Will plantar fasciitis go away on its own: 15-year data shows women recover at half the rate of men
Will plantar fasciitis go away on its own? Often, but slowly, and less reliably than most advice suggests. In a Danish study that tracked patients for up to 15 years, 54% were free of heel pain an average of 9.7 years after it started. The other 46% still had symptoms, and women became pain-free at about half the yearly rate of men.
Plantar fasciitis is a problem in the plantar fascia, the thick band of collagen that runs from the heel bone to the toes and holds up the arch. It hurts most on the first steps after rest. Waiting is one plan. The research supports a better one: stretch the fascia and calf daily, splint the foot at night if mornings are the worst part, and strengthen the foot while the tissue remodels.
This article explains what 15 years of follow-up data shows about recovery, why women in their 40s and 50s sit in the slower group, and what a 2023 clinical guideline and 486 comments from women over 40 say about what helps.
- Will plantar fasciitis go away on its own? What 15 years of follow-up shows
- Why plantar fasciitis takes longer to go away on its own for women over 40
- What helps plantar fasciitis heal: the 2023 guideline, ranked by evidence
- What 486 women reach for, compared with what the guideline backs
- Collagen for plantar fasciitis: where Botavive Collagen Peptides fits, and where the evidence stops
- Frequently asked questions
| The question | What the data shows |
|---|---|
| Will it go away on its own? | In a 174-patient Danish cohort, 54% were symptom-free and 46% still had symptoms an average of 9.7 years after onset. All had received treatment. |
| How long does it take when it does clear? | About two years on average (725 days) among those who recovered, with a range from 41 days to 11 years. |
| Is recovery different for women? | Women became symptom-free at about half the yearly rate of men (hazard rate ratio 0.49). |
| Does a heel spur change the outlook? | No. Neither a heel spur nor a thicker fascia on ultrasound predicted who recovered. |
| Which treatments hold the top guideline grade? | Stretching, taping, night splints and hands-on manual therapy hold grade A in the 2023 physical therapy guideline. |
| What do women reach for first? | Shoes came up in 31% of 486 comments from women over 40. Night splints came up in 4% and taping in 1%. |
Will plantar fasciitis go away on its own? What 15 years of follow-up shows
For about half of patients, yes, and it takes years. A 2018 study in the Orthopaedic Journal of Sports Medicine re-examined 174 people who had been diagnosed with plantar fasciitis at a Danish sports clinic between 2001 and 2011. Liselotte Hansen and colleagues estimated the chance of still having the condition at 80.5% one year after symptoms began, 50.0% at five years, 45.6% at ten years and 44.0% at fifteen.
Read those numbers in order. Most of the recovery happened between year one and year five. After that the curve went nearly flat. A patient who still had heel pain at five years had little better odds at fifteen.
Among the 94 patients who became symptom-free, symptoms had lasted 725 days on average, about two years. The shortest case cleared in 41 days. The longest took 11 years.
Two cautions keep these figures honest. First, this was not a study of doing nothing. Patients had tried 3.8 treatments each on average: 93% had an ultrasound-guided steroid injection, 79% used insoles and 66% did rehabilitation. Second, the authors describe the group as likely harder to treat than the average case, and the people who did not return for follow-up were probably doing better. Odds across everyone with heel pain are likely more favorable than 54%.
The ultrasound results add a twist. Only 24% of the patients who had become pain-free had a normal-looking fascia on ultrasound. Fascia thickness shrank over time whether or not symptoms remained, and a heel spur at the start had no effect on who recovered (P = .88). Pain-free and healed turned out to be different things, and the spur on an X-ray said nothing about the outlook.
Why plantar fasciitis takes longer to go away on its own for women over 40
Sex was one of only two factors that predicted recovery in the Danish cohort. Women became symptom-free at about half the yearly rate of men (hazard rate ratio 0.49, 95% confidence interval 0.30 to 0.80). Pain in both heels was the other (0.33). BMI, smoking, a job spent standing, heel spurs and fascia thickness did not predict who got better.
The average patient was 46.7 years old when the pain began, and 91 of the 174 were women. The 2023 clinical practice guideline from the American Physical Therapy Association's orthopaedic and sports academies places the condition most often between ages 40 and 60, with no sex bias in who gets it. Women do not appear to develop plantar fasciitis more often. In this cohort they kept it longer.
Hansen's team calls the reason unknown and names hormones, physical differences and footwear as candidates. Menopause status was not among the factors the study analyzed, so the data stops short of blaming estrogen. Three explanations fit what is known, followed by one caution.
