Plantar fasciitis is one of the most common causes of heel pain. Patients often describe a sharp pain under the heel when they first get out of bed in the morning or after sitting for while. The pain may ease slightly as they start walking, only to return later in the day.
The condition involves irritation of the plantar fascia – the thick band of tissue running along the sole of the foot.
It is particularly common in people who spend long hours on their feet, runners, those who suddenly increase exercise levels or people wearing unsupportive footwear.
One of the biggest misconceptions is that complete rest is the answer. Treatment is usually centred on activity modification, calf stretching, supportive footwear and improving flexibility. Small changes can often make a significant difference:
- Avoid very flat, unsupportive shoes
- Stretch the calf muscles regularly
- Wear cushioned, supportive trainers
- Increase exercise gradually
- Maintain a healthy weight
Persistent cases sometimes require more targeted treatment. Treatments I offer include extracorporeal shockwave therapy or a targeted steroid injection, both of which can stimulate healing and reduce chronic pain without surgery. For patients with ongoing symptoms despite extensive conservative treatment, surgery may occasionally be appropriate. One procedure I commonly perform is a calf muscle release (gastrocnemius release), which reduces tightness in the calf and decreases tension through the plantar fascia. In carefully selected patients, this can significantly improve pain and function.
Bunions: More than just a cosmetic problem
Bunions are another condition many people quietly tolerate for years. A bunion develops when the big toe gradually drifts sideways, creating a prominent bump on the inside of the foot.
Although often dismissed as cosmetic, bunions can lead to significant pain, difficulty with footwear and reduced walking tolerance. As the deformity progresses, it can also affect the lesser toes, leading to problems such as hammer or overriding toes.
Women are affected more frequently, partly because of footwear choices, but genetics and underlying foot structure play a major role.
Importantly, bunions are not caused simply by “bad shoes”, although narrow footwear can certainly aggravate symptoms.
Not every bunion requires surgery. Many patients manage well with footwear changes, orthotics and activity modification.
However, when pain begins to interfere with daily life, surgery can be extremely effective.
Modern bunion surgery aims not simply to “shave off the bump”, but to correct the underlying alignment of the bones and restore a more normal position of the big toe. Surgical techniques and recovery pathways have improved significantly in recent years, and many patients are pleasantly surprised by how manageable recovery can be. The goal is to reduce pain, improve function and allow patients to return to comfortable footwear and normal activity.
Do not ignore persistent foot pain
The biggest message I would give is simple: persistent foot pain is not “normal”.
Keeping active is one of the most important things we can do for our long-term health, particularly as we get older.
Foot and ankle pain often stops people exercising, walking, travelling and enjoying everyday life long before they seek help.
In many cases, early assessment and treatment can prevent years of discomfort and help people remain active, mobile and independent for longer.
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Simon Mordecai is a consultant orthopaedic foot and ankle surgeon. If you have any foot or ankle concerns and would like expert advice, you can book an appointment with Mr Mordecai at Hendon Hospital by phone on 020 8131 5572 or online at circlehealthgroup.co.uk
