Plantar Fasciitis Treatment
in Los Angeles
Medically Reviewed by Dr. Pegah Panirian, DPM, foot and ankle surgeon
Overview
Plantar fasciitis is the most common cause of heel pain, and most cases improve with stretching and supportive shoes [9]. If yours keeps coming back or has lasted for months, Dr. Pegah Panirian, DPM, one of the top foot and ankle surgeons in Los Angeles, examines your heel, confirms the cause and treats it with orthotics, injections including PRP or amniotic injections, shockwave therapy or surgery.
Key points
- What it is: irritation of the plantar fascia, the thick band under your foot, where it attaches to your heel. The classic sign is sharp heel pain on your first steps out of bed.
- Other causes of heel pain: a trapped nerve, a stress fracture of the heel bone or a tendon problem can feel like plantar fasciitis.
- When to see a specialist: heel pain that is no better after two weeks of home treatment [9].
- Appointments: next-day appointments are available, and same-day when the schedule allows.
What is plantar fasciitis?
The plantar fascia is a thick band of tissue that runs under your foot from your heel bone to the base of your toes and holds up your arch. Plantar fasciitis is irritation of the plantar fascia where it attaches to the front of your heel bone. That attachment takes your weight every time you step and push off.
A tight calf is one of the main reasons it becomes irritated. When your calf muscles and Achilles tendon limit how far your ankle bends upward (ankle dorsiflexion), the plantar fascia carries more of your weight with each step [1][2]. Other risk factors include:
- Standing work: spending most of the working day on your feet, especially on hard floors [2].
- Running and jumping sports: repeated impact on the heel [1].
- Higher body weight: in people who are not athletes, a body mass index above 27 raised the odds of plantar fasciitis about 3.7 times in one study [2].
- Age: it is most common between 40 and 60 [3].
What does plantar fasciitis feel like?
The classic symptom is a sharp, stabbing pain under your heel on your first steps in the morning or after sitting for a while [1][3]. It usually eases once you have walked a little, and it may come back after a long day on your feet.
- Where it hurts: under the front of the heel bone, toward the arch side [1].
- When it hurts most: standing up after a long car ride, and after exercise rather than during it [1][3].
- Tender to press: pressing under the inner front of your heel brings on the same pain.
Is it plantar fasciitis or something else?
Several other conditions cause heel pain, and each tends to differ from plantar fasciitis in where it hurts and when [7]:
| Condition | Where it hurts | What it feels like, and when |
|---|---|---|
| Plantar fasciitis | Under the heel, toward the inner side | Sharp on first steps, eases as you walk, returns after long standing |
| Heel nerve entrapment (Baxter’s nerve, a small nerve under the heel) | Inner side of the heel | Burning over the inner heel [2] |
| Tarsal tunnel syndrome (a trapped nerve at the inner ankle) | Sole of the foot, sometimes the toes | Tingling, pins and needles or numbness [2][7] |
| Heel bone stress fracture | Across the heel bone | Starts slowly after more running or walking; at first hurts only with activity, later at rest too [7] |
| Fat pad bruising or thinning (the cushion under the heel) | Center of the heel | Deep, bruise-like ache, worse barefoot or on hard floors [7] |
| Insertional Achilles tendinopathy (wear of the Achilles tendon where it joins the heel) | Back of the heel | Stiff and sore, worse with activity or pressure from the back of a shoe [7] |
| Posterior tibial tendon problem (the tendon that supports your arch from the inner ankle) | Inner ankle and arch | Pain when you push your foot inward against resistance; the arch may flatten over time [2] |
| Spine or joint conditions (a pinched nerve root in the lower back, or inflammatory arthritis) | Heel, sometimes both heels | Pain that runs from the back down the leg, or heel pain alongside stiffness in the back or other joints [2][7] |
How does Dr. Panirian confirm the diagnosis?
Dr. Panirian diagnoses plantar fasciitis mainly from your symptoms and a hands-on exam, usually at the first visit [2]. She checks for nerve, bone and tendon causes at the same time:
- What you tell her: where the pain is, when it is worst, and each treatment you have tried and for how long.
- The exam: pressing along your heel, arch and inner ankle, testing the nerves in your foot for burning or numbness, and measuring your range of motion in different positions, and a biomechanics exam.
- Imaging when it is needed: an x-ray of your heel bone, an ultrasound to measure the thickness of the plantar fascia, or an MRI if a stress fracture or tendon tear is suspected. On ultrasound, a plantar fascia thicker than 4 mm supports the diagnosis [1][2].
She orders scans when your pain persists despite treatment or she finds signs of another cause during the exam [1], and reviews any scans and records from your previous doctors.
An x-ray may show a heel spur, a small hook of bone at the front of the heel bone, but most people with heel spurs have no heel pain and the spur does not cause plantar fasciitis pain [3].
