Plantar Fasciitis Perth | Persistent Heel Pain Assessment
Plantar fasciitis: When heel pain won’t go away
If you have been treated for plantar fasciitis but your heel still hurts, it may be time to reconsider the diagnosis. Persistent heel pain can have other causes, and a foot and ankle surgical assessment may help clarify what is going on.
Plantar fasciitis Perth
Is your heel pain definitely plantar fasciitis?
Plantar fasciitis is one of the most common causes of heel pain. It affects the plantar fascia, a strong band of tissue running from your heel towards your toes that helps support the arch of your foot.
Typical symptoms include pain underneath the heel, particularly with your first steps in the morning or when standing after sitting for a long time.
For many people, plantar fasciitis improves with non-surgical care such as stretching, physiotherapy, footwear changes, orthotics and activity modification.
But what happens when your heel pain does not go away?
If you have had appropriate treatment for plantar fasciitis and the pain continues, one of the questions we need to ask is whether the original diagnosis still explains your symptoms.
Persistent heel pain does not necessarily mean you need foot surgery. It does mean that further assessment may be worthwhile.
Heel pain specialist Perth
What else can cause heel pain?
Several foot and ankle conditions can cause symptoms that look like plantar fasciitis.
Depending on your symptoms, we may consider other possible causes such as:
- Stress injury or stress fracture of the heel bone
- Nerve irritation or compression
- Problems involving the heel fat pad
- Achilles tendon problems
- Arthritis or other joint conditions
- Structural or alignment problems affecting the foot
This is why it may be useful to reassess persistent heel pain.
When should I see a foot and ankle surgeon?
A foot and ankle surgical opinion may be appropriate when heel pain has continued for an extended period despite appropriate non-operative treatment.
During your consultation, we will look at where your pain occurs, how long it has been present and which treatments you have already tried. We may also assess your foot structure, ankle movement, calf flexibility and the way you walk.
X-rays or other imaging may be recommended when the diagnosis is unclear or your symptoms have continued despite treatment.
The purpose of seeing a foot and ankle surgeon is not to assume that an operation is necessary.
Sometimes the most useful outcome of a surgical consultation is confirming that foot surgery is not required. The priority is understanding why the heel is still painful and identifying the most appropriate next step.
If your heel pain turns out to be caused by a condition that has not previously been identified, we will explain what that diagnosis means and discuss the treatment options available to you.
Depending on the cause, this may involve further non-surgical treatment, a different rehabilitation approach or, in some cases, foot or ankle surgery. The next step depends on what we find during your reassessment and how much the condition is affecting your daily life.
Plantar fasciitis surgery Perth
Does plantar fasciitis ever need surgery?
Surgery for plantar fasciitis is uncommon. It may be considered when plantar fasciitis has been confirmed as the cause of your heel pain, symptoms remain significant despite an appropriate period of non-operative treatment, and the pain continues to affect your daily activities.
If we are considering surgery, we first need to be confident that the plantar fascia is actually the source of the pain. Only then can we decide whether an operation is appropriate.
One possible procedure is a plantar fascia release, also known as a plantar fasciotomy. This involves releasing part of the plantar fascia to reduce tension through the painful area.
The decision to proceed depends on your symptoms, previous treatment, general health and individual circumstances. We will discuss the potential benefits, limitations and risks before recommending surgery.
Foot surgeon Perth
Why The Foot & Ankle Centre?
The Foot & Ankle Centre has focused on foot and ankle care in Perth since 1996. Our role in persistent heel pain is to look beyond the label of plantar fasciitis and determine whether there is another problem contributing to your symptoms.
If you have already tried appropriate treatment for plantar fasciitis and your heel pain continues, you are welcome to make an appointment for further assessment.
We will review your diagnosis, previous treatment and individual circumstances before discussing whether any further specialist or surgical treatment is appropriate.
FAQs
Can plantar fasciitis be misdiagnosed?
Yes. Plantar fasciitis is a common cause of heel pain, but it is not the only one. Several foot, ankle and nerve conditions can cause similar symptoms, which means the original diagnosis may sometimes need to be reconsidered.
In one retrospective study of 250 people with plantar heel pain, 53.2% were diagnosed with plantar fasciitis alone. Other diagnoses included heel fat-pad atrophy, differences in foot structure and nerve-related pain.
If your heel pain is not improving as expected, reassessment can help determine whether plantar fasciitis is still the most likely diagnosis.
What conditions can be mistaken for plantar fasciitis?
Conditions that can cause similar heel pain include heel fat-pad problems, calcaneal stress fractures, nerve compression, Achilles tendon conditions and some forms of arthritis.
Baxter’s nerve entrapment is one example. This involves compression of a small nerve around the heel and can produce symptoms that overlap with plantar fasciitis. Baxter’s nerve entrapment is an under-recognised cause of chronic heel pain that can produce symptoms similar to plantar fasciitis.
