Plantar fasciitis or heel spur syndrome is a very common condition that involves sharp pain beneath the heel. It usually develops spontaneously (without a specific cause), but can also occur after mild trauma, extended walking (vacation, travel), or in runners. It involves inflammation and eventually thickening of the attachment area of the plantar fascia at the calcaneus (heel bone). The area becomes inflamed and occasionally swollen and the condition is sometimes associated with a "heel spur" on x-ray scans.
Diagnosis is made by history of first-step pain with a pattern of mild improvement after early activity and worsening at the end of activity. Physical examination shows pain directly at the origin of the plantar fascia on the calcaneus, and occasional mild swelling. X-rays are rarely helpful, but may show an incidental heel spur. The spur is not usually considered to be the source of pain.
Symptoms of plantar fasciitis are similar with nearly all patients. Pain is sharp and intense with first steps in the morning or after sitting. It usually lessens after warming up, but then throbs and worsens by the end of the day. Shoes feel better than barefoot walking. Pain sometimes radiates up the heel and down the arch.