About Dr Damien Lafferty Dr Damien Lafferty — Podiatric Surgery | 38 Years’ Experience | 6,000+ Ingrown Toenail Procedures | 20 Years Teaching | Sydney Podiatric Surgery
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Frequently Asked Questions About Conservative Treatment

By |2026-08-22T02:47:02+10:00August 18th, 2026|Learning Centre|

Frequently Asked Questions Can an ingrown toenail grow out by itself? Sometimes. Very early ingrown toenails may settle if pressure is reduced and the inflammation resolves. However, once the nail has become deeply embedded in the surrounding skin, spontaneous resolution becomes much less likely. Should I keep cutting the painful corner? Usually not. Repeatedly digging into [...]

What Is a Partial Nail Avulsion?

By |2026-08-22T02:47:02+10:00August 18th, 2026|Learning Centre|

What Is a Partial Nail Avulsion? A partial nail avulsion is one of the most common procedures used to treat an ingrown toenail. Despite the name sounding major, it is actually a relatively minor procedure performed under local anaesthetic. The aim is simple. Only the narrow strip of nail causing the problem is removed. The healthy [...]

Does Ingrown Toenail Surgery Hurt?

By |2026-08-22T02:47:02+10:00August 18th, 2026|Learning Centre|

The Biggest Fear Most Patients Have For many patients, the greatest fear is not the procedure itself. It is the fear of pain. This is particularly true if they have had a previous painful experience or have heard frightening stories from friends or family. Fortunately, modern techniques are designed to make the procedure as comfortable as [...]

Do You Need Antibiotics?

By |2026-08-22T02:47:00+10:00August 18th, 2026|Learning Centre|

Are Antibiotics Always Necessary? No. This is one of the biggest misconceptions surrounding ingrown toenails. Many people assume that redness, swelling and pain automatically mean they need antibiotics. In reality, most ingrown toenails begin as inflammation caused by the nail penetrating the skin. Infection, when it occurs, is usually a secondary complication rather than the primary [...]

Proper Nail Cutting: Does It Really Prevent Ingrown Toenails?

By |2026-08-22T02:47:00+10:00August 18th, 2026|Learning Centre|

Does Nail Cutting Cause Ingrown Toenails? Improper nail trimming is frequently blamed for ingrown toenails. While incorrect trimming can certainly contribute, it is rarely the only cause. Many people cut their nails perfectly and still develop recurrent ingrown toenails because of their nail shape, genetics or repeated shoe pressure. Likewise, some people trim their nails poorly [...]

Does Footwear Really Cause Ingrown Toenails?

By |2026-08-22T02:47:02+10:00August 18th, 2026|Learning Centre|

Can Shoes Really Cause an Ingrown Toenail? Footwear is one of the most common contributing factors to ingrown toenails. However, shoes are rarely the only cause. Most people who develop an ingrown toenail already have an underlying predisposition, such as a naturally curved nail, thick nail plate or repeated trauma. Poorly fitting footwear simply increases the [...]

Can an Ingrown Toenail Heal Without Surgery?

By |2026-08-22T02:47:00+10:00August 18th, 2026|Learning Centre|

Can an Ingrown Toenail Heal Naturally? One of the most common questions patients ask is: "Can this heal without surgery?" The answer is yes—sometimes. Whether conservative treatment is successful depends largely on how advanced the ingrown toenail has become. Very early cases, where the nail has only just started irritating the skin, often respond well to [...]

Home Treatments That May Actually Help

By |2026-08-22T02:47:00+10:00August 18th, 2026|Learning Centre|

Can You Treat an Ingrown Toenail at Home? Home treatment can be effective—but only in carefully selected cases. The earlier the problem is recognised, the greater the chance that conservative measures will settle the inflammation before the nail becomes deeply embedded. Once the nail has penetrated significantly into the skin, home treatment is far less likely [...]

Returning to Walking, Running and Sport

By |2026-08-22T02:46:58+10:00August 18th, 2026|Learning Centre|

One of the biggest concerns for patients recovering from chronic heel pain is knowing when they can safely return to normal activities. Whether the goal is walking comfortably around the neighbourhood, returning to the gym, playing weekend sport or training for a marathon, the same principle applies: the tissues must be ready before the activity resumes. [...]

