Author: Dr. Lee Moon-young (Chief Director, Gangbuk Anjeong Korean Medicine Clinic) This content has been created in compliance with relevant laws including medical practice laws.
What is Plantar Fasciitis? The Most Common Cause of Heel Pain
Among patients who visit hospitals for heel pain, plantar fasciitis is the most commonly diagnosed condition. The plantar fascia refers to a thick fibrous connective tissue band that supports the medial longitudinal arch of the sole and absorbs impact during walking. When repeated micro-injuries and inflammation accumulate in this band, it leads to plantar fasciitis. The 2023 JOSPT Clinical Practice Guideline defines this as injury caused by overuse.
According to Seoul National University Hospital Health Information, the most characteristic symptom of plantar fasciitis is a sharp pain felt on the inner side of the heel when taking the first step out of bed in the morning. This pain is somewhat relieved after walking briefly, but worsens again with prolonged standing or increased activity.
It is a common enough condition that approximately 10% of the general adult population experiences it at least once in their lifetime, and it occurs particularly frequently in active adults aged 40-60. However, not all heel pain is plantar fasciitis, so differentiation from gout, nerve entrapment, and stress fractures is important.
▪ One-line summary: Plantar fasciitis develops from repeated injury and inflammation of the fibrous band on the sole of the foot, with morning first-step pain being the most distinctive characteristic.
Causes of Plantar Fasciitis — Structural, Lifestyle, and Systemic Factors
The causes of plantar fasciitis are broadly divided into intrinsic factors and extrinsic factors. Since the two often work in combination, correcting just one factor may not resolve the problem.
| Category | Main Factors |
|---|---|
| Intrinsic — Structural/Physical | Flat feet (pes planus), high-arched feet (pes cavus), obesity (elevated BMI), Achilles tendon shortening and decreased calf muscle flexibility, restricted ankle dorsiflexion, excessive inversion (overpronation) foot posture |
| Intrinsic — Degeneration/Systemic | Decreased plantar fascia elasticity after age 40, concurrent systemic diseases such as gout, lupus, and ankylosing spondylitis |
| Extrinsic — Lifestyle/Environmental | Prolonged standing or walking, sudden increase in running training volume, shoes with low heels or hard soles, barefoot walking, hard work environment |
A clinical study published on PubMed (PMC8249066) conducted comprehensive analysis of extrinsic and intrinsic risk factors, and another study (PMC1884155) reports through multivariate analysis that obesity (BMI ≥ 30) increases the risk of chronic heel pain approximately 2.9-fold, while excessive inversion foot posture increases it approximately 3.7-fold.
Severance Hospital Health Information also explains the mechanisms of flat feet and high-arched feet. With flat feet, the medial arch of the foot collapses during walking, causing repeated excessive tension on the plantar fascia, while with high-arched feet, the arch is excessively stretched when lifting the toes, and inflammation accumulates. The treatment approach differs depending on whether the cause is simply overuse or a structural problem, so accurate diagnosis must come first.
▪ One-line summary: Plantar fasciitis results from the combined effect of intrinsic factors (foot structure, obesity, systemic disease) and extrinsic factors (overuse, footwear, environment), and identifying the cause is the starting point for treatment.
Treatment Methods for Plantar Fasciitis — From Conservative Treatment to Korean Medicine Approaches
Treatment of plantar fasciitis is recommended to be approached in stages. Refer to the flow below to identify your current stage.
▪ Stage 1 — Cause Correction and Self-Management First address modifiable extrinsic factors such as incorrect exercise methods, excessive training volume, and uncomfortable footwear. Seoul National University Hospital Health Information recommends stretching of the plantar fascia and Achilles tendon as the cornerstone of primary conservative treatment. A typical exercise involves placing one foot on the opposite knee while seated and slowly pulling the big toe toward the top of the foot.
▪ Stage 2 — Orthotic Devices, Taping, and Physical Therapy Combining foot orthotic devices (prefabricated or custom insoles) with taping helps increase arch support and reduce strain on the plantar fascia. Seoul Asan Medical Center Health Information also recommends combining orthotic devices with physical therapy.
▪ Stage 3 — Night Splint The 2023 JOSPT Clinical Practice Guideline recommends prescribing a night splint that prevents ankle plantarflexion during sleep as a 1-3 month program, and is particularly suitable for those with prominent morning first-step pain.
▪ Stage 4 — Korean Medicine Treatment According to the National Institute of Korean Medicine Health Webzine, acupuncture treatment is used by inserting needles at major acupuncture points on the sole and lower leg to relax tense muscles and promote qi and blood circulation. Herbal acupuncture treatment directly injects refined herbal components into the affected area to aim at reducing inflammation and pain. Herbal medicine treatment can also be utilized as a means to assist in recovery of plantar fascia damage.
Gangbuk Anjeong Korean Medicine Clinic is addressing both inflammation reduction of the plantar fascia and functional recovery of the lower limbs through skilled chiropractic treatment, high-concentration bee venom acupuncture, and acupuncture therapy. During treatment, each individual is accommodated in a private, dedicated space.
▪ Stage 5 — Extracorporeal Shock Wave Therapy and Surgery Consideration If conservative treatment is ineffective after 6 months or longer, extracorporeal shock wave therapy (ESWT) can be considered, and if there is still no improvement, surgical plantar fascia release may be reviewed. Seoul National University Hospital Health Information also provides guidance on this step-by-step flow. According to PubMed research (PMC10072183), when properly diagnosed and treated, approximately 80% of patients show symptom improvement within one year.
