Heel Pain Treatment in Singapore - Shockwave Therapy For Plantar Fasciitis

The most common cause of heel pain is plantar fasciitis. This happens when the thick band of tissue along the bottom of your foot, known as the plantar fascia, becomes irritated or overstretched. Because this tissue supports your arch and absorbs impact, it can get strained from everyday habits and lifestyle factors.

Common causes of plantar fasciitis include:

• Spending long hours standing or walking
• Wearing flat or unsupportive footwear
• Having flat feet or high arches
• Sudden increases in exercise or activity
• Tight calf muscles that pull on the heel
• Higher body weight, which increases pressure on the feet

People often notice sharp heel pain when getting out of bed or after sitting for a while. The encouraging news is that plantar fasciitis is very treatable, and early care can help you recover faster and get back to moving comfortably.

Heel pain isn’t always caused by plantar fasciitis. It can also stem from the Achilles tendon, nerve compression, ligament stress, issues with the heel fat pad, stress fractures, or a biomechanical overload. That’s why a thorough, precise diagnosis is the most critical first step.

At Feet First Podiatry Clinic, our approach is comprehensive and focused on finding the true source of your pain so your treatment is accurate and effective.

Our diagnostic process may include:

• A detailed, hands-on foot and ankle examination to pinpoint the painful areas.
• Gait and Biomechanical Assessment to see how your body moves and how you distribute load.
• Muscle strength and flexibility testing.
• Evaluation of your footwear and activity levels.
• In-clinic Gait Analysis to identify specific load patterns contributing to your pain.
• Referral for diagnostic imaging (like X-ray or ultrasound) if needed, to check for issues like stress fractures or confirm tissue damage.

Plantar fasciitis and heel spurs are related, but they’re not the same thing.

Plantar fasciitis is a soft-tissue injury that occurs when your plantar fascia becomes irritated or inflamed, causing that sharp, tender heel pain you feel with your first steps in the morning.

A heel spur, on the other hand, is a small bony growth that can form on the heel bone over time. It often develops because the plantar fascia has been under long-term stress.

The important thing to know is that many people with heel spurs don’t actually feel pain from the spur itself. The discomfort usually comes from the irritated plantar fascia. Treating plantar fasciitis typically helps relieve symptoms, whether a heel spur is present or not.

That sharp, stabbing pain when you take your first steps in the morning or after sitting for a while is the classic hallmark of plantar fasciitis.

Here’s why it happens:

1. Rest Shortens the Fascia: When you sleep or sit, your foot is usually in a relaxed, downward-pointing position, allowing the plantar fascia to shorten.
2. Healing Attempt: During rest, your body attempts to repair the micro-tears in the fascia.
3. Tearing the Repair: When you stand up and put your full weight on your foot, the sudden tension stretches and rips the delicate, newly formed repair tissue. This intense tearing and stretching is what causes that sudden, severe pain.

As you continue to walk, the fascia gradually stretches out, which is why the pain often lessens after the first few steps, until the cycle repeats after another period of rest.

Yes, we do! At Feet First Podiatry Clinic, we are proud to offer state-of-the-art therapies like Extracorporeal Shockwave Therapy (ESWT) and Swift Microwave Therapy for patients who need more advanced care or when standard treatment has been less effective.

• Shockwave Therapy (ESWT):
  • How it works: ESWT delivers controlled, high-energy acoustic waves to the painful area of the heel.
  • The Benefit: This process creates a micro-trauma that stimulates a strong, natural healing response. It increases blood circulation and encourages the body to replace damaged tissue with healthy tissue, providing significant pain relief.
• Swift Microwave Therapy:
  • How it works: Swift uses microwave energy delivered through a small probe to generate localised heat in the affected tissue.
  • The Benefit: While traditionally used for warts, it has shown promise in treating long-standing Plantar Fasciitis by effectively remodelling the chronic, damaged tissue and encouraging the body’s immune system to clear the injury and heal.

These therapies are typically considered a safe, non-invasive option when other conservative measures haven’t fully resolved the pain.

Custom orthotics are an incredibly effective component of a complete treatment plan, but they rarely work in isolation.

Think of orthotics as a tool that corrects the underlying mechanics causing the problem. They help in two main ways:

1. Reducing Strain: The orthotic is specifically moulded to your foot to provide support exactly where you need it. This reduces the excessive pulling and straining on the plantar fascia, giving the injured tissue a chance to rest and heal.
2. Optimising Foot Alignment: They help correct any abnormal foot mechanics (like excessive pronation or ‘flat feet’) that may be overloading the heel. By guiding your foot into a more neutral, balanced position, they improve your gait and distribute pressure more evenly.

The Cure: Heel pain is truly “cured” when the orthotics are combined with targeted stretches, strengthening exercises, and a reduction in aggravating activities.

This is a very common question, and we want to set realistic expectations! You should expect to feel a difference fairly quickly, but full resolution takes time.

• Initial Relief (Mild to Moderate Pain): Most patients begin to feel a noticeable difference within 2 to 4 weeks of consistent orthotic use.
• Persistent or Long-Standing Pain: For long-standing heel pain (pain lasting more than a few months), it may take 6 to 8 weeks as the chronically injured tissues need more time to settle and adapt to the new support.