Collagen repair
The plantar fascia is built from collagen, and it heals by slowly replacing damaged fibers. Estrogen takes part in how connective tissue makes and repairs collagen, a link covered in our article on joint pain with perimenopause and the tendon problems behind it. We found no study that tests this directly in the plantar fascia.
Load on the heel
The guideline lists high BMI in people who are not athletes, limited upward bend at the ankle, running and long hours of weight-bearing work as risk factors. Weight often shifts during the menopause transition, and every added pound passes through the heel with each step. In the Danish cohort BMI did not predict recovery (P = .09), so weight looks like a stronger factor in getting plantar fasciitis than in keeping it.
Shoes and hard floors
The guideline recommends a heel cushion or cushioned footwear for feet that absorb shock poorly, and it flags weight-bearing work on surfaces with poor shock absorption. By the same logic, thin flats, worn-out sneakers and bare feet on tile all raise the load on the fascia.
Look-alikes
Not every sore heel is plantar fasciitis. The guideline names heel fat pad syndrome, nerve irritation and stress fracture of the heel bone among the other causes of plantar heel pain. A heel that feels bruised in the center and is worst barefoot on hard floors points toward the fat pad, covered in our article on fat pad atrophy. Burning or tingling points toward a nerve, covered in burning feet at night.
What helps plantar fasciitis heal: the 2023 guideline, ranked by evidence
The 2023 guideline grades each treatment by letter, with A as its strongest rating. Four treatments hold an A: stretching, taping, night splints and hands-on manual therapy from a clinician. Strengthening exercise, dry needling and low-level laser hold a B.
Stretching, grade A
Clinicians should use plantar fascia-specific stretching and calf stretching for both short-term and long-term pain and function. For the fascia stretch, sit, cross the sore foot over the opposite knee, and pull the toes back toward the shin until the arch feels taut. For the calf, lean into a wall with the back knee straight and the heel on the floor.
Pro Tip: Do the fascia stretch before your feet touch the floor in the morning and before standing up after long sitting. Those first steps are when the pain peaks, and a stretch done after the walk to the bathroom comes too late.
Night splint, grade A
For people with consistent pain on the first step in the morning, the guideline recommends a night splint for one to three months. The splint holds the ankle at a right angle so the fascia and calf do not spend the night in a shortened position.
Taping, grade A
Rigid or elastic tape on the foot, used alongside other treatment, reduces pain and improves function in the short term, a window the guideline puts at one to six weeks. A physical therapist teaches the pattern in one visit, and it is repeatable at home.
Strengthening, grade B
The 2023 revision calls for resistance training for the muscles of the foot and ankle. Slow heel raises are the usual starting point.
Insoles and shoes
Here the guideline is cooler than the shoe aisle. It advises against insoles as a stand-alone treatment for short-term pain (grade B) and supports them only in combination with other treatments (grade C). Advice on footwear sits at grade E, one of its lowest ratings.
Steroid injections
Injections fall outside a physical therapy guideline, but the authors summarize the evidence. One pooled analysis ranked injections among the options most likely to reduce pain. A Cochrane review rated the evidence as low quality, and reported risks include fat pad atrophy and rupture of the plantar fascia. In the Danish cohort 93% of patients had received one, and the study design does not allow any conclusion about whether the injections helped or hurt.
What 486 women reach for, compared with what the guideline backs
To see how real-world habits line up with the evidence, we read 486 comments left by women over 40 in a public menopause support thread that asked what helps plantar fasciitis. We counted how many comments mentioned each remedy. A mention is not an endorsement, since some women named a remedy to say it failed, and many comments named more than one.
Shoes dominated. Stretching, the best-supported treatment, appeared in fewer than one comment in six.
| Approach | 2023 guideline grade | Share of 486 comments | Best for |
|---|---|---|---|
| Supportive or cushioned shoes | E, for footwear advice | 31% (151 comments) | Lowering the load on hard floors, as an add-on |
| Ball rolling or massage | Self-massage is not graded. Manual therapy from a clinician holds an A | 15% (75) | Short-term relief between stretches |
| Plantar fascia and calf stretching | A | 15% (72) | Everyone, from the first day |
| Insoles or orthotics | B against using them alone. C when combined with other treatment | 14% (69) | An add-on to stretching and strengthening |
| Steroid injection | Outside the guideline's scope. Evidence rated low quality | 10% (48) | A decision with a physician after other care |
| Night splint or boot | A, for one to three months | 4% (18) | Pain on the first steps every morning |
| Taping | A, short term | 1% (7) | Flare-ups lasting one to six weeks |
Shoes came up twice as often as stretching. The two grade A tools built for the exact complaints women describe, night splints for first-step morning pain and taping for flare-ups, came up in 4% and 1% of comments. Strengthening exercise appeared in 6%.
