Stabbing heel pain worst on the first steps out of bed. Treatable, but measured in months rather than weeks.
Assessed and treated by a GMC-registered GP
Prescriptions, sick notes and referral letters included
A written treatment plan after every appointment
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Plantar fasciitis is the commonest cause of heel pain. It affects the thick band of tissue running along the sole from the heel to the toes, where it attaches to the heel bone.
The symptom that identifies it is unmistakable: pain in the heel with the first few steps out of bed in the morning, easing after five or ten minutes of walking, then returning after sitting for a while. Nothing else behaves quite like that.
Two corrections worth making early:
The honest timescale: most people improve within six to twelve months, and a majority get better with stretching, footwear changes and load management alone. It is slow, it is frustrating, and it does resolve.
One thing worth knowing: steroid injections give short-term relief but carry a real risk of rupturing the fascia, and are not a first move.
Overload of the plantar fascia, producing degenerative change where it attaches to the heel. Usually from a change in load rather than load itself.
A heel spur is a consequence, not a cause. Spurs are found on X-rays of large numbers of people with entirely painless feet, and plenty of people with severe plantar fasciitis have no spur at all.
Being told "you have a spur" leads people to believe something must be cut out. It does not, and surgery for a spur is not the treatment, which is why an X-ray is rarely useful here.
Plantar fasciitis is diagnosed from the history, and the morning-first-steps pattern is so characteristic that it does most of the work. A video consultation handles this well.
X-rays are not needed and frequently mislead, because they show heel spurs that are unrelated to the pain. Ultrasound can confirm thickening of the fascia where the diagnosis is uncertain. Imaging is worth doing where a stress fracture is suspected, which is a different problem entirely.
Where the pattern suggests inflammatory disease — both heels affected, someone under 45, back pain, psoriasis or a family history — we check inflammatory markers and consider rheumatology referral. Heel pain is a recognised early feature of axial spondyloarthritis and is often the presenting complaint years before diagnosis.
Reduce the aggravating activity temporarily rather than stopping everything. Swap running for cycling or swimming for a period, break up long periods standing, and build back gradually.
Once the initial pain settles, progressive calf and foot strengthening — particularly heel raises with the toes propped on a rolled towel — has good evidence and reduces recurrence.
Simple analgesia and topical anti-inflammatory gel. Ice after activity. Night splints, which hold the foot at right angles overnight, help some people considerably with the morning pain — though they are not comfortable to sleep in.
Steroid injections give short-term relief but carry a genuine risk of plantar fascia rupture and fat pad atrophy, both of which cause worse and longer-lasting problems. They are not a first-line treatment, and repeated injections should be avoided.
Podiatry and physiotherapy — self-referral is available in many areas. For pain persisting beyond a year: shockwave therapy, which has reasonable evidence. Surgery is rarely needed.
Plantar fasciitis is not an emergency. Seek prompt medical attention for:
Book an appointment for:
Frequently the missing piece. Hard floors with no cushioning are a major aggravator, and people who do everything else right often continue padding around barefoot on tiles and laminate all evening. Supportive indoor shoes or sandals, worn consistently.
Six to twelve months for most people, and the majority get there with stretching, footwear and load management alone. It is slow and it is genuinely wearing, but it is not permanent — and the people who recover fastest are the ones who keep the stretches going after the pain has settled.
Heel pain in both feet — particularly under 45, or alongside back pain, psoriasis or other joint symptoms — may be inflammatory rather than mechanical. Heel pain is a recognised early feature of axial spondyloarthritis and is often present years before anyone makes the connection.
Plantar fasciitis resolves in the large majority of people within a year, whatever is done — which is worth knowing before spending money, because almost any treatment will appear to have worked eventually.
The treatments with the best evidence cost very little. Calf and plantar fascia stretching, done daily and persisted with for months, is the intervention that changes outcomes. Off-the-shelf insoles cost a few pounds and perform as well as custom orthotics in trials — which matters, because custom orthotics are frequently sold at many times the price.
NHS physiotherapy is free, with self-referral in many areas, and it is the right route.
Where money is commonly wasted: custom orthotics, extracorporeal shockwave therapy sold as a first-line treatment when it belongs later in the pathway, and repeated steroid injections — which give short-term relief but carry a real risk of fat pad atrophy and plantar fascia rupture with repetition.
Where a consultation is genuinely worth paying for is confirming the diagnosis, since heel pain is not always plantar fasciitis — nerve entrapment, stress fracture and inflammatory arthritis all present similarly — and setting realistic expectations about the timescale, which prevents a great deal of expensive treatment-shopping.
Heel pain with morning stiffness elsewhere, or in a young man with back stiffness, should raise inflammatory arthritis and warrants different assessment.
NICE Clinical Knowledge Summary, Plantar fasciitis, is the principal reference. It recommends rest, footwear modification, insoles and stretching exercises as first-line, with analgesia as required, and notes that most cases resolve within a year.
CKS states that off-the-shelf orthoses are as effective as custom-made devices for plantar heel pain — the basis for the cost point above.
CKS advises caution with corticosteroid injection, noting the risk of plantar fascia rupture and heel fat pad atrophy, and reserving it for short-term relief where conservative measures have failed.
NICE IPG311 covers extracorporeal shockwave therapy for refractory plantar fasciitis, positioning it as a second-line option after conservative treatment rather than an initial one.
CKS sets out differential diagnoses including calcaneal stress fracture, tarsal tunnel syndrome and seronegative spondyloarthropathy — the last being the reason enthesitis elsewhere warrants further assessment.
Because the fascia shortens and tightens overnight while the foot is relaxed, and the first steps stretch it abruptly. That pattern — severe for the first few minutes, easing as you walk, returning after sitting — is what identifies plantar fasciitis, and it is why stretching before you stand up makes such a difference.
Stretch before your feet touch the floor. Sit up in bed, pull your toes back towards you, hold for 30 seconds, three times — then put on supportive shoes before standing. Almost nobody is told to do it in that order, and it changes the morning pain more than anything else.
No. Heel spurs appear on X-rays of large numbers of people with entirely painless feet, and many people with severe plantar fasciitis have no spur at all. It is a consequence rather than a cause, nothing needs removing, and this is precisely why an X-ray is rarely useful here.
Six to twelve months for most people — slow and genuinely frustrating, but the majority recover with stretching, footwear changes and managing load, without injections or surgery. Progress is not linear; flares after long days on your feet are normal.
Not as a first step. Steroid injections relieve pain briefly but carry a real risk of rupturing the fascia or thinning the heel's fat pad — both of which cause worse and longer-lasting problems. Repeated injections should be avoided. Shockwave therapy is a better option for pain persisting beyond a year.
Usually, at reduced volume — complete rest is not necessary and not helpful. Cut back, swap some sessions for cycling or swimming, run on softer surfaces, and rebuild by about 10% a week. Pain that worsens the longer you run, rather than easing after the first minutes, is different and should be assessed for a stress fracture.
Rarely, at least initially. Inexpensive over-the-counter arch supports or heel cups work well for most people, and there is little evidence that custom devices do better as a first step. Save the expense until simpler measures have been given a proper trial.
It does, and it is worth mentioning specifically. Heel pain in both feet — particularly under 45, or with back pain, psoriasis or morning stiffness lasting over half an hour — can be an early sign of inflammatory arthritis rather than a mechanical problem. It is a recognised early feature of axial spondyloarthritis, and it frequently precedes the diagnosis by years.
August 24, 2026
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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