When Should You Seek Help Again?

By |2026-08-22T02:46:58+10:00August 18th, 2026|Learning Centre|

Many episodes of mild heel pain improve with temporary activity modification, sensible footwear choices and allowing the tissues time to recover. However, not all heel pain resolves on its own. Knowing when to seek professional advice can make the difference between a relatively straightforward recovery and a problem that becomes chronic and much more difficult to [...]

Common Myths About Chronic Heel Pain

By |2026-08-22T02:46:58+10:00August 18th, 2026|Learning Centre|

Despite being one of the most common musculoskeletal conditions affecting the foot, chronic heel pain remains surrounded by misconceptions. Many of these myths have been repeated for years and may lead patients to delay appropriate treatment or pursue therapies that are unlikely to address the true cause of their symptoms. Understanding what current research tells us [...]

Looking After Your Feet for Life

By |2026-08-22T02:46:58+10:00August 18th, 2026|Learning Centre|

Our feet carry us through every stage of life. From our first steps as children to maintaining independence in later years, they absorb millions of steps and countless hours of standing, walking and exercise. Despite this extraordinary workload, they are often one of the most neglected parts of the body until pain develops. Looking after your [...]

Frequently Asked Questions About Chronic Heel Pain

By |2026-08-22T02:46:58+10:00August 18th, 2026|Learning Centre|

After many years of treating patients with chronic heel pain, certain questions arise repeatedly. While every patient is unique, the answers below address some of the most common concerns based on current evidence and clinical experience. Can chronic heel pain heal without surgery? Yes. The majority of patients recover without surgery. Conservative treatment remains the first-line [...]

Final Thoughts: Taking the Next Step Towards Pain-Free Walking

By |2026-08-22T02:46:58+10:00August 18th, 2026|Learning Centre|

If you have read this handbook from beginning to end, you have already taken one of the most important steps towards overcoming chronic heel pain—understanding it. Knowledge is a powerful part of healthcare. Patients who understand their condition are better equipped to make informed decisions, recognise misleading information, participate actively in their rehabilitation and work collaboratively [...]

Maintaining a Healthy Body Weight and Why Every Kilogram Matters

By |2026-08-22T02:46:58+10:00August 18th, 2026|Learning Centre|

One of the most sensitive topics discussed during a heel pain consultation is body weight. It is important to approach this subject with compassion because chronic heel pain affects people of every age, body shape and fitness level. Many slim, athletic individuals develop persistent heel pain, while many people carrying excess weight never experience symptoms. Body [...]

Exercises to Keep Your Feet Strong and Healthy

By |2026-08-22T02:46:58+10:00August 18th, 2026|Learning Centre|

When people think about preventing heel pain, stretching is often the first thing that comes to mind. While flexibility remains an important part of maintaining healthy feet, modern research has shown that strength is equally—if not more—important. Strong muscles help absorb the forces generated during walking, running and standing, reducing the mechanical stress placed on the [...]

Can Chronic Heel Pain Be Prevented?

By |2026-08-22T02:46:57+10:00August 18th, 2026|Learning Centre|

One of the most common questions patients ask after recovering from heel pain is, "How can I stop this happening again?" The encouraging news is that while not every case of heel pain can be prevented, many of the factors that contribute to chronic heel pain can be identified and managed before they lead to long-term [...]

Choosing the Right Footwear for Heel Pain

By |2026-08-22T02:46:57+10:00August 18th, 2026|Learning Centre|

One of the first questions many patients ask is, "What are the best shoes for heel pain?" It is an understandable question, particularly when there are hundreds of shoes marketed as being specifically designed to relieve heel pain. The reality, however, is more nuanced. There is no single shoe that is best for everyone because every [...]

Do Heel Spurs Need to Be Removed?

By |2026-08-22T02:46:57+10:00August 18th, 2026|Learning Centre|

One of the most common misconceptions surrounding chronic heel pain is that the heel spur is the problem. Many patients are told they have a "large heel spur" after having an X-ray and naturally assume that the bony projection is digging into the soft tissues every time they stand or walk. Fortunately, this is rarely the [...]

