Time to discuss a clinical topic Section

Stark facts for long term chronic heel pain (fasciitis)

Not always a simple condition to treat


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This is a common condition that I have written about before in Footlocker; since 2014 I have blogged the subject 5 times – July 2016, March 2016, October 2015, June 2015 and August 2014.

However my post bag seems to be growing in regard to enquiries. Why is a podiatric surgeon a last resort I ask myself? I see a need for better patient help and yet, given the wide range of specialty clinicians that can become involved, lack of improvement is worrying.

Can I help? Maybe, but it is unlikely that after 11 people: orthopaedics, podiatrists (non surgical), chiropractors, rheumatologists mainly, and a number of interventions this is unlikely.

The longer the problem exists, the more difficult it is to deal with. Do I do anything different? My approach IF it is fasciitis:

rule out medical disease
ensure the problem is localised and not damaged
install conservative treatment for 6 months (cost can limit some patients)
utilise one injection per key area ONLY
counsel occupational related causes
consider percutaneous (key hole surgery) fact sheet 21 under education information.

The typical cost of dealing with fasciitis as a programme of care. From £350 – £5000 (at my facility). Staggering! but then seek 11 clinicians over 4 years, well that adds up to a high cost as well as increasing disability. At Spire we work across a team of professionals and have excellent diagnostic services available.

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