Plantar Fasciitis Treatment in Vancouver

Plantar fasciitis is a common cause of heel and arch pain. Symptoms are often most noticeable with the first few steps after getting out of bed in the morning or after sitting for an extended period, and they may also increase with prolonged standing, walking or activity.

At Vancouver Orthotics, Dr. Michael Horowitz & Associates assess plantar fasciitis and other potential causes of heel and foot pain. Your assessment may include examination of your feet, lower-extremity biomechanics, footwear, activities and walking mechanics to help determine appropriate treatment options.

Treatment depends on the individual and may include changes to activity, stretching and exercise, footwear recommendations, supportive devices and custom orthotics when clinically appropriate.

Plantar Fasciitis & Heel Pain

In this video, Dr. Michael Horowitz discusses plantar fasciitis, heel pain, assessment and treatment considerations.

What Is Plantar Fasciitis?

The plantar fascia is a strong band of connective tissue along the bottom of the foot that extends from the heel toward the forefoot and helps support the arch of the foot.

Plantar fasciitis refers to pain associated with irritation or degeneration of the plantar fascia, commonly near its attachment at the heel. Although heel pain is a typical symptom, discomfort may also extend into the arch of the foot.

Not every case of heel pain is plantar fasciitis. Other conditions can produce similar symptoms, which is one reason an individual assessment can be helpful when heel pain persists or interferes with normal activities.

What Are the Symptoms of Plantar Fasciitis?

Plantar fasciitis symptoms can vary from person to person, but a characteristic pattern is pain around the bottom or inner portion of the heel.

Common symptoms may include:

The location and pattern of your symptoms are important because heel pain can have more than one possible cause. An assessment can help determine whether your symptoms are consistent with plantar fasciitis or whether another condition should be considered.

What Causes Plantar Fasciitis?

Plantar fasciitis is generally associated with repeated stress and loading of the plantar fascia. There is not always one single cause, and several factors may contribute to symptoms.

Factors that may be relevant include:

Because different factors may contribute to heel pain, treatment should be based on the individual rather than assuming that every case of plantar fasciitis has the same cause.

How Is Plantar Fasciitis Assessed?

An assessment for plantar fasciitis begins with your symptoms and clinical history. Your practitioner may ask when the pain started, where it is located, what activities aggravate it and whether you experience the characteristic first-step pain after sleeping or resting.

Your assessment may also consider:

When appropriate, digital assessment technology may also form part of the evaluation. Vancouver Orthotics uses 3D digital foot scanning as part of the custom orthotic process, and select clinic locations also provide 2D electronic walking gait analysis.

Plantar Fasciitis Treatment Options

There is no single treatment approach that is appropriate for every person with plantar fasciitis. Treatment recommendations depend on your symptoms, examination findings, activities, footwear and other individual factors.

Conservative treatment options may include a combination of:

Persistent or worsening heel pain should be individually assessed rather than assuming that the symptoms are plantar fasciitis.

Custom Orthotics for Plantar Fasciitis

Custom orthotics may be considered as part of a treatment plan for some patients with plantar fasciitis, particularly when foot mechanics, footwear and the way forces are distributed through the feet may be contributing to symptoms.

A custom orthotic is prescribed for the individual rather than simply for the diagnosis of plantar fasciitis. The prescription can take into account your foot structure, biomechanical assessment, symptoms, activities and the footwear in which the orthotics will be used.

At Vancouver Orthotics, custom orthotic assessment may include a clinical and biomechanical examination together with 3D digital foot scanning. Electronic walking gait scanning is also available at select locations.

Learn more about custom orthotics cost and assessment fees.

3D Foot Scanning and Gait Analysis

3D foot scanning and electronic gait scanning provide different information and should not be confused with one another.

A 3D foot scan creates a three-dimensional digital representation of the shape and contours of your feet. When custom orthotics are prescribed, this information can form part of the orthotic design and manufacturing process.

An electronic gait scan evaluates aspects of how the feet function while walking. Vancouver Orthotics currently provides a 2D electronic walking gait scan at select clinic locations.

Neither type of scan diagnoses plantar fasciitis by itself. The information is considered together with your symptoms and clinical and biomechanical assessment.