Three smaller counts: sixteen comments (3%) mentioned hormone therapy or estrogen, six mentioned magnesium and five mentioned collagen. Those numbers are too small to say anything about benefit. Hoka was the most-named shoe brand, in 18 comments, ahead of Oofos (11) and Brooks (9).
The practical reading: keep the shoes, and add what the comments skipped. A daily stretch, a night splint if mornings are the worst part, and heel raises cost little and carry the grades that shoes and insoles lack.
How we counted: comments were read on November 11, 2026 and matched by keyword to each remedy. This is one thread and a self-selected group, so the shares show what women try, not what works.
Know when to seek professional evaluation:
- Heel pain that began with a fall, a jump or a sudden pop in the arch
- Pain at rest or at night, or a heel that is swollen, red or warm
- Numbness, tingling or burning in the foot
- Pain in both heels together with morning stiffness in other joints
- Any foot pain or skin change if you have diabetes
- No improvement after two to three months of consistent stretching and splinting
Collagen for plantar fasciitis: where Botavive Collagen Peptides fits, and where the evidence stops
The plantar fascia is collagen tissue that remodels slowly. Stretching and strengthening give it the signal to rebuild. Diet supplies the raw material, and that is the only gap a supplement is positioned to fill.
Botavive Grass-Fed Collagen Peptides Powder is unflavored hydrolyzed bovine collagen, 20 g per two-scoop serving. The evidence for collagen and connective tissue is early. A 2022 systematic review in the Journal of the International Society of Sports Nutrition examined 19 studies on nutrition and tendon problems. Collagen-derived peptides were the most-studied supplement, individual studies looked promising, and combining a supplement with training seemed to produce better clinical and functional outcomes. The authors also found too few high-quality studies to make a firm recommendation. Our search found no published randomized trial of oral collagen for plantar fasciitis as of November 2026.
So collagen is an optional add-on to the stretching, splinting and strengthening above. It does not treat plantar fasciitis and does not replace any of them. For timing around exercise, see our article on when to take collagen after 40.
Frequently asked questions
How long does plantar fasciitis last?
In the Danish study, patients who recovered had symptoms for about two years on average, with a range from 41 days to 11 years. One year after symptoms began, an estimated 80.5% still had the condition. Five years in, the figure was 50%.
Why does my heel hurt in the morning and ease after a few steps?
Overnight the foot rests with the toes pointed and the plantar fascia in a shortened position. The first steps stretch it at its attachment on the heel bone, which is why pain on the first steps after rest is among the defining signs in the 2023 guideline. A night splint, graded A for this pattern, keeps the fascia lengthened while you sleep.
Will plantar fasciitis go away if I lose weight?
Weight loss alone is not a reliable fix. The guideline lists high BMI in non-athletes as a risk factor for developing plantar fasciitis, but in the Danish cohort BMI did not predict who recovered. The guideline's advice on body weight holds grade E, one of its lowest ratings.
Does menopause make plantar fasciitis worse?
No study we found has tested menopause directly. The pieces that exist: the condition is most common between ages 40 and 60, the average age at onset in the Danish cohort was 46.7, and women in that cohort recovered at about half the rate of men. The authors list hormones as one possible reason and call for more research.
Does a heel spur mean plantar fasciitis will not heal?
No. In the Danish cohort a heel spur at diagnosis had no effect on who recovered (P = .88), and neither did the thickness of the fascia on ultrasound. A spur on an X-ray is a finding, not a forecast.
Sources
- Hansen L, Krogh TP, Ellingsen T, Bolvig L, Fredberg U, 2018. Long-term prognosis of plantar fasciitis: a 5- to 15-year follow-up study of 174 patients with ultrasound examination. Orthopaedic Journal of Sports Medicine. pmc.ncbi.nlm.nih.gov/articles/PMC5844527
- Koc TA Jr, Bise CG, Neville C, Carreira D, Martin RL, McDonough CM, 2023. Heel pain, plantar fasciitis: revision 2023. Clinical practice guideline. Journal of Orthopaedic and Sports Physical Therapy. orthopt.org, Heel Pain Plantar Fasciitis revision 2023 (PDF)
- Hijlkema A, Roozenboom C, Mensink M, Zwerver J, 2022. The impact of nutrition on tendon health and tendinopathy: a systematic review. Journal of the International Society of Sports Nutrition. pmc.ncbi.nlm.nih.gov/articles/PMC9354648