Can Multiple Heel Pain Procedures Be Performed at the Same Time?

By |2026-08-22T02:46:57+10:00August 18th, 2026|Learning Centre|

One of the most common assumptions patients make is that there is a single operation capable of fixing every type of chronic heel pain. In reality, chronic heel pain is often far more complex. Some patients have one clearly defined condition, while others have several separate pathologies contributing to their symptoms. Understanding this distinction is one [...]

What Happens on the Day of Heel Pain Surgery?

By |2026-08-22T02:46:57+10:00August 18th, 2026|Learning Centre|

One of the greatest sources of anxiety for patients considering heel pain surgery is not the operation itself but the uncertainty surrounding the day of surgery. Knowing what to expect can significantly reduce stress and help patients feel more confident about the process. Although every operation is individualised, heel pain surgery generally follows a structured pathway [...]

Recovery After Heel Pain Surgery

By |2026-08-22T02:46:57+10:00August 18th, 2026|Learning Centre|

One of the first questions most patients ask after deciding to proceed with surgery is, "How long will it take to recover?" The answer depends on several factors, including the specific condition being treated, the surgical procedure performed, the patient's general health and how well the rehabilitation programme is followed. While every patient heals at a [...]

What Are the Risks and Complications of Heel Pain Surgery?

By |2026-08-22T02:46:57+10:00August 18th, 2026|Learning Centre|

Every surgical procedure carries some degree of risk. Although heel pain surgery is generally safe when performed for the correct indication, it is important that patients understand both the potential benefits and the possible complications before deciding whether surgery is appropriate. An informed patient is better equipped to weigh the advantages of surgery against its risks [...]

What Does the Research Say About Heel Pain Surgery?

By |2026-08-22T02:46:57+10:00August 18th, 2026|Learning Centre|

One of the most important questions patients ask before deciding on surgery is, "Does it actually work?" The answer is encouraging, but it comes with an important qualification. The scientific literature consistently demonstrates that heel pain surgery can be highly effective when the correct operation is performed for the correct diagnosis in the correct patient. In [...]

Surgery for Baxter’s Nerve Entrapment

By |2026-08-22T02:46:57+10:00August 18th, 2026|Learning Centre|

Baxter's nerve entrapment is one of the most frequently overlooked causes of chronic heel pain. Because its symptoms often resemble plantar fasciosis, many patients undergo months or even years of treatment directed at the plantar fascia before the true source of their pain is recognised. Fortunately, most patients improve with appropriate non-surgical treatment, meaning surgery is [...]

Surgery for Tarsal Tunnel Syndrome

By |2026-08-22T02:46:57+10:00August 18th, 2026|Learning Centre|

Fortunately, most patients with tarsal tunnel syndrome improve with appropriate non-surgical treatment. Activity modification, footwear optimisation, rehabilitation, management of underlying biomechanical factors and treatment of the condition responsible for the nerve compression often reduce symptoms without the need for surgery. For this reason, surgical decompression is generally reserved for carefully selected patients whose symptoms persist despite [...]

Frequently Asked Questions About Tarsal Tunnel Syndrome

By |2026-08-22T02:46:55+10:00August 18th, 2026|Learning Centre|

Tarsal tunnel syndrome is often misunderstood because it shares many symptoms with other causes of heel pain. Patients commonly have questions about nerve compression, treatment options and recovery. These are some of the questions I am most frequently asked in clinical practice. Is Tarsal Tunnel Syndrome the Same as Plantar Fasciitis? No. Plantar fasciosis is a [...]

When Is Surgery Appropriate for Chronic Heel Pain?

By |2026-08-22T02:46:55+10:00August 18th, 2026|Learning Centre|

One of the most common questions patients ask is, "Do I need surgery?" Fortunately, the answer is usually no. The vast majority of people with heel pain recover without an operation when the correct diagnosis is established and appropriate treatment is commenced. Even patients who have experienced symptoms for many months can often improve with evidence-based [...]

