After finishing surgery and chemotherapy, many people ease back into activity by walking. It can be discouraging when the very body that once handled a treadmill now aches after just a few thousand steps — with a sharp pain in the center of the heel that makes each walk harder. This kind of heel pain is often linked to plantar fasciitis, an irritation of the thick band of tissue (the plantar fascia) that runs along the sole of the foot and absorbs load with every step.
The most common question is whether this is a "chemotherapy side effect." Plantar fasciitis is not usually listed among the direct, typical effects of chemotherapy drugs. However, several conditions that come with treatment can leave the feet more vulnerable. After a long stretch of reduced activity, the calf and foot muscles and tendons weaken (deconditioning); ramping up walking too quickly then overloads the fascia. Weight loss can thin the fat pad that cushions the heel, and swelling, steroid use, or unsupportive shoes can all play a part.
It helps to separate this from chemotherapy-induced peripheral neuropathy (CIPN). Neuropathy usually shows up as tingling, burning, or numbness at the toes and soles of both feet, and is felt even at rest. Plantar fasciitis, by contrast, is a stabbing heel pain that appears when you put weight on the foot — classically with the first steps in the morning or after sitting for a while. The two can occur together, so rather than deciding on your own, it is wise to note your symptoms.
You do not have to give up walking. Because the real problem is "too much, too soon," it helps to cut back briefly and then increase your walking by roughly 10% a week. Avoid walking barefoot on hard floors, and use cushioned shoes or insoles that support the heel. Gently stretch the calf and sole before and after walking, and apply cold after activity — rolling a cold bottle under the arch is a common, simple method.
See a clinician if the pain does not improve after two to three weeks of rest and cold packs; if it hurts at rest or at night, or comes with numbness or loss of sensation; if the foot is red, swollen, or warm; or if both feet worsen quickly. These signs can point to something other than simple plantar fasciitis — a nerve problem, swelling, infection, or, less often, a bone or circulation issue. A rehabilitation or orthopedic clinic can examine the foot, and if you are still in treatment, tell your oncologist about the symptom along with the medications you are currently taking.
This article is general information and does not replace individual medical care or diagnosis. Pain patterns and accompanying symptoms differ from person to person, so if you notice a change that worries you, please discuss it with your healthcare team.