Diagnosing Plantar Fasciitis

At NYU Langone, our specialists diagnose plantar fasciitis, a painful condition that arises in the ligament, or fibrous band of tissue, that runs from the heel to the toes on the bottom of the foot. This connective tissue, called the plantar fascia, is designed to support the arch of the foot.

Too much pressure and stress on this fibrous band of tissue can cause inflammation, leading to a stabbing pain and stiffness near the heel. Pain and stiffness can also occur in the arch of the foot. The discomfort is often most noticeable after you step on the floor to get out of bed in the morning and after exercising.

Risk factors for plantar fasciitis include high arches; tight calf muscles that make flexing your feet difficult; tight Achilles tendons, which attach the calf muscles to the heels; high-impact exercise such as running; and having excess weight or obesity, which can put extra pressure on your feet. You also have a high risk of plantar fasciitis if your feet pronate, or roll inward, as you walk, which increases the pressure on the arch. Our doctors perform a physical exam and use imaging tests to diagnose plantar fasciitis and rule out other potential causes of pain.

Physical Exam

During the physical exam, your doctor palpates and presses on your heel and other areas on the bottom of your foot to assess for problems and to ascertain where the pain is arising. You may also need to flex your foot and describe any sensations or pain you are feeling. Your doctor may also ask you to walk to see whether you are altering your gait to avoid foot pain.

Imaging Tests

Your doctor may order an X-ray, which creates images of your bones, to rule out other causes of foot pain, such as a stress fracture.

An ultrasound or an MRI, which both create images of soft tissues, can confirm a diagnosis of plantar fasciitis, especially in cases in which nonsurgical treatments haven’t already reduced the pain. These imaging tests can also determine whether an irritated or inflamed nerve is causing the pain rather than an inflamed fascia.