Surgery for Chronic Plantar Fasciosis

By |2026-08-22T02:46:55+10:00August 18th, 2026|Learning Centre|

Fortunately, only a small proportion of patients with chronic plantar fasciosis require surgery. Most people improve with a combination of appropriate load management, footwear modification, rehabilitation, regenerative treatments where indicated and sufficient time for the degenerative tissue to recover. Surgery is generally reserved for patients whose symptoms persist despite comprehensive evidence-based treatment and whose diagnosis has [...]

What Causes Tarsal Tunnel Syndrome?

By |2026-08-22T02:46:55+10:00August 18th, 2026|Learning Centre|

Tarsal tunnel syndrome develops when the posterior tibial nerve, or one of its branches, becomes compressed as it passes through the tarsal tunnel on the inside of the ankle. Similar to carpal tunnel syndrome in the wrist, the problem is not the nerve itself but the pressure placed upon it. Anything that reduces the available space [...]

What Are the Symptoms of Tarsal Tunnel Syndrome?

By |2026-08-22T02:46:55+10:00August 18th, 2026|Learning Centre|

The symptoms of tarsal tunnel syndrome differ from many other causes of chronic heel pain because they arise from an irritated nerve rather than an injured tendon, ligament or bone. While plantar fasciosis usually causes localised pain beneath the heel, tarsal tunnel syndrome often produces burning, tingling or numbness that may spread into the sole of [...]

How Is Tarsal Tunnel Syndrome Diagnosed?

By |2026-08-22T02:46:55+10:00August 18th, 2026|Learning Centre|

Diagnosing tarsal tunnel syndrome can be challenging because its symptoms often overlap with other causes of chronic heel pain. Burning pain beneath the heel may easily be mistaken for plantar fasciosis, while numbness and tingling may be attributed to diabetes, lumbar spine disorders or peripheral neuropathy. The diagnosis therefore depends on combining a careful clinical assessment [...]

How Is Tarsal Tunnel Syndrome Treated?

By |2026-08-22T02:46:55+10:00August 18th, 2026|Learning Centre|

The treatment of tarsal tunnel syndrome focuses on relieving pressure around the posterior tibial nerve while addressing the underlying cause of the compression. Unlike plantar fasciosis, where treatment targets a degenerative ligament, tarsal tunnel syndrome is a nerve compression disorder. Successful management therefore depends on reducing irritation of the nerve rather than simply treating pain. The [...]

What Does the Research Say About Tarsal Tunnel Syndrome?

By |2026-08-22T02:46:55+10:00August 18th, 2026|Learning Centre|

One of the most consistent findings in the literature is that accurate diagnosis is critical. Tarsal tunnel syndrome is frequently overdiagnosed in patients with burning heel pain and underdiagnosed in those with atypical symptoms. Research has repeatedly shown that many patients labelled with tarsal tunnel syndrome are ultimately found to have plantar fasciosis, Baxter's nerve entrapment, [...]

When Is Surgery Appropriate for Tarsal Tunnel Syndrome?

By |2026-08-22T02:46:55+10:00August 18th, 2026|Learning Centre|

Fortunately, most patients with tarsal tunnel syndrome improve with appropriate non-surgical treatment. Activity modification, footwear optimisation, orthotic therapy where indicated, rehabilitation and treatment of the underlying cause are often successful in reducing pressure around the posterior tibial nerve. Surgery is therefore reserved for carefully selected patients whose symptoms persist despite comprehensive conservative management or when a [...]

What Is Tarsal Tunnel Syndrome?

By |2026-08-22T02:46:55+10:00August 18th, 2026|Learning Centre|

Tarsal tunnel syndrome is a condition in which the posterior tibial nerve, or one of its branches, becomes compressed as it passes through a narrow space on the inside of the ankle known as the tarsal tunnel. Although it is far less common than plantar fasciosis, it is an important cause of chronic heel pain because [...]

What Does the Research Say About Calcaneal Stress Fractures?

By |2026-08-22T02:46:53+10:00August 18th, 2026|Learning Centre|

Calcaneal stress fractures are less common than plantar fasciosis but remain an important cause of chronic heel pain, particularly in runners, military personnel and people who have recently increased their physical activity. Although the condition has been recognised for decades, research continues to improve our understanding of how these injuries develop, how they should be diagnosed [...]

When Is Surgery Appropriate for a Calcaneal Stress Fracture?

