Heel or sole
Plantar Fasciitis & Chronic Heel Pain
Quick answer
Plantar fasciitis is a load-related irritation of the plantar fascia at the heel, typically causing sharp pain on the first steps in the morning or after sitting. It is assessed clinically, managed with load management, calf and foot strengthening, and footwear advice — with shockwave therapy considered for selected persistent cases alongside that rehabilitation.
Common symptoms
- First-step pain in the morning
- Pain returning after sitting for a while
- Discomfort during prolonged standing or walking
- Running-related heel pain that eases and then returns
- Tenderness under the inner heel
Potential causes and contributing factors
- Rapid increases in walking, standing or running load
- Reduced calf and ankle mobility
- Limited foot and calf strength capacity
- Footwear or surface changes
- Long periods on hard floors at work
Who commonly experiences it
Common in runners, people whose work involves long hours standing, adults returning to exercise, and people who have recently increased their daily step count.
How it is assessed at Back2Health
- Pain history and 24-hour symptom pattern
- Palpation of the plantar fascia insertion
- Calf and ankle mobility testing
- Foot and calf strength capacity
- Walking and running load review
- Footwear review
Where shockwave may fit
Chronic heel pain is one of the more frequently studied indications for shockwave therapy, and it may be considered when symptoms persist despite an appropriate period of load management and exercise.
Where it may not fit
It is less relevant when symptoms are very recent and responding well to load changes, when heel pain is caused by nerve irritation or a bone-stress problem, or when a clear diagnosis has not yet been established.
Rehabilitation and alternative treatment
Whether or not shockwave is used, the rehabilitation plan does the long-term work. Alternatives and adjuncts may include physiotherapy alone, manual therapy where indicated, load management, footwear or equipment changes, and referral for imaging or a medical opinion.
- Load management and step-count planning
- Calf and ankle mobility work
- Progressive calf and foot intrinsic strengthening
- Footwear and orthotic discussion where relevant
- Graded return to walking and running
When medical referral may be needed
Heel pain with numbness, night pain, or a history of trauma may need imaging or medical review before any treatment is started.
Seek urgent care for major trauma, sudden inability to bear weight, suspected fracture, severe swelling or redness, fever, unexplained weight loss, progressive weakness, or loss of bladder or bowel control.
Plantar Fasciitis & Chronic Heel Pain — questions patients ask
It is a commonly considered option for persistent cases and is generally used alongside progressive loading rather than on its own. Response varies between individuals.
Medical disclaimer. Information on this website is provided for general education and does not replace an individual clinical diagnosis or medical advice. Shockwave therapy is not suitable for every person or every condition. A qualified clinician must assess suitability.
Written by the Back2Health physiotherapy and rehabilitation team · Clinically reviewed by the Back2Health clinical team · Last reviewed 3 August 2026
Find out whether shockwave is right for your condition
Start with a clinical assessment. The Back2Health team will evaluate the source of your symptoms, explain whether shockwave is appropriate and build a rehabilitation plan around your goals.