Plantar Fasciitis (Heel Pain)

Pain in the sole of the foot or front of the heel, associated with repetitive stress causing tear or strain of the soft tissues of the sole of the foot.


Diagnosis of Plantar Fasciitis is derived from the patient’s history and physical exam with no indicators of potentially serious pathology.

Chiropractors perform a thorough history of complaint and examination (orthopaedic, neurological and chiropractic testing).

Assessment may also include referral for diagnostic imaging including X-ray and MRI or blood tests.

Evidence based summary for manual therapy [53]

The highest quality of scientific trials show there is moderate quality evidence (on a scale of low, moderate and high) that manual therapy of the foot and/or full kinetic chain (pelvis to foot) combined with exercise therapy is effective for plantar fasciitis [121]. This study compared manual therapy with exercise compared to electrotherapy with exercise for patients with plantar heel pain and found manual therapy plus exercise was superior.

Other evidence for the chiropractic approach to lower leg problems

There is evidence to support chiropractic approach to help care for patients with lower extremity conditions [108].

There is evidence to support the effectiveness of exercise and manual therapy to help and prevent ankle sprains [118 -120].

Other effective non-invasive physical treatments or patient education [53]

Stretching and foot orthoses for plantar fasciitis [122].

Back-in-Action Clinic Comment

Chiropractic treatment of Plantar Fasciitis initially is based on promoting soft tissue healing and relieving pain.

Self help recommendations of using ice or heat is often given in the acute stage and it is recommended to limit aggravating activities. Nutritional approaches can be beneficial to help support soft tissue healing.

Cross friction massage and muscle release techniques may be applied. Areas of severe muscle spasm may also benefit from massage or acupuncture. An emphasis is placed on self help exercise which might include self mobilisation, stretching, strengthening and balance training.

Both pain relief and preventative approaches focus on improving the movement, position and stability of the lower leg and related structures in order to reduce the risk of stress and further tissue damage. Core stability exercise often is useful for improving the position of the low back, pelvis and hip. Functional neurological treatment and exercises are sometimes helpful.

Foot orthotics, heel lifts, sitting advice and other ways to improve postural problems affecting the lower leg may be suggested to help prevent reoccurrence. Education on running style and preparation can be useful.

Chiropractic adjusting techniques (manipulation) and mobilisation may be applied to the foot and ankle and to improve the function of related joints in the lower back and leg.

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