First, the good news: 90% of plantar fasciitis cases can be successfully resolved with simple, conservative treatments.
What’s the bad news? The longer plantar fasciitis goes unaddressed, the longer the healing process takes and the more potential complications that may arise. Not allowing your arch enough rest time after a foot injury, working a job that requires a lot of time on your feet, participating in high-impact activities without proper footwear or support, and failing to follow through with at-home treatments after symptoms develop are the most common ways plantar fasciitis persists and gets worse.
Risks of Untreated Plantar Fasciitis
Symptoms of plantar fasciitis and heel pain usually develop gradually, although some cases can develop more quickly (for instance, after a foot injury). If heel pain and other symptoms of plantar fasciitis (like redness, inflammation, and swelling in the feet) are left untreated, other more serious complications can arise:
Over time, if plantar fasciitis is left untreated, the inflammation and stress to the plantar fascia can result in small tears in the fascia (sometimes called “micro-injuries”). You may not be aware of the exact moment that each small tear appears, however you will notice your pain level gradually worsen. If these tears are left unaddressed, they may grow in size and number, and make the plantar fascia more vulnerable to rupture and debilitation.
Plantar rupture can happen if plantar fasciitis is not addressed, but an individual continues to participate in activities that place a great deal of impact on the plantar fascia. These activities might include jogging, sports, or even standing for long periods of time in ill-fitting footwear.
Symptoms of plantar fascia rupture usually include a loud popping sound, followed by intense pain, bruising, and swelling in the foot. Putting weight on the affected foot will be very painful. If you suspect plantar rupture, you should seek medical help immediately. You will likely be required to wear a boot or crutches for a period of time after a ruptured plantar fascia.
Research also shows that steroid injections, a common treatment for pain relief of chronic plantar fasciitis, are a significant risk factor for plantar rupture, because of the way that the steroids interfere with collagen synthesis in the foot.
Plantar fibromatosis is a condition in which benign, slow-growing nodules form along the plantar fascia. The nodules often grow slowly and undetected, followed by sudden, rapid growth. As time passes and the nodules grow, walking may become uncomfortable or painful.
While many cases of plantar fibromatosis are believed to be triggered by genetics, there is is a correlation between individuals with plantar fasciitis and individuals with plantar fibromatosis. Some researchers believe that plantar fibromatosis can be triggered by a tear in the fascia that is left untreated.
Heel spurs are one of the most common consequences of leaving plantar fasciitis untreated. In an attempt to protect the arch of your foot and mitigate damage, your body sends an army of cells to the site of the problem, which begins depositing calcium. Over time, these deposits can build up into sharp protrusions that dig into the fatty pad of the heel and cause a great deal of pain with each step.
Heel spurs can build up over several months’ time without causing pain. In other words, allowing plantar fasciitis to go untreated may mean that a secondary problem brews unnoticed–until the sharp pain reappears.
Complicated Decisions About Surgery and Medical Interventions
Left untreated, plantar fasciitis can become chronic and make surgery more likely. While surgery can be a successful last resort for cases of chronic plantar fasciitis that don’t respond to conservative treatments like orthotics, rest, and icing, it’s important to remember that surgery can often be avoided through prompt and consistent treatment when heel pain arises.
Help avoid complicated (and expensive) decisions about surgery and other medical interventions by taking symptoms of plantar fasciitis seriously!
Hip, Knee, and Back Pain from Plantar Fasciitis
Over time, untreated plantar fasciitis and heel pain can lead to unexpected hip, back, and knee pain. The arches of the feet work in tandem with the tendons, ligaments, and muscles throughout the lower body. When the plantar fascia is compromised, other muscles, ligaments, and tendons must work harder to compensate. This cascade of overuse can eventually lead to pain outside the arch.
Plantar fasciitis can also lead to abnormal gait patterns while walking or standing, leading to repetitive stress injuries as the hips, knees, and backs are repeatedly required to move in abnormal ways.
Listen to the Warning Signs of Plantar Fasciitis
Recognizing the symptoms of plantar fasciitis and treating this condition early is the best way to avoid secondary problems and complications. Think of the pain from developing plantar fasciitis as a warning, encouraging you to address the problem at hand before more damage occurs. Stretching, icing, and using special orthotic inserts are all effective ways to curb the damage from plantar fasciitis and begin healing.
This article was originally published on May 17, 2020, and updated on January 31, 2021.