# Plantar heel pain > Plantar heel pain is pain under the heel, often worst with your first steps in the morning or after rest. Self-care is the usual first step: easing back, stretching, supportive shoes and ice. If it isn't settling, a podiatrist, GP or physiotherapist can suggest other options. Guide in [Heel and arch pain](https://footanklelowerlimb.com.au/learn/topics/heel-and-arch-pain), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/plantar-heel-pain Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **It's pain under the heel,** often worst with your first steps in the morning or after rest. - **It's common,** and most often affects people aged 40 to 60. - **Self-care comes first:** easing back, stretching, supportive shoes and ice. - **Scans are usually not needed,** because your history and an examination normally give the answer. - **If it isn't settling,** a podiatrist, GP or physiotherapist can talk through next steps. ## What is plantar heel pain, and how common is it? Plantar heel pain is pain under the heel that comes on gradually and may spread into the arch of your foot [1]. It involves the plantar fascia (a strong band of tissue running from your heel to your toes) [2]. You may also hear it called plantar fasciitis or, in clinical terms, plantar fasciopathy. It's often wrongly described as an inflammatory condition [3]. It's very common: about 1 in 10 adults get it at some point [1]. It's most often seen between about 40 and 60 years of age, but it can happen at any age [2]. ## What causes it, and who gets it? The exact cause isn't clear, and it's likely to be a mix of things [1]. A common view is that small tears build up in the plantar fascia faster than your body can repair them, so it thickens and becomes sore [2]. Higher body weight, tight calf muscles or limited ankle movement, and long periods of standing or walking are the factors named most often [4]. It's common in runners but also affects people who aren't active [4]. The evidence behind each of these is slight [5], so they're clues rather than certainties. If your work or sport involves a lot of standing, walking or running, try building up gradually rather than suddenly. ## What does it feel like, and how is it diagnosed? The main sign is pain under the heel, often at one tender spot [6]. It's usually worst with your first steps after getting out of bed or after resting, and it usually eases after a few minutes of walking [6][7]. A podiatrist or doctor can usually diagnose it from your story and an examination [8]. Before an appointment, it helps to note when the pain is worst, exactly where it is, and what changed beforehand, such as activity, footwear or work. Sometimes the picture doesn't fit. Numbness or tingling in the foot can point to a nerve problem such as tarsal tunnel syndrome [9], and a stress injury of the heel bone or a nerve problem from the lower back can also feel similar [8]. If your pain seems atypical, a clinician can look for these causes. ## What helps first? Self-care is the first step, and you can start most of it yourself. Care recommended for everyone starts with understanding the problem, easing back on what aggravates it, pain relief, ice, stretching and better footwear [8]. - **Ease back.** Use pain as your guide. If your foot is sore, rest it, and avoid running or lots of walking and standing [6]. - **Stretch.** For recent-onset plantar fasciitis, starting with plantar fascia stretching improved pain and function more than shockwave therapy [8]. - **Choose supportive shoes.** Wide, comfortable shoes with a low heel and soft sole, with soft insoles or heel pads, can help [10]. - **Use ice.** Wrap an ice pack in a towel and place it on your heel for up to 20 minutes every 2 to 3 hours [10]. - **Ask about pain relief.** A pharmacist can advise on options such as paracetamol [10]. > [!tip] Try this > Before you get out of bed, sit up and cross your sore foot over the other knee. Gently pull your toes back towards your shin until you feel a stretch along your arch, and hold for a slow count. Repeat a few times. A podiatrist or physiotherapist can show you more stretches and exercises. Rehabilitation, advice and exercise together are considered the most effective way to manage it [11]. Exercise alone wasn't consistently helpful in the short term, but it did help pain and function over the long term [1]. Orthoses (shoe inserts) didn't work better than fake inserts or other simple care [12], so they aren't a must-have first step. ## What helps if that isn't enough? If home care isn't helping, a GP, podiatrist or physiotherapist can confirm the diagnosis and talk through options. Corticosteroid injections and shockwave therapy (sound waves through the skin) were ranked among the treatments most likely to help, but no commonly used treatment was shown to be better than the others [1]. Injections have only a modest effect, and can increase pain, thin the heel's fat pad, injure a nerve or rupture the plantar fascia [1]. They're not advised as an early step [13]. Shockwave therapy can be uncomfortable, and temporary pain, altered feeling, swelling and bruising can follow [14]. Orthoses mostly helped when combined with shockwave therapy [1]. Before agreeing to either, ask about the expected benefit, the risks and the alternatives. ## How long does it take to get better, and how can I stop it coming back? It isn't clear yet how long recovery usually takes, so give each step a fair go rather than expecting a quick change. In long-term follow-up, women and people with pain in both heels had a worse outlook [5]. Once the pain settles, it's sensible to keep up gentle stretching and supportive footwear, and to build activity back up gradually. Whether these stop the pain coming back isn't clear yet. If you're not improving, go back to your GP, podiatrist or physiotherapist rather than waiting it out. ## When to see a podiatrist Go to the nearest emergency department if your foot or ankle is badly out of shape after an injury [9]. See your GP or a podiatrist the same day if: - you have severe pain after an injury, a snap, grinding or popping noise, difficulty moving your ankle or foot, or you can't put weight on it, as these can mean a broken bone or a torn Achilles tendon [9]; - you feel a sudden pain in your calf or heel while exercising [7]; - you have diabetes and a wound, sore, blister or colour change on your foot; - you notice spreading redness, heat, swelling or pus in your foot; - you have sudden severe pain or numbness in a leg or foot. