Conditions
Plantar fasciitis: heel pain treatment by video
Plantar fasciitis is the best-known cause of heel pain: it hurts most with the first steps in the morning or when you stand up after sitting. It is diagnosed from your symptoms and treated with stretching, ice, good shoes and pain relievers if appropriate. The doctor assesses you by video; if you do not improve over time or have diabetes with foot changes, we refer you in person.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- The pain started after a fall or a blow and you cannot put weight on the foot
- A red, hot, swollen heel or foot, especially with fever
- A swollen, warm or painful calf on one side
- Diabetes with a sore, wound or color change on the foot
- Numbness or tingling that does not go away
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At a glance
Plantar fasciitis
Common symptoms
- Pain on the bottom of the foot, near the heel
- Pain and stiffness that are worst with the first steps in the morning
- Pain when you stand up after sitting for a while
- Pain that can be dull or sharp
- Pain that gets worse after walking or standing for a long time
- Other names
- Heel pain
- Treatment
- Stretching, ice, supportive shoes, a night splint and pain relievers if appropriate
On this page(8)
What is plantar fasciitis?
The plantar fascia is a thick band of tissue that runs along the bottom of the foot, from the heel to the toes. When it is overstretched or overused, it gets irritated and painful: that is plantar fasciitis.
You are more likely to get it if you have flat feet or high arches, run long distances or on uneven ground, carry extra weight or gained weight suddenly, have a tight Achilles tendon, wear shoes with poor arch support or soft soles, or suddenly changed how active you are. In Puerto Rico, spending the day in flip-flops or barefoot on the beach gives your arch no support.
What about heel spurs? Heel spurs were once thought to cause plantar fasciitis, but research found they do not: some people have spurs and no pain, and some have plantar fasciitis with no spur.
How we treat plantar fasciitis by video
You see Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. We evaluate, diagnose and treat: plantar fasciitis is recognized from your history, so the doctor asks when and where it hurts, what shoes you wear, how much you walk or run and whether you have diabetes, and asks you to show her your foot and where pressing hurts.
From that she builds a stretching and care plan. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances. If you do not improve after a period of treatment, we refer you for an X-ray or to a foot specialist, who can offer custom inserts, a boot or injections.
If you have diabetes, the doctor also goes over foot care with you; see type 2 diabetes and our chronic condition care.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer. Have your feet bare and the shoes you wear most nearby.
Get your plan.
Stretches, home care and, if appropriate, the doctor prescribes and we send your prescription to your pharmacy.
What the visit costs
A doctor visit costs US$79, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. A doctor’s note after your visit is included at no extra charge. We do not bill insurance. See all prices. The service is run by The Health Initiative, a nonprofit.
Plantar fasciitis symptoms
The typical signs are:
- Pain on the bottom of the foot, near the heel
- Pain and stiffness that are worst with the first steps in the morning
- Pain when you stand up after sitting for a while
- Pain that can be dull or sharp
- Pain that gets worse after walking or standing for a long time
Plantar fasciitis treatment, and when you need an X-ray
Most people get better without surgery with this care, per MedlinePlus:
- Stretches for the sole of the foot and the calf, several times a day.
- Ice on the heel for 10 to 15 minutes at least twice a day, more often in the first days.
- Supportive shoes with good arch support and a firm sole; avoid going barefoot or wearing flip-flops.
- Relative rest: cut back on the activity that causes the pain, such as running.
- A night splint that keeps the foot stretched while you sleep.
- Over-the-counter pain relievers, such as ibuprofen, if appropriate for you.
Recovery is slow: per MedlinePlus, most people feel better within 6 to 18 months, and surgery is rarely needed. An X-ray is usually not needed; it is considered to rule out other causes or if you do not improve with treatment, and then we refer you.
If you have diabetes: check your feet every day. If you notice sores, blisters, color changes, tingling, burning or loss of feeling, your foot needs to be seen in person; we refer you.
When to get in-person care or go to the ER
Plantar fasciitis is not an emergency, but some foot and leg signs need in-person care soon. For your safety, go to urgent care or the emergency room, or call 911 if it is severe. See when to go to the ER.
- The pain started after a fall or a blow and you cannot put weight on the foot
- A red, hot, swollen heel or foot, especially with fever
- A swollen, warm or painful calf on one side
- Diabetes with a sore, wound or color change on the foot
- Numbness or tingling that does not go away
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Why does my heel hurt when I get out of bed?
Do heel spurs cause heel pain?
How long does plantar fasciitis take to heal?
Do I need an X-ray for plantar fasciitis?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (2)
- Plantar fasciitis (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Diabetes and Your Feet (CDC) (opens in a new tab) (accessed 2026-10-02)