If the first few steps out of bed feel like someone drove a nail into the bottom of your heel, and the pain eases once you have walked around the kitchen, you are describing the textbook symptom of plantar fasciitis. It is one of the most common foot complaints an orthopedic office sees, it shows up a lot in Colorado’s runners, walkers and people who stand all day, and the good news buried in the medical literature is that nearly everyone gets better without surgery. Here is what the National Institutes of Health and the American Academy of Orthopaedic Surgeons say about it, what to do at home, and where a newer option, shockwave therapy, fits for the cases that will not budge.
What plantar fasciitis is
The plantar fascia is the thick band of tissue on the bottom of the foot that runs from the heel bone to the toes and holds up the arch. When it is overstretched or overused it becomes irritated and swollen, and that is plantar fasciitis. The NIH’s MedlinePlus encyclopedia lists the usual culprits: flat feet or high arches, running long distances, downhill or on uneven ground, extra weight or sudden weight gain, a tight Achilles tendon, shoes with poor arch support or soft soles, and a change in how active you are. That last one is worth underlining in October, when people who spent the summer hiking switch to pavement, or start a training plan for a Thanksgiving turkey trot after a quiet September.
One myth to retire: heel spurs. MedlinePlus notes that spurs were once blamed for the pain, but they turn up on X-rays of people with and without plantar fasciitis. The fascia, not the bone, is the problem.
Why it hurts most in the morning
The fascia tightens when you rest. Overnight, or during a long stretch at a desk, it shortens; the first steps yank it back to length, and that is the stabbing sensation the AAOS describes. The pain often fades as you move, then creeps back after standing a long time, climbing stairs or a hard workout. It can build slowly over weeks or arrive all at once after one long day on your feet.
What actually helps at home
Both sources land on the same unglamorous plan, and both say it works for most people. The AAOS calls stretching the most effective way to relieve the pain: stretch the arch and the Achilles tendon three times a day, on both sides, and keep doing it after the pain fades. MedlinePlus adds the practical list: rest the foot as much as you can for at least a week, ice the sore spot for 10 to 15 minutes at least twice a day, wear well-cushioned shoes with real arch support (skip thin, hard soles and worn-out trainers), and use an over-the-counter pain reliever if you need one. A night splint, which holds the foot gently stretched while you sleep, is the fix for that first-step pain. One more habit MedlinePlus recommends: stretch the fascia each morning before your feet hit the floor.
Patience is part of the treatment. The AAOS says about 90 percent of people greatly improve within two to three months of starting care, and more than 98 percent get better without surgery. MedlinePlus is blunter about the long tail: symptoms can take several months to two years to fully resolve, with most people feeling better within 6 to 18 months.
When to get it looked at
MedlinePlus says to contact a provider if you have the symptoms, and there are good reasons not to self-treat forever. Heel pain is not always plantar fasciitis; the AAOS lists Achilles tendonitis, arthritis and stress fractures as the things a clinician rules out with an exam and sometimes an X-ray. If the home plan has not moved the needle, MedlinePlus describes the next rungs on the ladder: a walking boot for three to six weeks, custom orthotics, or a steroid injection into the heel. Surgery is rarely needed, and the AAOS says it is considered only after six to twelve months of treatment without improvement. Parents should know the same overuse logic applies to kids in fall sports; our guide to telling a sprain from something worse covers when a young athlete needs a look.
Where shockwave therapy fits
Neither the MedlinePlus page nor the AAOS guide covers shockwave therapy, so treat it as an option to ask about rather than a first step. It is offered by some sports medicine and chiropractic clinics for soft-tissue problems that have stalled. In Littleton, Raise Chiropractic lists plantar fasciitis first among the conditions it treats with shockwave therapy, alongside Achilles tendonitis, shin splints, patellar tendonitis, IT band syndrome and old scar tissue. The practice describes it as a non-surgical treatment meant for pain that has not improved with chiropractic care, stretching or massage alone; its page says sessions run 10 to 15 minutes with no downtime, that most patients notice improvement within six to eight sessions, and that it charges $150 per session with packages available. The clinic also has a physical therapist on staff, which matters because the stretching and strengthening work above is still the foundation whatever else you add.
Sensible questions for any clinic offering it: how many sessions they expect for your case, whether they will keep you on a stretching program at the same time, what they will do if you are not improving after the first few visits, and what it costs and whether your insurance covers any of it. Ask up front.
Disclosure: Raise Chiropractic is a Holland Health Marketing client.
A Colorado note for turkey trot season
If you are nursing a heel while eyeing the TD5K in Highlands Ranch or the Mile High United Way Turkey Trot in Washington Park, the sources above argue for a month of stretching, better shoes and shorter runs now rather than a limp through five kilometers on Thanksgiving morning. Walking the course is allowed, and so is signing up for next year.
This is general information, not medical advice.
Sources
- Plantar fasciitis, MedlinePlus Medical Encyclopedia, U.S. National Library of Medicine (reviewed June 27, 2026)
- Plantar Fasciitis, OrthoInfo Basics, American Academy of Orthopaedic Surgeons
- Shockwave therapy, Raise Chiropractic, Littleton
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