Plantar fasciitis is the most common cause of heel pain. It is also one of the most frustrating conditions to live with, because it tends to be worst during the first steps out of bed — setting the tone for the whole day before it has started.
The plantar fascia is a thick band of connective tissue running along the sole of the foot, from the heel bone to the base of the toes. When the tissue near its attachment at the heel becomes irritated and degenerative, the result is a sharp, localized pain at the front of the heel.
Classic presentation: pain on the first steps in the morning or after sitting, easing after a few minutes of walking, then returning later in the day or after prolonged standing.
Heel pain has several possible causes, and they do not all respond to the same treatment. Fat pad atrophy, nerve entrapment, calcaneal stress fracture, and referred pain from the lower leg can all present similarly.
This is why the first visit is an assessment rather than a treatment. Getting the diagnosis right is the single largest factor in whether anything that follows works.
Most plantar fasciitis responds to conservative care: a structured loading program for the calf and foot, activity and footwear adjustments, and addressing what changed — a jump in training volume, a new job on your feet, a shoe change, a stiff ankle shifting load into the heel.
This is not a formality before the interesting treatment. For a large share of people it is the treatment, and skipping it is why heel pain becomes chronic.
If your heel pain has persisted past six months despite genuine conservative effort, shockwave therapy becomes a reasonable next step — and this is the one musculoskeletal condition where it carries an FDA approval.
The Swiss DolorClast system we use at BodyPro is FDA-approved as a non-surgical option for chronic proximal plantar fasciitis in patients 18 and older, with symptoms of six months or more, who have not improved with conservative care.
In the trial supporting that approval, 61% of treated patients met the study's success threshold at three months versus 42% with placebo. Pooled data across eleven randomized controlled trials shows average pain reductions of roughly 2.8 to 3.0 points on a 10-point scale — among the more consistent findings in the tendon and fascia literature.
Honest framing: that is a real effect, meaningfully better than placebo, and not a guarantee. Around four in ten patients in the trial did not reach the success threshold.
The standard protocol is three sessions spaced one to two weeks apart, matching both the FDA trial design and the research literature. Each session involves a few minutes of treatment time — no anesthesia, no incision, and you walk out on your own foot.
You will feel the treatment; most patients describe a dull ache, and the first minute over a tender heel can be uncomfortable. Afterward, temporary soreness and occasionally minor redness or bruising are normal and usually settle within a day or two.
Be skeptical of a twelve-session package sold before treatment begins. The evidence base is built on short courses.
In the research, shockwave performs best as part of a program that includes progressive loading of the tissue. We treat it that way: shockwave calms the irritable tissue, and the rehab work is what keeps the problem from returning.
If your calf is stiff, your foot mechanics are feeding the problem, or your training volume jumped before the pain started, those get addressed alongside treatment — not after it.
Three things need to be true before shockwave is the right conversation: the pain is chronic (six months or more), it is genuinely proximal plantar fasciitis, and conservative care has been tried and failed rather than skipped.
If you do not meet those, we will tell you, and we will tell you what to do instead.
If heel pain has outlasted six months of honest effort, it is worth a proper assessment. At BodyPro Chiropractic & Sports Medicine we treat everyone from professional athletes to people whose heel pain is simply making the walk from the parking lot miserable.
Learn more about our shockwave therapy, or contact our team to book an assessment. We are on Santa Monica Blvd in West LA.
This page is general information, not medical advice. Heel pain has several possible causes that require different treatment. Talk to a qualified clinician about your specific situation.