What are the recommended first-line treatments for a patient diagnosed with plantar fasciitis?

Recommended first-line treatments for plantar fasciitis include:

• Advise the patient about sources of information and support, such as NHS and Versus Arthritis patient information resources.
• Encourage self-care measures: rest the foot if needed, avoid prolonged standing or walking, wear comfortable shoes with good arch support and a small heel, avoid walking barefoot, and consider over-the-counter insoles or heel pads to cushion the heel.
• Advise weight loss if the patient is overweight or obese.
• Recommend regular plantar fascia and gastrocnemius muscle stretching exercises for 4–6 weeks.
• Consider simple analgesia such as paracetamol and/or NSAIDs for symptom relief, taking into account comorbidities and contraindications.
• Apply ice packs to the painful area for 15–20 minutes every few hours as needed.
• If symptoms persist or self-care is ineffective, offer referral to a podiatrist, orthotist, or physiotherapist for supervised stretching, strengthening exercises, orthoses, night splints, or foot/ankle taping.

These first-line treatments focus on symptom relief, functional improvement, and prevention of recurrence, tailored to the patient's symptoms and lifestyle.

Note: Corticosteroid injections and more invasive treatments are generally reserved for persistent symptoms beyond 3–6 months or when initial management fails.

All recommendations are based on UK best practice guidelines and expert consensus. ¹