Plantar fasciitis
A very common cause of heel pain, particularly with the first steps of the day, that usually responds well to treatment
Plantar fasciitis is one of the most common causes of heel pain. It involves the plantar fascia, the band of tissue that runs along the sole of the foot, becoming painful where it attaches to the heel. It is often most noticeable with the first steps in the morning. While it can be persistent, it usually responds well to the right approach.
Written for patients and reviewed by Dr Liubov Borukhson, Consultant Rheumatologist (GMC 7021928). Last clinically reviewed: June 2026.
Common symptoms
Plantar fasciitis has a fairly typical pattern. Features may include:
- Pain under the heel, often sharp with the first steps in the morning or after sitting
- Pain that eases as you get moving but can return after long periods on your feet
- Tenderness when pressing the underside of the heel
How it is diagnosed
Plantar fasciitis can usually be recognised from the history and examination. It is worth confirming the diagnosis, as other conditions can also cause heel pain and are managed differently.
Ultrasound can help by showing thickening or changes in the plantar fascia and excluding other causes. Dr Borukhson uses point-of-care ultrasound during the consultation, so the heel can often be assessed in the same visit. You can read more on the ultrasound clinic page.
How it is treated
Treatment usually begins with simple measures such as stretching, supportive footwear, and reducing the activities that aggravate it, alongside pain relief. These help most people. Where symptoms persist, an ultrasound-guided injection may be considered, with ultrasound guidance allowing accurate placement. The plan is agreed with you.
Why assessment helps
Heel pain that is not settling is worth assessing to confirm the cause and put in place an effective plan, rather than letting it become long-standing. If you have persistent heel pain, a specialist review, with ultrasound where helpful, can clarify it.
Common questions
Will plantar fasciitis go away on its own?
For many people heel pain from plantar fasciitis does settle over time, especially with simple measures such as stretching, supportive footwear and easing off the activities that aggravate it. It can be slow to improve and sometimes persists, which is why a clear plan helps rather than simply waiting. If the pain is not settling, a specialist review can confirm the cause and put effective treatment in place before it becomes long-standing.
How is plantar fasciitis diagnosed?
Plantar fasciitis can usually be recognised from your history and an examination of the heel, without the need for scans in most cases. Where it is helpful, ultrasound can show thickening or changes in the plantar fascia and rule out other causes of heel pain. Dr Borukhson uses point-of-care ultrasound during the consultation, so the heel can often be assessed in the same visit.
Why does my heel hurt most with the first steps in the morning?
This first-step pain is one of the most typical features of plantar fasciitis. The plantar fascia tightens while you rest, so the first steps after waking or after sitting can feel sharp before easing as you get moving. Pain that follows this pattern is a useful clue, though it is still worth confirming the diagnosis, as other conditions can cause heel pain and are managed differently.
Do I need surgery for plantar fasciitis?
Surgery is rarely needed for plantar fasciitis. Most people improve with simple measures such as stretching, supportive footwear, activity changes and pain relief, and where symptoms persist an ultrasound-guided injection may be considered, with the ultrasound allowing accurate placement. The right plan is agreed with you, and a specialist assessment helps match the treatment to your particular case.
Persistent heel pain?
A specialist assessment, with ultrasound where helpful, can confirm plantar fasciitis and agree a plan to settle the pain
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