Tendons & heel
Plantar fasciitis and heel pain
Pain under the heel: exercise, footwear, shockwave therapy and the limits of injection treatments.
Understanding the condition
Plantar fasciitis causes pain beneath the heel, often worst with the first steps after rest. Similar pain can arise from other conditions, so persistent or unusual symptoms deserve assessment. Imaging is not always needed but may help when the diagnosis is uncertain.
Treatment options
Initial treatment includes modifying painful loading, supportive footwear, plantar-fascia and calf exercises and suitable pain relief. Insoles or a night splint may help selected people. Persistent symptoms may prompt discussion of shockwave treatment, injection or, infrequently, surgery.
What a procedure may involve
Shockwave therapy applies acoustic energy through the skin. Injections deliver a chosen substance to the target area, sometimes using ultrasound. Steroid can offer short-term relief but has specific risks. PRP is a separate option with uncertain benefit; it is not a guaranteed cure.
Risks and benefits to discuss
Exercise can temporarily aggravate symptoms if loading increases too quickly. Shockwave may cause discomfort or bruising. Injection risks include infection, bleeding and a flare; steroid has additional risks including tissue or fat-pad damage and fascial rupture. Surgery has wound, nerve and persistent pain risks.
Rehabilitation and aftercare
Rehabilitation is central: build walking and exercise gradually while adjusting to symptom response. Avoid suddenly returning to prolonged standing, running or jumping. After a procedure, use the specific activity and exercise plan supplied rather than assuming pain relief means full recovery.
Expected outcomes and recovery
Improvement may take several months and symptoms can recur. The goal is comfortable daily activity and durable loading tolerance. A treatment that helps one patient may not help another; evidence and cost should form part of the discussion.
When to seek urgent help
Seek urgent assessment for a sudden injury with inability to bear weight, a hot swollen foot with fever, or new loss of sensation. People with diabetes, poor circulation or reduced sensation should seek early advice about new foot pain. After an injection, escalating pain with redness or fever needs urgent review.
Your consent discussion
Ask which treatment best addresses your symptoms, what alternatives are reasonable, what the main risks mean for you, and what recovery will involve at home and work. This guide supports that discussion; consent is completed with your treating team. Your individual written instructions take priority.
Your consent discussion
Use the patient pack to record your priorities, the proposed procedure, its alternatives, the benefits you hope for and risks that matter to you. A clinician will discuss your individual circumstances and complete the appropriate hospital consent process with you.
Reading or downloading a guide does not give consent. You can ask further questions, decline treatment or change your mind before the procedure.
Further reading & sources
Prepared 10 October 2026 for the practice of Mr Peyman Bakhshayesh. Professional background. General patient education; your clinical assessment and written instructions determine your care.
Private care in Huddersfield
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