Plantar Heel Pain: What is it and what treatment is available?

What is Plantar Heel Pain?

Plantar Heel Pain encompasses a number of conditions that can cause pain around the heel bone.

This condition is most commonly thought of as Plantar Fasciitis, however studies how shown that it is not primarily inflammatory in nature and should be referred to as Plantar Heel Pain,

Plantar Fasciosis or Plantar Fasciopathy. We refer to it as Plantar Heel Pain as a broader diagnostic term until further confirmation of the condition via a clinical or radiographic diagnosis.

What other conditions commonly affect the heel?

Pain at the plantar heel could be due to plantar fasciopathy, fat pad contusion, calcaneal stress fracture, medial calcaneal nerve entrapment, Baxter’s Neuritis (Lateral calcaneal nerve entrapement), Heel Spur syndrome, Tarsel Tunnel Syndrome and bursitis.



What are the cause or risk factors for Plantar Heel Pain?

Plantar Heel Pain has a strong biomechanical component, with high arch and low arch feet at increased risk of injury.

With the high load capacity of the feet, increased body weight is a strong risk factor.

Other causes include inflexibility of the ankle associated with tightness of the calf muscles, inappropriate footwear, activity types and surfaces, sharp increases in activity and load as well as inappropriate footwear.


Why is it necessary to get professional management of Plantar Heel Pain?

Due to the complex anatomy of the plantar heel and the number of other associated conditions it is important to get a thorough assessment.

A podiatrist understands the rearfoot anatomy, mechanism of injuries and symptomatic presentation of plantar heel pain to provide a clinical diagnosis.

If we are think is necessary, we can refer for X-ray or Ultrasound to provide further insight and accuracy to your diagnosis.

In particular, Ultrasound is a non-invasive, accurate and reliable form of imaging used to measure plantar fascial thickness, tissue quality, and guide treatment options.



What treatments are used for Plantar Heel Pain?

A combination of conservative treatments is often required, particularly in the initial stages of injury:

  • Rigid taping techniques
  • Dry Needling and Massage
  • Strengthening and Stretching
  • Foot Mobilisation
  • Footwear adjustment or prescription
  • Pre-fabricated Orthotics
  • Semi-Custom or Custom Orthotics

If a conservative treatment regime is unsuccessful, we can discuss more extensive treatments such as:

  • Shockwave therapy
  • Injection Therapies
  • Surgical Opinion