Plantar Fasciitis Treatment: Understanding Heel Pain

Is heel pain that’s worse first thing in the morning troubling you? You’re likely experiencing plantar fasciitis, a condition that is very treatable.

What is plantar fasciitis?

Plantar fasciitis is characterised by irritation or degenerative change within the plantar fascia, a thick band of connective tissue that runs from the heel towards the toes and helps support the arch of the foot.

Despite its name, persistent plantar fasciitis is not usually considered a purely inflammatory condition. In longer-standing cases, changes within the tissue are thought to relate more to repeated loading and the fascia’s response to that load.

Common Plantar Fasciitis Symptoms

The symptoms of plantar fasciitis can vary, but they often include:

- Pain under the heel or along the arch of the foot

- Pain that worsens with prolonged periods of standing or walking

- Discomfort during the first steps after getting out of bed

- Initial pain that eases with movement but intensifies later in the day

- Tenderness when pressure is applied to the inside of the heel

- A feeling as if there’s a marble in your shoe

These symptoms can affect one or both feet.

Who is at Risk?

Plantar fasciitis can affect anyone, but it is particularly common among:

- Individuals who spend extensive time standing or walking

- Runners and recreational athletes

- Those who have recently ramped up their activity levels

- People with limited ankle mobility or altered foot mechanics

- Individuals returning to activity after a break

Additionally, it can develop gradually without a single identifiable injury.

Typical Treatments for Plantar Fasciitis

Most cases of plantar fasciitis improve with appropriate heel pain treatment, though this generally involves a multifaceted approach rather than relying on a single treatment option.

Common treatment methods include:

- Load management and modifications to daily activities to reduce excessive strain on the plantar fascia

- Targeted stretching and strengthening exercises as part of a rehabilitation program

- Assessing and improving calf, ankle and foot function

- Using supportive footwear or temporary orthotics

- Manual therapy, where indicated

We frequently see patients with plantar fasciitis, one of the most common causes of heel pain. When symptoms have persisted for several months despite self-management or rehabilitation, focused shockwave therapy combined with a targeted rehabilitation programme can be a useful next step in treatment.

What Makes Our Approach Unique

At Tenby Health we prioritise thoroughly understanding the problem before deciding on a treatment plan. 

When clinically appropriate, diagnostic ultrasound can be used to assess the plantar fascia and look for structural changes that may support the clinical diagnosis, while also helping us consider other potential causes of heel pain.

For appropriate cases, we may also use focused shockwave therapy, which accurately delivers energy deep into the affected area of the plantar fascia, stimulating the body’s natural healing processes. This is complemented by:

- A comprehensive clinical assessment

- Supervised rehabilitation sessions

- A clear, progressive exercise plan to address contributing factors

This integrated method is designed to be effective, efficient, and evidence-informed, facilitating recovery while minimising unnecessary appointments.

Next Steps

If plantar heel pain is disrupting your daily life, the first step is establishing what is causing it and what is likely to help.

Book a new patient consultation and we will assess your symptoms, establish the most likely diagnosis and clearly explain your treatment options. Depending on your presentation, this may involve rehabilitation, focused shockwave therapy, diagnostic ultrasound, or a combination of approaches.

Our aim is for you to leave your first appointment understanding what is likely causing your heel pain and what the next steps should be.