomes more severe when standing or walking for a long time, especially at the end of the day.
Pain in the heel or sole resembling being pricked by a needle or a sharp object.
A burning sensation in the heel or sole.
Some cases may have numbness if there is compression of nearby nerves.

In general, the external appearance of the foot in patients with plantar fasciitis usually does not show clear swelling, redness, or heat like infection-related inflammation, but a clear tender point can be found under the inner side of the heel, which is an important location that helps physicians diagnose the condition.

If you have these symptoms continuously for several weeks, do not ignore them, because receiving treatment from the early stage will help reduce the chance of chronic foot pain and help you return to walking with confidence faster.

Who Is at Risk of Plantar Fasciitis?

Plantar fasciitis is a condition caused by repeated injury of the plantar fascia over a long period. The main contributing factor is excessive or improper foot use, causing the plantar fascia to receive continuous tension and impact. Therefore, this condition is commonly found in the following risk groups:

Risk groups from behavior and foot use

Elderly individuals, as the plantar fascia degenerates and loses elasticity with age.
People whose work requires standing or walking for long periods, such as sales staff, medical personnel, or general laborers, causing continuous tension in the plantar fascia.
People who are overweight or obese, as the plantar fascia receives more impact and pressure than normal.
People who regularly wear hard-soled, thin-soled, or high-heeled shoes, which lack proper shock absorption.

Risk factors from structure and physical condition

In addition to usage behavior, physical abnormalities of the feet and legs also play an important role in plantar fasciitis, including:

Abnormal foot structure, such as excessively flat arches or excessively high arches, causing imbalanced weight distribution.
Tight or shortened Achilles tendon, resulting in increased tension on the plantar fascia.
Heel spur, which may be found together with plantar fasciitis and increases pain when bearing weight.

If you are in these risk groups, adjusting behavior, choosing appropriate footwear, and regularly taking care of foot health will help reduce the chance of plantar fasciitis and prevent progression into chronic foot pain.

Treatment Approaches for Plantar Fasciitis

Treatment of plantar fasciitis is mainly non-surgical, as many patients can improve if properly and continuously managed. Common treatment approaches include:

Medication to reduce pain and inflammation. In the early stage, non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce pain and inflammation. In cases of severe pain or no response to initial treatment, physicians may consider local steroid injection to relieve pain in the short term. However, steroid injection must be used cautiously and should not be done frequently, as it may cause thinning of the fat pad under the foot and tendon rupture.
Use of orthotic devices. The use of insoles or arch supports helps distribute weight and reduce tension on the plantar fascia, reducing pain while standing or walking and helping prevent recurrence.
Exercise and stretching. Regular exercise is the key to treatment, including stretching the plantar fascia, stretching calf muscles and the Achilles tendon, and strengthening foot muscles, which helps increase flexibility, reduce tension, and improve symptoms in the long term.
Physical therapy modalities. Extracorporeal Shock Wave Therapy (ESWT) helps stimulate tissue repair, reduce pain, and is suitable for patients with chronic symptoms or those who do not improve with basic treatment.

In general, if patients receive appropriate treatment and adjust foot usage behavior, heel pain from plantar fasciitis will gradually improve, reducing the chance of chronic foot pain.

In cases where complete non-surgical treatment does not improve symptoms, physicians may consider surgery, which is rare and used only in certain patients.

Prevention of Plantar Fasciitis That You Can Do Yourself

Plantar fasciitis, if it occurs, may make every step painful and affect work and daily life in the long term. The good news is that this condition can be prevented if the plantar fascia is properly cared for early with simple methods as follows:

Reduce activities that require prolonged standing or walking. If unavoidable, take breaks periodically to reduce tension and cumulative injury of the plantar fascia.
Choose footwear suitable for foot structure. Select shoes that support the arch and absorb impact well. Avoid overly flat or thin-soled shoes, and reduce wearing high heels and walking barefoot for long periods.
Avoid heavy foot use without preparation. Before exercise or sports that heavily use the feet, always warm up and stretch calf muscles, the Achilles tendon, and the plantar fascia to reduce the risk of injury.
Maintain appropriate body weight. Excess body weight increases pressure and impact on the plantar fascia directly. Weight management helps effectively reduce the chance of plantar fasciitis.

