Conditions & Treatments

Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain in active patients. Most cases resolve with conservative treatment, but a subset become chronic and debilitating. Dr. Hanson has extensive experience managing plantar fasciitis from initial presentation through refractory cases that have not responded to standard care.

Understanding Plantar Fasciitis

The plantar fascia is a thick band of tissue that runs along the bottom of the foot, connecting the heel bone to the toes. When this structure is overloaded, it develops microtears and inflammation at the point where it attaches to the heel. The result is the characteristic sharp heel pain that is worst with the first steps in the morning or after prolonged rest.

Plantar fasciitis is especially common in active patients who spend significant time on their feet, those who have recently increased their activity level, and patients with certain foot structure characteristics such as flat feet or high arches. In the majority of cases, it resolves with appropriate conservative treatment over a period of weeks to months.


What Plantar Fasciitis Feels Like

  • Sharp, stabbing pain at the bottom of the heel, worst with the first steps in the morning
  • Pain that eases after walking for a few minutes, then may return after prolonged activity
  • Tenderness directly at the inner heel where the fascia attaches to the bone
  • Pain that worsens after long periods of standing or after sitting for extended periods
  • Occasional aching through the arch of the foot

Not all heel pain is plantar fasciitis. Stress fractures of the heel, nerve entrapment, and tarsal tunnel syndrome can produce similar symptoms. An accurate diagnosis is important before starting treatment.


From Conservative Care to Surgical Release

The vast majority of plantar fasciitis cases resolve with non-surgical treatment when it is done correctly and consistently. Surgical intervention is reserved for the small percentage of patients who have persistent, disabling symptoms despite thorough conservative care over six months or more.

Non-Surgical
  • Calf and plantar fascia stretching program
  • Supportive footwear and arch support
  • Custom orthotics
  • Night splinting
  • Corticosteroid injections
  • Platelet-rich plasma (PRP) injections
  • Extracorporeal shockwave therapy
  • Physical therapy and activity modification
Surgical
  • Endoscopic plantar fascia release
  • Open plantar fascia release
  • Gastrocnemius recession (when calf tightness is contributing)
  • Removal of heel spur if symptomatic

When Standard Treatment Has Not Worked

If you have been treated for plantar fasciitis and have not seen meaningful improvement, it is worth seeking an expert evaluation. In some cases, the diagnosis needs to be reconsidered. In others, there is a contributing factor, such as calf tightness or a structural problem, that has not been addressed. Dr. Hanson sees a significant number of patients who are referred after failing initial treatment elsewhere and is experienced in identifying why improvement has stalled.

Take the Next Step

Request a Consultation with Dr. Hanson

Dr. Hanson will take time to understand your specific situation, review any prior imaging or records, and give you an honest assessment of all your options including non-surgical approaches.

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