Plantar fasciitis — diagnosis & symptoms

How do I know if I have plantar fasciitis?

You cannot diagnose yourself from a webpage — but the pattern is often recognisable. Typical plantar fasciitis causes pain, stiffness, and tenderness under the heel or along the arch, often worst with the first few steps after rest. Pain at the back of the heel that worsens with uphill walking or pushing off fits better with Achilles problems. If the pattern sounds familiar, start the foundation work in

while arranging a review if anything feels atypical.

What are the typical symptoms?

Common features include pain under the heel, stiffness after sitting or sleeping, and tenderness when you press the inside front of the heel bone. Pain often begins gradually, though it can sometimes appear quite suddenly after a change in activity, shoes, or weight. Swelling is usually mild compared with an acute injury.

Why is the first step in the morning so painful?

This is a classic sign. Overnight, the plantar fascia and calf can shorten and stiffen. The first few steps stretch tissues that have been off load, which causes a sharp pain that often eases as you get moving. A slow toe stretch before standing and supportive shoes from the first step often help — see our

.

Where exactly does plantar fasciitis hurt?

The sore spot is usually on the underside of the heel, where the plantar fascia attaches to the heel bone — not at the back of the ankle. Some people also feel pain along the arch. Achilles tendinopathy tends to hurt at the back of the heel or lower calf, especially when loading the tendon. Your clinician will check where you are most tender.

How is plantar fasciitis diagnosed?

In most cases, diagnosis is clinical: your doctor or physiotherapist asks about your symptoms, examines where you are tender, and may watch you walk. If the story is typical and tenderness is in the usual place, plantar fasciitis can be diagnosed confidently in over 90% of cases without any scans. Imaging is usually reserved when the diagnosis is unclear or not improving as expected.

Do I need an ultrasound or MRI?

Usually not at first. Ultrasound is quick, inexpensive, and very good at showing plantar fascia thickening — it is the preferred first scan when imaging is needed. MRI is helpful when something else might be going on, such as a stress fracture, fascia rupture, nerve compression, or unusual swelling. If your pain is typical and you are following the basics, a scan seldom changes the first steps of treatment.

What else could cause my heel pain?

Problems affecting bone, nerve, joint, or tendon can all produce heel pain. The most common cause by far is plantar fasciitis. Less common possibilities include a calcaneal stress fracture, fat-pad bruising, tarsal tunnel syndrome, or Achilles tendinopathy at the insertion. If you are not improving, it is much more likely that load or stretching has not been adjusted enough than that you have a rare alternative diagnosis — but persistent or atypical pain deserves a proper review.

When should I get checked urgently?

Arrange urgent or routine medical review — whichever your situation warrants — if you have severe pain after an injury, cannot put weight through the foot, marked swelling or redness, fever, numbness, or symptoms that do not fit a simple plantar heel pain story. Also seek help if pain is worsening despite sensible self-care, or if you have followed the

properly for a fair period and are still stuck.