What Is Plantar Fasciitis?
Plantar fasciitis is the most common type of heel pain, with about one in 10 people experiencing symptoms at some point in their lives. The overuse injury primarily affects middle-aged and older adults, as well as people who frequently stand or walk on hard floors (Trojian & Tucker, 2019).
What Causes Plantar Fasciitis?
Plantar fasciitis occurs when the plantar fascia breaks down, leading to microtears and strain. While the condition is often described as an overuse injury, it's actually more of a degenerative condition, as the damaged tissue cannot fully heal itself over time.
The plantar fascia has a fairly limited blood supply, which can slow down healing (Miller & Latt, 2015). Factors like overuse, high-impact activity (e.g., running or dancing), systemic inflammation, poor foot mechanics, such as flat feet or high arches, or overall metabolic or nutritional health can make it more challenging for your body to repair these small injuries, allowing the pain to persist (Buchanan et al., 2024).
Regenerative therapies can be particularly beneficial for plantar fasciitis because they can promote angiogenesis (new blood vessel growth) and repair vascular structures (Leeper et al., 2010).
Who Is At Risk?
Several risk factors exist for plantar fasciitis relating to physical health, lifestyle, occupation, anatomy, and footwear (Trojian & Tucker, 2019).
Systemic Inflammation
Studies suggest that the foot condition may also arise from elevated C-reactive protein (CRP) levels. This suggests that the pain may signal a broader, systemic (whole-body) inflammation rather than just a localized problem (Elabd et al., 2024).
Physical Health
People with a higher body mass index (BMI), who are obese, and older people between the ages of 40 and 60 are more likely to develop this form of heel pain.
Occupation and Lifestyle
Jobs that require long hours standing or walking on hard surfaces, such as teaching, healthcare, construction, or retail, are high-risk.
Having a sedentary lifestyle, meaning little to no physical activity, or high-impact exercise like running or dancing, can contribute to plantar fasciitis.
Anatomy
Certain foot structures, such as a high arch (pes cavus) or flat feet (pes planus), affect weight distribution, increasing the risk of plantar fasciitis.
Footwear
Wearing footwear that doesn't provide proper arch support, stability, or cushioning is strongly associated with the development of plantar fasciitis.
Other Factors
Pregnancy (due to weight gain) and a sudden, intense increase in physical exercise may contribute to plantar fasciitis.
What Are The Symptoms?
The main symptoms of plantar fasciitis are sharp, stabbing pain or a dull ache in or near the heel. This pain typically worsens with the first morning steps, after a long resting period, or after exercise.
Your heel may also feel tight or stiff, and the affected area may be tender to the touch with some mild swelling.
How Is Plantar Fasciitis Diagnosed?
Plantar fasciitis is commonly misdiagnosed for similar conditions such as tarsal tunnel syndrome and posterior tibial nerve entrapment.
The degenerative condition is typically diagnosed with the following techniques (Thing et al., 2012):
Physical exam: A healthcare provider will check for any pain, swelling, or redness on your soles.
Ultrasound: Measures the thickness of the plantar fascia.
X-rays: Can help rule out stress fractures or assess heel spurs.
MRI: Recommended for chronic foot pain to visualize the inflammation or microtears in the tissue.
Visiting your provider for a comprehensive evaluation and diagnosis can help you start appropriate treatment and find the relief you deserve.
How Is Plantar Fasciitis Treated With Regenerative Therapies?
Plantar fasciitis is manageable with several treatments, including physical therapy, night splints, medication (such as NSAIDs), and medical procedures.
Platelet-Rich Plasma (PRP) Injections
Uses your own blood platelets to stimulate collagen production and tissue repair. A meta-analysis of 24 RCTs involving 1,653 participants discovered that PRP injections provided better pain management than corticosteroids (Zuo et al., 2025).
Extracorporeal Shockwave Therapy (ESWT)
A non-invasive procedure that uses high-energy sound waves. In a meta-analysis of 236 studies, ESWT was the most effective treatment for plantar fasciitis compared to other methods (Guimaraes et al., 2023). Combining ESWT with PRP can yield better results than either alone (Haddad et al., 2021).
Dextrose Prolotherapy
An injection therapy that uses a mix of dextrose and anesthetic to trigger a healing response. A meta-analysis of six studies found it safe and effective for plantar fasciitis (Lai et al., 2021).
Low-level Laser Therapy (LLLT)
Also known as cold laser therapy, this non-invasive treatment uses low-intensity laser light to reduce inflammation and pain (Naterstad et al., 2022).
Emerging Regenerative Therapies
Other regenerative therapies may be beneficial, but research is limited. These include ultrasound-guided nerve hydrodissection, amniotic membrane transplantation, and exosome injections.
Nutritional Support
A healthy diet can help reduce pain and inflammation from plantar fasciitis. Adopt an anti-inflammatory diet rich in omega-3 fatty acids, antioxidants, and vitamin C.
Takeaway
Plantar fasciitis is a common type of foot pain that is highly manageable when the root cause is addressed. Regenerative therapies that support healing, along with lifestyle changes, can help reduce strain on the plantar fascia.