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. See your GP soon if your pain wakes or keeps you up at night, or you have a fever, night sweats or weight loss with it [15]. See a podiatrist or your GP if: - your heel pain hasn't improved after 2 weeks of home care, keeps coming back, is getting worse, or has lasted over three months [10][15]; - you notice numbness or tingling, a change in the shape of your foot, weakness or frequent tripping, or a skin rash, discolouration or ulceration [15]; - the pain seems out of proportion, or isn't responding to usual treatment [8]; - you have diabetes and heel pain, because foot problems can be more serious [10]. ## Common questions ### Is a heel spur the cause of my heel pain? Probably not. A heel spur is a small point of extra bone on the heel bone. People with heel pain are more likely to have one on an X-ray, but spurs are unlikely to be the cause, and many people have a spur without any symptoms. In long-term follow-up, having a spur didn't make the outlook worse. ### Do I need an X-ray or ultrasound for heel pain? Usually not. Plantar heel pain is normally diagnosed from your history and an examination. An ultrasound can help confirm it, and an X-ray can help rule out other causes, particularly after an injury or if the pain isn't responding to treatment. An MRI is kept for heel pain that isn't responding to standard treatment, because it adds cost without helping when the picture is already clear. ### Does losing weight help heel pain? Higher body weight is a commonly reported risk factor for heel pain, and health service advice includes losing weight if you're overweight. Whether it prevents or eases heel pain isn't clear yet. A health professional can advise on a gradual approach that suits you. ## Further reading - [Plantar heel pain on Clindice](https://clindice.com/plantar-heel-pain-podiatry) - [Plantar Heel Pain - NHS Lanarkshire](https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/plantar-heel-pain/), NHS - [Plantar fasciitis: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/007021.htm), MedlinePlus - [A Patient's guide to Inferior Heel Pain :: Royal National Orthopaedic Hospital](https://www.rnoh.nhs.uk/patients-and-visitors/patient-information-guides/inferior-heel-pain), NHS - [Plantar fasciitis](https://www.nhs.uk/conditions/plantar-fasciitis/), NHS - [Plantar fasciitis – Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH)](https://www.rdash.nhs.uk/services/podiatry-foot-protection/musculoskeletal-foot-care/plantar-fasciitis/), NHS ## Sources 1. Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis · Babatunde OO, Legha A, Littlewood C et al. · British Journal of Sports Medicine · 2019. https://doi.org/10.1136/bjsports-2017-098998 2. Plantar Heel Pain · NHS Lanarkshire · 2022. https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/plantar-heel-pain/ 3. Plantar fasciopathy: a comprehensive, evidence-based guide for diagnosis and treatment · Tedeschi R · The Journal of Sports Medicine and Physical Fitness · 2026. https://doi.org/10.23736/s0022-4707.25.16993-4 4. Plantar Fasciitis · Trojian T, Tucker AK · American Family Physician · 2019. https://pubmed.ncbi.nlm.nih.gov/31194492/ 5. Long-Term Prognosis of Plantar Fasciitis: A 5- to 15-Year Follow-up Study of 174 Patients With Ultrasound Examination · Hansen L, Krogh TP, Ellingsen T et al. · Orthopaedic Journal of Sports Medicine · 2018. https://doi.org/10.1177/2325967118757983 6. Plantar fasciitis · Rotherham Doncaster and South Humber NHS Foundation Trust. https://www.rdash.nhs.uk/services/podiatry-foot-protection/musculoskeletal-foot-care/plantar-fasciitis/ 7. Heel pain · Healthdirect Australia · 2024. https://www.healthdirect.gov.au/heel-pain 8. Consensus statements and guideline for the diagnosis and management of plantar fasciitis in Singapore · Tan VAK, Tan CC, Yeo NEM et al. · Annals of the Academy of Medicine, Singapore · 2024. https://doi.org/10.47102/annals-acadmedsg.2023211 9. Heel pain · nidirect · 2018. https://www.nidirect.gov.uk/conditions/heel-pain 10. Heel pain · NHS. https://www.nhs.uk/symptoms/foot-pain/heel-pain/ 11. Plantar Fasciitis · Norfolk & Waveney Community Musculoskeletal Services (NoW MSK). https://norfolkandwaveneycommunityhealth.nhs.uk/msk/self-help/foot-and-ankle/plantar-fasciitis/ 12. Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis · Rasenberg N, Riel H, Rathleff MS et al. · British Journal of Sports Medicine · 2018. https://doi.org/10.1136/bjsports-2017-097892 13. Plantar heel · NHS. https://www.rightdecisions.scot.nhs.uk/ggc-msk-foot-and-ankle/rearfoot/plantar-heel/ 14. Complications of extracorporeal shockwave therapy in plantar fasciitis: Systematic review · Roerdink RL, Dietvorst M, van der Zwaard B et al. · International Journal of Surgery (London, England) · 2017. https://doi.org/10.1016/j.ijsu.2017.08.587 15. Foot and ankle · Hampshire and Isle of Wight Healthcare NHS Foundation Trust. https://hiowhealthcare.nhs.uk/msk/self-help/foot-ankle --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.