There are a number of conditions that cause pain on the bottom of your heel. The most common cause is plantar fasciitis, which affects approximately 1 in 10 people.

The plantar fascia is a ligament-like structure that runs from the bottom of the heel to the ball of the foot, and helps to support the arch.

Plantar fasciitis is characterised by a sharp pain when first getting out of bed in the morning, which reduces with walking. However, the pain may return at the end of the day, and be just as painful as the morning pain.

Risk factors for getting plantar fasciitis include being overweight, increased time spent standing and a decreased ankle joint range of motion. These risk factors all place extra stress on the plantar heel, resulting in pain. Therefore, addressing these risks are a key part of successful management.

There are a variety of treatments used for plantar fasciitis, however there is no agreement on which treatments are most effective.

Simple heel pain self-care treatments include:

• reducing weight (ideally a BMI below 30)
• reducing activity levels (e.g. amount of running) or time spent standing
• wearing supportive cushioned footwear (e.g. runners)
• performing calf and plantar fascia stretches before standing after a period of rest

If these treatment fail, there are a variety of other more complex and expensive treatment options. Two commonly provided treatments are foot orthoses (shoe insoles) and corticosteroid injections. Although these treatments are common, it is not known which treatment is more effective.

A new randomised trial (the SOOTHE Heel Pain Trial) will compare these interventions, and is looking for participants with plantar fasciitis.

For more information about participating in the trial please see the website www.heelpaintrial.com or contact Glen Whittaker on 9479 5785 or g.whittaker@latrobe.edu.au.