How is plantar fasciitis treated?
Dr. Panirian starts with stretching, supportive shoes and short-term pain relief. If your pain has not improved after several weeks, she adds a night splint, or fits a custom orthotic or gives a cortisone vs amniotic injection in her office. Shockwave therapy, also given in her office, can help for pain that has lasted several months [2][3].
| Treatment | What it does | When, and for how long |
|---|---|---|
| Calf and plantar fascia stretching | Loosens a tight calf and the plantar fascia. The treatment with the strongest guideline support [1] | Daily for weeks to months, and continued after the pain settles |
| Supportive shoes, indoors and out | Cushion your heel and support your arch [8] | From the first day |
| Rest, ice and anti-inflammatory medicine | Cutting back on the activity that brings on the pain, plus short-term pain relief. Does not heal the plantar fascia | A few days at a time. Check with a doctor before taking anti-inflammatories for more than 10 days in a row [9] |
| Physical therapy | Hands-on treatment, taping and exercises for your calf and foot [1] | Several weeks |
| Inserts, orthotics and night splints | Support your arch, or hold your foot bent upward overnight so the plantar fascia does not tighten while you sleep [1] | Several weeks; a night splint for 1 to 3 months [1] |
| Cortisone injection | Reduces heel pain for up to about a month [5]. Repeated injections can tear the plantar fascia or thin the fat pad under your heel [2] | Used sparingly, not as a first step |
| Shockwave therapy (ESWT) | Pulses of sound energy aimed at your heel, for chronic plantar fasciitis that persists despite other care [2]. Evidence is mixed [3] | After several months of other treatment |
| Platelet-rich plasma (PRP) injection | Uses concentrated platelets from your own blood. Evidence is still limited [3] | Not used as an early treatment |
What shoes are best for plantar fasciitis?
The best shoes for plantar fasciitis have a cushioned heel, firm arch support and a thick, unworn sole [3][8]. Look for these features in any brand:
- Cushioned heel and thick sole: softens each step on the front of your heel [8].
- Firm arch support: reduces the load on the plantar fascia [8].
- A slightly raised heel: flat shoes and flip-flops leave your heel and arch unsupported [8].
- Shoes indoors: walking barefoot on hard floors puts your full weight on your heel with no cushioning [8].
- Shoe age: replace athletic shoes once the sole and cushioning have worn down [3].
Do orthotics, heel cups and night splints help?
Orthotics, heel cups and night splints can ease plantar fasciitis pain when they are used alongside stretching [1]. In trials, custom orthotics and off-the-shelf inserts gave similar results [1][6], and whether the benefit lasts beyond the first few months is uncertain [6].
| Support | What it does | Who it suits |
|---|---|---|
| Off-the-shelf arch insert | Supports your arch and cushions your heel | Anyone starting treatment [1] |
| Custom orthotic | Molded to the shape of your foot | Very flat or very high arches, or when an off-the-shelf insert fails to help |
| Heel cup | Cushions your heel and adds a small lift | Shoes that cannot take a full insert |
| Night splint | Keeps your foot bent upward while you sleep | People whose first steps hurt every morning [1] |
When should you stop treating heel pain yourself?
See a foot specialist if heel pain has not improved after a week on its own, or after two weeks of home treatment [9]. If your pain is the same after several months of treatment for plantar fasciitis, ask for a full re-examination of your heel, including tests of the nerves in your foot.
Have your heel examined sooner if you notice:
- Burning, tingling or numbness in your heel or sole [7].
- Pain at rest or at night [7].
- Swelling or bruising of your heel, or pain that began after a fall or a sudden increase in running.
- Pain that keeps you from putting weight on your foot.
Is there surgery for plantar fasciitis?
Yes, although few people need it. Surgeons usually operate only after about a year of consistent non-surgical treatment without improvement [3]. Dr. Panirian performs both of the main operations:
- Gastrocnemius recession (calf lengthening): she lengthens the tight upper part of your calf muscle to reduce the pull on the plantar fascia. It suits people whose calf stays tight despite months of daily calf stretching [3][4]. Possible complications include calf weakness and injury to the sural nerve, a small skin nerve on the outer side of the foot [3].
- Partial plantar fascia release: she cuts part of the plantar fascia where it attaches to the heel bone to relieve the tension [3]. Releasing too much of it can flatten the arch or move pain to the outer edge of your foot [2][10].
Why is Dr. Panirian a top choice for plantar fasciitis in Los Angeles?
- Cedars-Sinai trained: surgical residency and chief resident at Cedars-Sinai Medical Center, where she is now a teaching attending.
- Board certified by the American Board of Podiatric Medicine and board qualified by the American Board of Foot and Ankle Surgery.
