Heel pain and plantar fasciitis explained
Why the underside of the heel hurts, especially with the first steps of the day, what contributes and what generally helps.
Plantar fasciitis, or plantar heel pain, is pain under the heel and along the arch of the foot, where a thick band of tissue called the plantar fascia attaches. It is a common problem for runners, people who are on their feet all day and those who have recently changed their activity levels.
When to get urgent help
Go to A&E or call 999 if you have any of these. They can be signs of a fracture, infection, blood clot or other emergency.
- A limb that looks deformed, or a joint that you cannot move or put weight on after an injury
- A cold, pale or numb foot or hand after injury
- A hot, red, swollen joint with a high temperature
- A painful, swollen, warm calf, with or without breathlessness or chest pain
What it can feel like
- Pain under the heel, often sharpest with the first steps after getting up or after sitting
- Pain that eases a little as you warm up but builds again after long periods standing or walking
- Tenderness when pressing on the inner side of the heel
- Sometimes tightness in the calf
Common contributors
- A recent increase in standing, walking or running
- Unsupportive or worn footwear, or a lot of time barefoot on hard floors
- Tight calf muscles
- Carrying extra weight, which increases load through the foot
General self-care
These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.
- Wear supportive, cushioned shoes and avoid walking barefoot on hard floors
- Gentle calf stretches and stretches for the underside of the foot can be comfortable for many people
- Build up standing, walking and running gradually
- Rolling the arch of the foot over a small ball can feel soothing
- If you use over-the-counter pain relief, follow the packet instructions or ask a pharmacist
When to see your GP
See your GP promptly, or call NHS 111, if you have any of the following:
- Pain after a significant injury, fall or twist
- Pain that is constant, severe or getting worse, or wakes you at night
- Unexplained weight loss, fever or feeling generally unwell with limb pain
Consider seeing your GP if:
- Your heel pain has not improved after about two weeks of self-care
- The pain is severe, stops you doing normal activities, is getting worse or keeps coming back
- You have tingling or loss of feeling in the foot, or you have diabetes and foot pain
Where an osteopath fits in
There is limited good-quality research showing that hands-on treatment changes the course of heel pain and plantar fasciitis, so I do not claim that osteopathy treats it.
What an osteopath can usefully do is examine your foot, ankle, calf and gait, look at footwear and activity levels, advise on stretching and graded loading, and refer to a podiatrist if insoles or a closer look at foot mechanics could help. The NHS lists physiotherapy and podiatry among the usual next steps if self-care does not settle it. If the assessment suggests you need your GP, a physiotherapist or a specialist instead, I will tell you.
If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.
Common questions
Why is my heel pain worst in the morning?
The NHS describes plantar heel pain as typically worst with the first steps after sleeping or resting, easing as you move around, but worse again after long periods of standing or walking.
What shoes help with heel pain?
The NHS suggests shoes with cushioned heels and good arch support, with insoles or heel pads if needed, and advises avoiding flip-flops, backless slippers, high heels and walking barefoot on hard floors.
Free 5-minute exercise sheet
A simple, printable sheet of gentle exercises and stretches, about five minutes a day, based on NHS physiotherapy leaflets. It is general information, not a personal treatment plan, and it is not suitable if you have any of the urgent signs listed above.
Sources and further reading
Links open in a new tab. Sources were checked in October 2026.
Related guides
This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.