▪ One-line summary: Conservative treatment including stretching, orthotic devices, and medication forms the foundation, while acupuncture, herbal acupuncture, and chiropractic treatment can be applied as supplementary approaches from early stages through chronic stages.
Check Your Current Status Before Treating Plantar Fasciitis
Before beginning treatment, check the items below. The more items that apply to you, the more professional medical consultation may be necessary.
▪ Signals That Immediate Consultation is Recommended
- Heel pain upon first step persists for more than 2 weeks
- Pain appears simultaneously on both feet
- Heel pain does not disappear even during rest
- Swelling or sensation of heat is felt around the foot area
- Pain is progressively worsening or the affected area is expanding
▪ Limitations of Korean Medicine Monotherapy — Cases Where Differential Diagnosis is Prioritized According to Severance Hospital Health Information, bilateral and chronic plantar fasciitis can occur when systemic diseases such as gout, lupus, and ankylosing spondylitis are present. Additionally, Seoul National University Hospital Health Information recommends differential diagnosis through imaging studies such as X-ray and MRI if symptoms are atypical or if there is no improvement with appropriate treatment. Nerve entrapment on the medial ankle (tarsal tunnel syndrome), stress fractures, and calcaneal fractures cannot be resolved by Korean medicine treatment alone and require differential diagnosis first.
▪ Habits That Help with Prevention and Self-Management
- Avoid shoes with very low heels or hard soles, and wear shoes with cushioning
- Make it a habit to stretch your toes toward the top of the foot before stepping on the ground immediately upon waking
- In a seated position, you can strengthen the intrinsic muscles of the sole by gripping and pulling a towel with your toes
- Weight management and moderation of exercise intensity are also important for preventing recurrence
Among patients with plantar fasciitis in the Suyu area visiting the clinic, some delay seeking treatment and come after their symptoms have become chronic, initially mistaking their sole pain for simple fatigue. Those looking for a Dobong plantar fasciitis Korean medicine clinic, as well as residents of nearby areas, are welcome to visit without hesitation.
▪ One-line summary: Heel pain persisting for more than 2 weeks, simultaneous bilateral presentation, and atypical symptoms strongly warrant professional consultation and differential diagnosis.
Consult About Sole Pain at a Nearby Location in Gangbuk's Suyu Area
Gangbuk Anjeong Korean Medicine Clinic is located near Exit 3 of Suyu Station and begins consultation from 8:00 AM on all weekdays, weekends, and holidays. If you experience ongoing sole pain, we recommend making an appointment at your convenience through Naver Reservations.
As confirmed by PubMed research (PMC10072183), the earlier diagnosis and treatment are initiated for plantar fasciitis, the higher the possibility of recovery. Conversely, neglecting pain or repeatedly attempting only self-treatment can lead to chronicity and longer treatment duration.
Consultation is available before morning commutes or early on weekends, and you can conveniently use free parking in the nearby Garden Tower (328 Dobong-ro) for vehicle access. Treatment is conducted in a private space with a bed of your own, allowing you to receive care in comfort without concern for others' gaze.
The cause of sole pain and the appropriate direction for your current condition can be confirmed together through consultation.
▪ One-line summary: Early diagnosis and treatment of plantar fasciitis is key to preventing chronicity. If pain persists for more than 2 weeks, begin a consultation at a nearby Korean medicine clinic.
Frequently Asked Questions About Plantar Fasciitis
Q1. Does plantar fasciitis go away on its own, or do you need treatment?
In mild early cases, symptoms may improve with rest and stretching alone. However, if pain persists for more than 2 weeks or interferes with daily walking, it is recommended to seek professional consultation rather than waiting for natural recovery. Leaving it untreated can lead to chronicity and a longer recovery period.
Q2. My foot hurts in the morning but feels fine during the day — is this plantar fasciitis?
The pattern of heel pain on the inner side when taking the first step in the morning that improves with walking is a classic symptom of plantar fasciitis. This occurs because the contracted plantar fascia during sleep suddenly bears weight upon getting up. Since improved pain during the day should not be taken as a sign of improvement, if symptoms recur, professional consultation is recommended.
Q3. What are good stretches for plantar fasciitis?
Sit and place one foot on the opposite knee, then slowly pull the big toe toward the top of the foot with your hand. Once you feel a stretch in the sole, hold for 10-15 seconds then relax, repeating this three or more times daily for best results. Combining with Achilles tendon stretching of the calf is effective.
Q4. If I have flat feet, am I more likely to develop plantar fasciitis?
Flat feet are a known risk factor for plantar fasciitis because the medial arch of the foot is lowered and becomes unstable during walking, causing repeated excessive strain on the plantar fascia. However, having flat feet does not necessarily guarantee plantar fasciitis will develop; lifestyle factors such as footwear selection, weight management, and exercise intensity modulation also have complex influences.
Q5. Is Korean medicine treatment (acupuncture, herbal acupuncture) helpful for plantar fasciitis?
Acupuncture treatment is used by inserting needles at major acupuncture points on the sole and lower leg to relax tense muscles and improve local blood circulation. Herbal acupuncture treatment directly injects refined herbal components into the affected area to aim at inflammation reduction. Korean medicine treatment can be applied alongside conservative treatment from early stages through chronic stages, and the effectiveness may vary depending on the individual's condition.
ℹ️ Treatment effects vary individually; please consult with a specialist before deciding.