- Hospital affiliations: Cedars-Sinai Medical Center, Cedars-Sinai Marina del Rey Hospital and Providence Saint John’s Health Center.
- Two offices: Los Angeles/Beverly Hills and Westchester/Marina Del Rey.
- Speaks English, Spanish and Farsi.
Whether your heel pain is new or has persisted despite injections, orthotics and previous treatment, the next step is confirming what is actually causing it. Dr. Pegah Panirian looks closely at what is keeping the plantar fascia under strain, including calf tightness and foot mechanics, while making sure another cause of heel pain has not been overlooked.
As a leading Los Angeles foot and ankle surgeon, Dr. Panirian offers the full range of plantar fasciitis care, from focused nonsurgical treatment and shockwave therapy to surgery when it is genuinely needed. Schedule a consultation at our Los Angeles or Marina Del Rey office to take the next step toward walking, exercising and moving through everyday life without planning around heel pain.
Frequently asked questions
Does plantar fasciitis go away on its own?
Usually, yes. Most people improve within a year without surgery [2][3], and daily calf and plantar fascia stretching helps in both the short and the long term [1].
Can you cure plantar fasciitis in a week?
No. Stretching, ice and supportive shoes can ease the pain within a week, but fully healing the plantar fascia can take weeks to months [9].
My plantar fasciitis is so bad I can’t walk. What should I do?
Keep weight off your foot and have it examined within a few days. Pain severe enough to stop you walking may come from a stress fracture of your heel bone [7] or, after cortisone injections, a tear of the plantar fascia [2].
Is a heel spur the same as plantar fasciitis?
No. A heel spur is bone, and plantar fasciitis is irritation of the plantar fascia next to it. Most people with a heel spur have no heel pain [3].
Can plantar fasciitis come back?
Yes, and if it does, restart the stretching and shoe changes that helped before. Have your heel examined if the pain is in a new place or stronger than last time.
What kind of doctor should I see for plantar fasciitis?
A foot and ankle specialist: a podiatrist (DPM) or an orthopedic foot and ankle surgeon.
How long does plantar fasciitis take to heal?
Most people improve within a year: studies report that 80% to 90% of people are better within 10 to 12 months of non-surgical treatment [2][3]. Improvement is gradual, and it may be slower if you keep standing for long hours or your calf stays tight.
Sources
- Koc TA Jr, Bise CG, Neville C, Carreira D, Martin RL, McDonough CM. Heel Pain – Plantar Fasciitis: Revision 2023. Journal of Orthopaedic & Sports Physical Therapy, 2023;53(12):CPG1-CPG39. https://www.jospt.org/doi/10.2519/jospt.2023.0303. Accessed September 24, 2026.
- Trojian T, Tucker AK. Plantar Fasciitis. American Family Physician, 2019;99(12):744-750. https://www.aafp.org/pubs/afp/issues/2019/0615/p744.html. Accessed September 24, 2026.
- Plantar Fasciitis and Bone Spurs. OrthoInfo, American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs/. Accessed September 24, 2026.
- Schneider HP, Baca JM, Carpenter BB, Dayton PD, Fleischer AE, Sachs BD. American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain. Journal of Foot and Ankle Surgery, 2018;57(2):370-381. https://doi.org/10.1053/j.jfas.2017.10.018. Accessed September 24, 2026.
- David JA, Sankarapandian V, Christopher PR, Chatterjee A, Macaden AS. Injected corticosteroids for treating plantar heel pain in adults. Cochrane Database of Systematic Reviews, 2017;6:CD009348. https://doi.org/10.1002/14651858.CD009348.pub2. Accessed September 24, 2026.
- Whittaker GA, Munteanu SE, Menz HB, Tan JM, Rabusin CL, Landorf KB. Foot orthoses for plantar heel pain: a systematic review and meta-analysis. British Journal of Sports Medicine, 2018;52(5):322-328. https://doi.org/10.1136/bjsports-2016-097355. Accessed September 24, 2026.
- Tu P, Bytomski JR. Diagnosis of Heel Pain. American Family Physician, 2011;84(8):909-916. https://www.aafp.org/pubs/afp/issues/2011/1015/p909.html. Accessed September 24, 2026.
- Plantar fasciitis: Diagnosis and treatment. Mayo Clinic, 2026. https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/diagnosis-treatment/drc-20354852. Accessed September 24, 2026.
- Plantar Fasciitis: Symptoms, Causes and Treatment Options. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/14709-plantar-fasciitis. Accessed September 24, 2026.
- Brugh AM, Fallat LM, Savoy-Moore RT. Lateral column symptomatology following plantar fascial release: a prospective study. Journal of Foot and Ankle Surgery, 2002;41(6):365-371. https://pubmed.ncbi.nlm.nih.gov/12500787/. Accessed September 24, 2026.