Plantar fasciitis

Borders Ref Help Toolkit
NHS Borders

Plantar fasciitis is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes, known as the plantar fascia.

Symptoms

  • Heel pain that often occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.
  • Pain in the arch of your foot.
  • Stiffness.

The cause of plantar fasciitis is poorly understood. It is more common in runners and in people who are overweight.

Plantar fasciitis

Who to refer, who not to refer, how to refer

Who to Refer

  • Those who have failed Primary Care Management

Urgent Referral Criteria

  • Nil

Who Not to Refer

  • Those who have not tried Primary care Management

 

Additional Info

  • Plantar fibroma- very rare for surgery. Customised insole
  • 99% of these will go to Podiatry – refer to them unless they have had input from them already
  • Unlikely to operate BMI >40

 

Imaging

  • USS only if diagnostic doubt

 

How to refer

We accept referrals through SCI gateway for those who are based in Scotland.

We also accept e referrals through the below email address using the attached form for those who are based just on the other side of the border. 

E- Referral Email address - bor.orthoreferrals@borders.scot.nhs.uk

Referral form - E-Referral to Orthopaedics (Non Sci-Gateway)      

Primary care management

  • Podiatry/Physio rehab- strengthening – focus on eccentric calf and tibialis posterior strength, plantar fascia and calf stretching over extended period (1yr)
  • Silicone Heel cup
  • Podiatry Input
  • Tried modified activity levels
  • Regular maximum multimodal analgesia
  • Education
  • BMI >35 engage in wellbeing support

Resources and links

Primary Care Foot Pathway  - developed by First Contact Practitioners / Podiatry (To be confirmed, will update when available)

Local service details

orthopaedics@borders.scot.nhs.uk

bor.orthoreferrals@borders.scot.nhs.uk

Editorial Information

Last reviewed: 31/07/2025

Next review date: 31/07/2027

Author(s): Mr Roshan Raghavan.

Author email(s): Roshan.Raghavan@nhs.scot.