What does plantar fasciitis feel like?

A stabbing pain under the heel with the first steps out of bed, or after sitting a while. It eases after a few minutes of walking, then builds again by the end of a long day on your feet. The sore spot is on the bottom of the heel toward the inside. Walking barefoot on a hard floor makes it worse.

Burning, tingling or numbness across the sole is different. That points to the nerves, often from blood sugar. Our peripheral neuropathy page covers that, and we check for both at the exam.

Why is plantar fasciitis so stubborn?

The plantar fascia is a thick band that holds up the arch like the string of a bow. Each step pulls on the spot where it anchors to the heel. Over months, the fibers at that anchor fray and thicken. In a heel that has hurt for more than a few months, there is little true inflammation left. It is a worn tissue that keeps getting re-injured each morning when the first step stretches it cold.

The load comes from the way people live and work here. Ten-hour shifts on the concrete floors of distribution centers. Nursing shifts. Standing at a machine. Tight calves, a sudden jump in walking or running, and extra body weight all pull harder on the band. High blood sugar stiffens it, which is why heel pain is so common with diabetes.

Why did my heel cortisone shot stop working?

Cortisone quiets heel pain quickly, often for a few weeks or months. It does not repair the worn fibers. Steroid in the heel can also thin the fat pad that cushions the heel bone, and in some cases weaken the fascia itself. So the first shot works, the next does less, and you are back where you started with a thinner heel pad.

Does PRP work for plantar fasciitis?

The comparison with cortisone is well studied. A 2025 analysis of 24 randomized trials with 1,653 patients found PRP gave better pain relief than steroid at three and six months, and better foot function at three, six and twelve months. At one month the two were about even, which fits how each one works: steroid is fast, PRP builds.

A 2026 network analysis of 59 trials ranked six injection types for this condition. Several, PRP among them, beat placebo for long-term pain, and the authors ranked PRP second, behind botulinum toxin. We read the full set of options at your visit. For a worn fascia that needs to rebuild, PRP is the one aimed at the tissue rather than the pain signal.

A 2024 analysis of 21 trials found PRP relieved heel pain better than shockwave, steroid and placebo. Results depend on what goes into the syringe and where it lands. We prepare a concentrated platelet dose and guide the needle with ultrasound into the thickened part of the fascia, not the fat pad.

What has to change for the heel to stay healed?

The calf and the fascia work as one unit. Tight calves pull on the heel all day. Your plan stretches the calf and the fascia before the first step in the morning and builds strength in the small muscles of the foot. Slow heel raises on a step, with a towel rolled under the toes, load the fascia the way it needs to rebuild. Supportive shoes on hard floors, and no barefoot walking for a while, protect the repair.

We also check blood sugar and weight, because both change how hard the band is pulled and how fast it heals.

Is strength work better than stretching for the heel?

It is faster. A Danish trial took 48 people with plantar fasciitis confirmed on ultrasound and gave all of them shoe inserts. Half added daily stretching. The other half did slow, heavy heel raises every second day, standing on a step with a towel rolled under the toes. At three months the strength group scored 29 points better on a 100-point foot function scale. By six and twelve months the two groups had met. Strength got people there sooner; it did not take them somewhere stretching could not.

Dr. Padda has sat in a cold plunge to reverse a heart rhythm he set off in himself during a sauna experiment, wired to an EKG the whole time. He respects what cold does. It numbs nerve endings and narrows blood vessels for an hour or so. It does not lay down new collagen. Use the frozen water bottle for the evening ache, and use the heel raises for the heel.

What can I do at home for plantar fasciitis this week?

Before you stand up in the morning, pull your toes back toward your shin for 30 seconds, three times. Then stand and stretch the calf against a wall. Put on supportive shoes or sandals before your first steps, even to the bathroom. Roll the arch over a frozen water bottle after work. Swap a hard workout for a bike or a pool for a few weeks. Cut back on long walks on concrete when you can.

Give that a few weeks. If the heel is still bad after three to six months of honest effort, the fascia needs more than stretching, and that is the point to treat the tissue itself.

What happens on the day?

You are awake. We numb the heel with local anesthetic and guide the needle with ultrasound. There is no sedation, and most people drive themselves home, though the heel is sore for about 48 hours. You may use a walking boot or a supportive shoe for a few days. A second injection depends on how the first one does.

Hurt it on the job in Illinois? Illinois generally lets the injured worker choose the treating doctor. Our injured at work page explains how that works.

Does plantar fasciitis ever need surgery?

Rarely. When six to twelve months of good care have failed, a surgeon can cut part of the band to take tension off the heel. It helps some people, but the fascia holds up the arch, and releasing it changes how the foot carries load, sometimes moving the pain to the outside of the foot. That is why we treat the tissue first and coordinate with a foot surgeon only when the heel has earned it.

Which heel symptoms need to be seen sooner?

• Heel pain that started after a jump, a fall or a sudden jump in walking or running, with pain when you squeeze the sides of the heel bone. That can be a stress fracture.
• A pop at the back of the heel and trouble pushing off. A torn Achilles tendon needs a surgeon within days.
• Burning, tingling or numbness across the sole, or a sore on a diabetic foot that is not healing.
• A red, hot, swollen heel with fever. Go to the emergency room.

When it is an emergency has the full list.

Frequently asked questions

Do I need a referral to treat plantar fasciitis?

No. You can book a heel pain visit directly. Some insurance plans still want a referral from your primary doctor before they pay, so it is worth checking your plan first. Your first visit from Illinois lays out the day.

How long does plantar fasciitis last?

Many cases settle within a year with stretching and good shoes. When it has lasted longer than six months despite that, it is time to treat the tissue directly.

Do heel spurs cause plantar fasciitis?

Usually not. Many people have a spur on X-ray with no pain, and many people with plantar fasciitis have no spur. The pain comes from the fascia.

What shoes help plantar fasciitis?

Shoes with a firm heel counter, arch support and some cushion. Avoid flat sandals and walking barefoot on hard floors while the heel heals.

Do night splints help plantar fasciitis?

They can. A night splint holds the foot flexed so the fascia does not tighten overnight, which makes the first steps in the morning less painful. Some people find them hard to sleep in.

Is PRP for plantar fasciitis covered by insurance?

Most plans do not cover it. That is a budgeting decision about what the plan funds. HSA and FSA funds can generally be used.

Can I keep working on my feet after a heel PRP injection?

Plan a few lighter days. Most people return to standing work within a week in supportive shoes, with the rehab running alongside.

Related reading

• Peripheral neuropathy
• Patellar tendonitis
• Metabolic health and pain
• Injured at work
• Sleep, movement and chronic pain
• The orthobiologics hub: PRP, bone marrow and fat