Tag Archive for: Heel pain

Review Article | Vol 6 | Issue 1 |  January-June 2026 | page: 27-32 | Osvaldo Valle Toledo

DOI: https://doi.org/10.13107/jrs.2026.v06.i01.197

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2026; The Author(s).

Submitted Date: 05 Mar 2026, Review Date: 20 April 2026, Accepted Date: April 2026 & Published: 30 June 2026

Author: Osvaldo Valle Toledo [1]

[1] Department of Orthopedic Surgery, Ankle and Foot Team, MEDS Clinic, Santiago de Chile, Chile.

Address of Correspondence
Osvaldo Valle Toledo,

Department of Orthopedic Surgery, Ankle and Foot Team, MEDS Clinic, Santiago de Chile, Chile.

E-mail: osvaldo.valle@meds.cl

Abstract

Mechanical wave-based therapies are a widely used and effective treatment for chronic plantar fasciopathy (PF); however, some patients do not achieve satisfactory clinical outcomes. Treatment failure is not necessarily related to the intrinsic efficacy of the method but is more frequently associated with modifiable clinical factors. This narrative review aims to analyze the most common causes of failure, focusing on diagnostic errors, inappropriate timing of treatment, inadequate technical application, and failure to address biomechanical abnormalities. Misdiagnosis is a major cause of therapeutic failure, as plantar heel pain may originate from multiple conditions other than PF, including tarsal tunnel syndrome, Baxter’s nerve entrapment, heel fat pad syndrome, calcaneal stress fractures, bursitis, tumors, and systemic inflammatory diseases. Technical factors, such as inappropriate energy delivery, incorrect targeting, and the use of local anesthesia, may also negatively influence outcomes. Furthermore, uncorrected gastrocnemius contracture and altered foot biomechanics contribute to persistent overload of the plantar fascia. Finally, both radial pressure waves and focused shockwaves appear to be more effective in chronic than in acute PF. A better understanding of these factors may improve patient selection and optimize treatment outcomes.

Keywords: Heel pain, Radial pressure waves, Focused shock waves, Plantar fasciitis

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