Heel Pain (including plantar fasciitis/plantar fasciopathy)
This is likely the most common affliction of the human hind or rear foot. The vast majority of cases respond to non-surgical intervention. Prefabricated and custom-made foot orthoses resolve the majority of cases and can be used to prevent a recurrence of the complaint. Oral or topical anti-inflammatory in conjunction with stretching and RICE (rest-ice, compression and elevation) are useful adjunctive forms of treatment. Strappings can be used for heel pain both diagnostically and therapeutically. That is a patient responding well to a strapping through a reduction in pain and an increase in support will usually respond well to orthotic therapy.
More severe cases of plantar fasciitis may require more intensive care involving the temporary use of walking boots and injection therapy (see information section). This is usually reserved for patients who have considerable pain and have great difficulty placing weight through their heel. Surgery is used for patients who do not respond to non-surgical management. Remember the vast majority of people with plantar fasciitis/plantar fasciopathy or or heel pain affecting the inside of the heel and arch will respond to non-surgical management.
Surgery commonly consists of two techniques – the plantar fasciotomy and the plantar fasciectomy (with or without heel spur resection). Sometimes heel pain has a ‘nerve component’ and surgery of this type is combined with posterior tibial nerve decompression but this is not commonly performed.
Our practitioners can discuss each of these treatment options with you. Prescription medication can be prescribed as required.
For a brief overview of plantar fasciitis (plantar fasciopathy) including treatment options, please click below (video six).