Heel pain – plantar fasciitis: revision 2023

This 2023 revision of the heel pain and plantar fasciitis guideline comes from the Academy of Orthopaedic Physical Therapy and the American Academy of Sports Physical Therapy, and was published in JOSPT. It concentrates on updating the treatment recommendations, carrying the earlier guidance on diagnosis and examination forward and refreshing its summary on imaging.

Its strongest recommendations support manual therapy to the joints and soft tissues of the lower limb (its evidence review includes joint mobilization, instrument-assisted soft tissue work and dry cupping), plantar fascia and calf stretching, rigid or elastic foot taping alongside other care, and night splints for people whose first steps in the morning are painful. It also supports dry needling of trigger points in the calf and foot muscles, resistance exercise for the foot and ankle, and low-level laser.

It advises against using foot orthoses alone for short-term relief, though orthoses may be combined with other treatment. It recommends against ultrasound added to stretching, and places electrotherapy behind manual therapy, stretching and orthoses as a second-line option.