Footwear and Plantar Fasciitis

Footwear can be an important consideration when managing plantar fasciitis. The appropriate shoe depends on the individual, the activity and the shape and mechanics of the foot.

When reviewing footwear, factors such as fit, support, cushioning, stability and compatibility with an orthotic may be considered. A shoe that works well for one person with plantar fasciitis may not necessarily be appropriate for another.

If you are attending an assessment for heel pain, consider bringing the shoes you wear most often for work, walking or exercise.

Stretching and Exercise for Plantar Fasciitis

Stretching and exercise are commonly included in conservative management of plantar fasciitis. Depending on the individual, exercises may address the plantar fascia, calf muscles, ankle mobility and strength of the foot and lower extremity.

Exercises should be appropriate for your symptoms and physical abilities. If an exercise significantly increases your pain or you are uncertain whether it is appropriate for you, seek individual clinical advice.

Vancouver Orthotics also has dedicated educational information about plantar fasciitis exercises.

Night Splints for Plantar Fasciitis

Night splints are sometimes used as part of conservative management for plantar fasciitis. They are designed to maintain the ankle and foot in a position that provides a prolonged stretch while sleeping.

They may be considered for some people who experience significant first-step heel pain in the morning, but they are not necessary or appropriate for everyone.

Learn more about night splints for plantar fasciitis.

When Should Heel Pain Be Assessed?

Consider having persistent heel or arch pain assessed when it is interfering with walking, work, exercise or other normal activities, when symptoms continue despite basic self-care, or when you are uncertain about the cause of the pain.

Prompt medical assessment may be appropriate for significant injury, severe or rapidly worsening pain, marked swelling, inability to bear weight, neurological symptoms or other concerning symptoms.

Plantar Fasciitis FAQ

Why does plantar fasciitis often hurt with the first steps in the morning?

First-step pain after sleeping or prolonged rest is a commonly reported feature of plantar fasciitis. Symptoms may be particularly noticeable when the plantar fascia is loaded again after a period of inactivity.

Can plantar fasciitis cause arch pain?

Yes. Plantar fasciitis is commonly associated with heel pain, but discomfort may also extend along the plantar fascia into the arch of the foot.

Do I need custom orthotics for plantar fasciitis?

Not everyone with plantar fasciitis requires custom orthotics. Whether orthotics are appropriate depends on your symptoms, foot mechanics, footwear, activities and clinical assessment.

Can flat feet contribute to plantar fasciitis?

Foot structure and biomechanics can be relevant in some cases of plantar fasciitis, but flat feet do not automatically cause plantar fasciitis. An individual assessment can help determine which factors may be relevant to your symptoms.

Are heel spurs the same as plantar fasciitis?

No. A heel spur is a bony finding, while plantar fasciitis involves the plantar fascia. The two may occur together, but the presence of a heel spur does not by itself establish the cause of heel pain.

Can I keep exercising with plantar fasciitis?

That depends on the severity of your symptoms and the activity involved. Temporary modification of activities that aggravate heel pain may be helpful while maintaining other activities that can be performed comfortably. Individual advice may be appropriate when symptoms persist.

How long does plantar fasciitis take to improve?

Recovery time varies. Factors such as how long symptoms have been present, activity demands, contributing factors and the treatment approach can all influence progress. Persistent symptoms should be reassessed rather than relying on a fixed recovery timeline.

Is plantar fasciitis treatment covered by extended health insurance?

Coverage depends on the treatment provided and the terms of your individual extended health benefit plan. Custom orthotic coverage and documentation requirements vary between insurers and plans, so patients should confirm their coverage directly with their insurance provider.

Plantar Fasciitis Assessment in Vancouver

Dr. Michael Horowitz & Associates assess plantar fasciitis, heel pain and foot biomechanics at Vancouver Orthotics clinic locations throughout Vancouver and the Greater Vancouver area.

If custom orthotics are being considered, your assessment can include clinical and biomechanical findings together with 3D digital foot scanning and other information relevant to your individual orthotic prescription.

Information on this page is provided for general educational purposes and is not a substitute for an individual clinical assessment or medical diagnosis.