• Microtrauma to plantar fascia near its attachments leading to attempted repair and chronic inflammation
  • The most common cause of heel pain
  • May be associated with a calcaneal spur
  • No clear single etiology for pain
  • No single treatment
  • Common in runners and dancers



  • Calcaneodynia (heel pain)
  • “First step pain” in morning
  • Pain along plantar, medial aspect of heel
  • Pain may extend distally toward metatarsal heads
  • Pain worsens with dorsiflexion of toes


  • Conservative, nonsurgical is the mainstay of treatment, including:
  • Heel cord stretching regimen
  • Anti-inflammatory medications
  • Heel cushioning
  • Orthotic insert under longitudinal arch of foot if flat foot present
  • Corticosteroid injection (right)
  • Night splint tmaintain neutral position of ankle tprevent Achilles tendon shortenong overnight
  • Absolute rest – casting
  • Over 80% of patients respond tconservative management

Surgical therapy:

  • If nimprovement after 1 year of conservative treatment:
  • Excision of plantar heel spur,
  • if present
  • Release of plantar fascia