Tips to Speed Up Your Recovery:

• Gradual Break-In: Break in your orthotics gradually over the first week to allow your body to adjust.
• Wear Supportive Footwear: Wear your orthotics in supportive, enclosed footwear as much as possible.
• Avoid Barefoot Walking: Avoid walking barefoot on hard, uncarpeted floors during the early phase of recovery.
• Follow Your Plan: Strictly follow the stretching and strengthening plan and the complete rehabilitation program designed by your podiatrist.

Remember: Orthotics work best when they’re part of a complete treatment plan tailored to your condition.

Choosing the right shoes is critical for giving your heel a chance to heal!

Wear These (Supportive Footwear):

• Shoes with Firm Midsole Support: Look for shoes that don’t easily twist in the middle, providing stability.
• Good Arch Support: Shoes that naturally support the curve of your arch (even without your orthotics inserted).
• Slight Heel/Elevated Heel: A small 1-2 cm heel (often seen in running shoes) can slightly reduce tension on the plantar fascia.
• Cushioned House Slippers or Thongs: For indoor use, wear a supportive sandal or slipper with an arch to keep your foot supported inside the house.

Avoid These (Aggravating Footwear):

• Completely Flat Shoes: Ballet flats, canvas sneakers (like Converse), and moccasins offer zero support.
• Worn-Out or Flimsy Athletic Shoes: Shoes past their prime will not provide the necessary cushioning or support
• Walking Barefoot (especially on hard surfaces)
• High Heels (over 2 inches): These drastically shorten your calf muscles and can overload the heel upon landing.

Yes, absolutely. In fact, specific stretches and exercises are just as important as orthotics or therapy, because they help rebuild the strength and flexibility needed for long-term recovery.

Your podiatrist will prescribe a tailored programme, but it will likely focus on two key areas:

• Calf and Fascia Stretching: Tight calf muscles pull on the heel bone, increasing tension on the plantar fascia. Daily stretches, especially the calf wall stretch and towel plantar fascia stretch (where you pull your toes toward you with a towel), are essential.
• Foot and Arch Strengthening: Exercises like towel scrunches or marble pickups help strengthen the small muscles that support the arch of your foot, improving the foot’s natural ability to absorb shock and protect the fascia.

Consistency is key. Performing these exercises daily, and especially first thing in the morning before your feet hit the floor, will significantly accelerate your recovery.

Standing for long hours will not typically cause permanent damage but it can certainly cause chronic, painful irritation.

Extended standing, especially on hard surfaces, increases the cumulative load and stress on your feet. This can lead to:

• Overuse and Fatigue: Over time, the muscles and ligaments in your feet and legs, including the plantar fascia, become fatigued and more susceptible to injury.
• Exacerbated Plantar Fasciitis: If you have underlying foot mechanics issues, long hours of standing will constantly pull on the fascia, making an existing case of Plantar Fasciitis much more difficult to resolve.

The Solution: The key is to manage the load. This includes wearing proper supportive footwear (and orthotics, if prescribed), using anti-fatigue mats at work, and taking regular short breaks to stretch or sit down.

Recovery time is highly individual and depends on factors like how long the pain has been bothering you and how diligently you follow your treatment plan. We focus on a realistic and monitored approach to ensure you get the best results.

• Mild to Moderate Heel Pain: We typically see great results and significant pain reduction in 3 to 4 sessions, spaced about 7 to 10 days apart, followed by an ongoing home program.
• Persistent or Severe Cases: For cases that have been bothering you for months or years, it may take up to 7 or 8 sessions for full, long-lasting recovery.

Your progress is closely monitored by our podiatrist at every visit, allowing us to adjust the treatment plan to ensure it stays targeted and effective for your specific healing rate. Our goal is to get you back to your regular activities, pain-free.

Returning to high-impact activities too soon is one of the most common reasons for a heel pain relapse. The golden rule is to return gradually and only when your body is truly ready.

We recommend returning to running or high-impact sports only when you can meet all of the following criteria:

• Zero Pain During Walking/Daily Activity: You should be able to walk, stand, and move comfortably all day without any heel pain.
• Pass Strength Tests: You must be able to complete specific strength and mobility tests (as determined by your podiatrist) that show your foot and calf muscles can handle the load.
• Controlled Return: You must commit to a gradual return-to-activity programme (e.g., walk/run intervals) to allow your fascia to adapt slowly to the increased force, preventing re-injury.

If your heel pain is becoming more intense, lasting longer, or starting to affect your daily activities, it’s a sign to get it checked. You should seek prompt attention if you experience:

• Sudden, Severe Pain: An abrupt increase in pain severity, especially after an accident or change in activity.
• Pain that Doesn’t Go Away: Pain that is constant and does not reduce after a few steps or with rest, which could indicate a stress fracture.
• Numbness, Tingling, or Burning: This could signal nerve compression or damage that needs urgent investigation.
• Swelling or Redness: Significant swelling, redness, or heat in the heel area that persists.
• Inability to Bear Weight: If you can’t put any weight on your foot without sharp, intense pain.