Consistently making these small behavioral adjustments will help prevent injury to the plantar fascia, reduce the risk of plantar fasciitis, and help you walk confidently every day.

Plantar Fasciitis May Not Be a Minor Issue—Pay Attention and Take Care Before Chronic Pain Develops

Intermittent heel pain is not a minor issue and should not be ignored. If left untreated for a long time without proper care, plantar fasciitis may develop into chronic pain, making walking difficult, inability to stand for long periods, and requiring longer treatment time compared to early care.

If you begin to have symptoms consistent with plantar fasciitis, it is recommended to see a physician promptly to determine the cause and plan appropriate treatment, because the earlier the treatment begins, the higher the chance of recovery and return to normal life.

At the Orthopedic Center, Praram 9 Hospital, we are fully equipped with specialized orthopedic physicians, standardized diagnostic tools, and treatment approaches based on current medical principles to ensure patients receive precise and effective care.

In addition, we emphasize physical therapy and foot rehabilitation to help patients return to walking confidently, reduce the chance of recurrence, and achieve good quality of life in the long term.

Do not let heel pain disturb every step. Paying attention and receiving proper treatment from today is the key to sustainable pain relief.

For more information

Facebook: Praram 9 Hospital International & Expats
Line: @Praram9Hospital
Tel. 1270

Frequently Asked Questions About Plantar Fasciitis

1. What are the complications of plantar fasciitis?

When plantar fasciitis occurs, the plantar fascia becomes inflamed or degenerates, causing patients to feel pain in the heel, especially when bearing weight. In the early stage, patients often unconsciously adjust their walking posture to avoid pain, and this small change becomes the starting point of problems in other joints of the body when avoiding weight-bearing on the heel.

Patients often place more weight on the side of the foot or the forefoot.
Step length becomes shorter, and walking rhythm deviates from normal.
This walking pattern causes imbalance in body movement mechanics (biomechanics) and transfers abnormal forces to other joints as follows:

Effects on joints and muscles in different parts

Ankle: Misaligned weight-bearing causes the ligaments around the ankle to work harder, which may lead to ligament inflammation, ankle instability, or ankle pain.
Knee: When force from the foot is not transmitted evenly, it increases pressure on the knee joint, especially on the inner or outer side, causing knee pain or inflammation of the ligaments around the knee.
Hip: Prolonged abnormal walking posture causes the muscles around the hip to compensate for movement, resulting in tightness or hip pain, especially on the lateral side of the hip.
Lower back: When body weight distribution is imbalanced, the alignment of the pelvis and spine may change, causing lower back pain.

If plantar fasciitis is left untreated, it may lead to chronic pain and long-term complications, making treatment more complex and requiring longer recovery time compared to early management.

2. How can plantar fasciitis be treated by oneself?

In the early stage or in cases where symptoms are not severe, patients can relieve plantar fasciitis symptoms by themselves by choosing cold or hot compress appropriately according to the stage of symptoms. Cold compress is suitable when there is significant pain or inflammation, such as after standing or walking for a long time, as it helps reduce inflammation and pain signals. Hot compress is suitable when there is no swelling but there is tightness or stiffness in the sole of the foot and calf muscles, helping increase blood circulation and relax tissue tension. In addition, regular stretching of the plantar muscles and calf muscles, reducing activities that require prolonged standing or walking, and using heel pads or shoes with soft soles and good shock absorption all help reduce tension on the plantar fascia and relieve pain. However, if symptoms do not improve within 2–4 weeks or pain becomes more severe, a physician should be consulted for evaluation and appropriate treatment planning to prevent chronic foot pain in the long term.

References

Mayo Clinic Staff. (2023, September 7). Plantar fasciitis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846

Larson, J. (2024, November 14). What to Know About Plantar Fasciitis. Healthline. https://www.healthline.com/health/plantar-fasciitis

Buchanan BK, Sina RE, Kushner D. Plantar Fasciitis. [Updated 2024 Jan 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431073/

Plantar fasciitis. (n.d.). Healthdirect. https://www.healthdirect.gov.au/plantar-fasciitis

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