Plantar fasciitis is irritation and swelling of the thick tissue on the bottom of the foot.

The plantar fascia is a very thick band of tissue that covers the bones on the bottom of the foot. This fascia can become inflamed and painful in some people, making walking more difficult.

Risk factors for plantar fasciitis include foot arch problems (both flat foot and high arches), obesity, sudden weight gain, running, and a tight Achilles tendon (the tendon connecting the calf muscles to the heel). A typical patient is an active man age 40-70.

This condition is one of the most common orthopedic complaints relating to the foot.

Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen commonly both in people with and without plantar fasciitis.

The most common complaint is pain in the bottom of the heel, usually worst in the morning and improving throughout the day. By the end of the day the pain may be replaced by a dull aching that improves with rest.

Typical physical exam findings include tenderness on the bottom of the heel, closer to the midline, and mild swelling and redness.

X-rays may be taken to rule out other problems, but the presence or absence of a heel spur is not significant.