Lived experience and attitudes of people with plantar heel pain: a qualitative exploration

Key points

1. 01First-step pain and reduced ability to walk, stand, or exercise were the most commonly reported impacts.
2. 02Participants were uncertain about the cause, underlying pathology, and prognosis of their condition.
3. 03A trial-and-error approach to treatment was common, associated with frustration and a lack of consistent guidance.
4. 04Online information was widely used but described as confusing, conflicting, and rarely useful.
5. 05Patients wanted face-to-face consultations, clear written handouts, and trustworthy online resources tailored to their condition.

How it was conducted

Design

Qualitative descriptive study using semi-structured interviews

Analysis

Framework approach with respondent validation (member checking)

Participants

18 adults with a clinical diagnosis of plantar heel pain in metropolitan Melbourne and regional Victoria, Australia

Inclusion criteria

Age 18+, symptoms >1 month, average pain >20 mm VAS, pain on palpation of medial calcaneal tubercle

Recruitment

Purposive sampling to capture range of sex, age, symptom duration, and prior treatment

Data collection

Interviews lasted 6 to 31 minutes (mean 15 minutes); audio recorded and transcribed verbatim

What they found

• 18 participants interviewed; mean age 58.2 (SD 6.6) years; 66% female.
• Mean symptom duration was 15.9 (SD 16.3) months.
• Mean first-step pain VAS was 45.6 (SD 34.0) mm; average pain over past 7 days was 43.9 (SD 24.7) mm.
• Mean Foot Pain score on the Foot Health Status Questionnaire was 51.4 (SD 17.5) out of 100; mean Foot Function score was 52.8 (SD 30.4) out of 100.
• Framework analysis identified 8 themes and 43 sub-themes covering impact, perceptions, coping, information sources, patient needs, unmet needs, advice to others, and interest in online education.
• All participants confirmed transcripts were accurate during respondent validation.

Limitations

• Recruited symptomatic participants may over-represent those with negative experiences, potentially skewing findings.
• Some interview questions were closed-ended, which may have limited depth of responses and contributed to short interview durations (some as brief as 6 minutes).
• Single interviewer conducted all interviews, which may introduce bias despite independent secondary coding.
• Sample was drawn from one region of Australia; findings may not generalise to other health systems or cultures.

Why it matters

For patients

Patients with plantar heel pain can expect their concerns about uncertainty and unmet needs to be recognised, and should seek a clinician willing to explain the diagnosis, likely prognosis, and a clear stepwise treatment plan.

For clinicians

Clinicians should adopt a biopsychosocial approach, proactively address patient uncertainty about diagnosis and prognosis, provide take-home written resources, and avoid conflicting or jargon-heavy explanations.

For readers

This study is the first to document patient-reported experiences and education needs for plantar heel pain, providing a foundation for designing clinical guidelines and patient-facing resources.