Signs and Symptoms

It is not unusual for a patient to go months, if not years before seeking medical attention [5]. Patients usually cannot recall a traumatic event preceding their initial heel pain. The pain is usually sharp, ranging from mild to debilitating, and localized to the inside heel with occasional tenderness through the arch. Classically, the pain is most intense with the first few steps after prolonged periods of rest (medical term: post-static dyskinesia), most notably when getting out of bed in the morning. Why? Rest permits the heel to heal as no stress is placed on the plantar fascia. When standing up, the arch flattens, suddenly separating the plantar fascia from the calcaneus and destroying whatever healing took place. Because some healing did occur, it hurts more as the newly formed fibers are torn from the heel. The pain tends to slowly settle with activity. In more severe cases, the pain will only subside with rest.

Symptoms may be exacerbated by a nerve around the heel becoming trapped due to the inflammatory process and/or resulting scar tissue. When this occurs, patients generally experience a more intense pain that is burning and tingling in nature that may radiate into the arch or the ankle.