By |2026-08-22T02:46:53+10:00August 18th, 2026|Learning Centre|

Fortunately, surgery is very rarely required for calcaneal stress fractures. Unlike certain stress fractures that occur in bones with a relatively poor blood supply, such as the navicular, the calcaneus has an excellent blood supply and therefore possesses a strong healing capacity. When diagnosed early and managed appropriately, the overwhelming majority of calcaneal stress fractures heal [...]

Frequently Asked Questions About Calcaneal Stress Fractures

By |2026-08-22T02:46:53+10:00August 18th, 2026|Learning Centre|

Calcaneal stress fractures are often confused with plantar fasciosis because both conditions produce pain beneath the heel. As a result, patients frequently have many questions after receiving the correct diagnosis. The following are some of the questions I am most commonly asked in clinical practice. Can I Still Walk on a Calcaneal Stress Fracture? Many people [...]

When Is Surgery Appropriate for Heel Fat Pad Syndrome?

By |2026-08-22T02:46:53+10:00August 18th, 2026|Learning Centre|

Patients with persistent heel pain often ask whether surgery can repair a damaged heel fat pad. Fortunately, surgery is very rarely required for heel fat pad syndrome. Unlike conditions involving a torn tendon or compressed nerve, the problem is usually a gradual deterioration of the heel's natural shock-absorbing system rather than a discrete structural abnormality that [...]

What Is a Calcaneal Stress Fracture?

By |2026-08-22T02:46:53+10:00August 18th, 2026|Learning Centre|

A calcaneal stress fracture is a small crack or series of microscopic cracks that develops within the heel bone after repeated mechanical loading. Unlike an acute fracture caused by a major injury, a stress fracture develops gradually when the bone is exposed to repetitive forces that exceed its ability to repair itself. The calcaneus is the [...]

What Causes a Calcaneal Stress Fracture?

By |2026-08-22T02:46:53+10:00August 18th, 2026|Learning Centre|

A calcaneal stress fracture develops when repetitive mechanical loading exceeds the heel bone's ability to repair itself. Unlike an acute fracture, which occurs after a single traumatic event, a stress fracture develops gradually over days or weeks as microscopic areas of bone damage accumulate faster than new bone can be formed. It is essentially an overuse [...]

What Are the Symptoms of a Calcaneal Stress Fracture?

By |2026-08-22T02:46:53+10:00August 18th, 2026|Learning Centre|

Calcaneal stress fractures often begin subtly, which is one of the reasons they are frequently mistaken for plantar fasciosis. Most patients cannot recall a single injury or traumatic event. Instead, the pain develops gradually over days or weeks and progressively worsens as the heel bone becomes increasingly overloaded. The most common symptom is a deep ache [...]

How Is a Calcaneal Stress Fracture Diagnosed?

By |2026-08-22T02:46:53+10:00August 18th, 2026|Learning Centre|

Diagnosing a calcaneal stress fracture requires a high index of suspicion because the symptoms often resemble more common causes of heel pain such as plantar fasciosis. Unlike an acute fracture, there is usually no history of a fall or major injury. Instead, the diagnosis is based on recognising the pattern of symptoms, identifying risk factors and [...]

How Is a Calcaneal Stress Fracture Treated?

By |2026-08-22T02:46:53+10:00August 18th, 2026|Learning Centre|

The treatment of a calcaneal stress fracture focuses on allowing the heel bone to heal while preventing the injury from progressing into a complete fracture. Unlike plantar fasciosis, where gradual loading is often encouraged early in rehabilitation, a stress fracture requires the opposite approach. The injured bone must be protected from excessive mechanical stress until sufficient [...]

What Does the Research Say About Heel Fat Pad Syndrome?

By |2026-08-22T02:46:53+10:00August 18th, 2026|Learning Centre|

Compared with plantar fasciosis, heel fat pad syndrome has received relatively little research attention. For many years, it was considered an uncommon cause of heel pain and was often overlooked in favour of more familiar diagnoses such as plantar fasciitis. However, more recent research has shown that heel fat pad syndrome is probably underdiagnosed rather than [...]

What Causes Heel Fat Pad Syndrome?

By |2026-08-22T02:46:51+10:00August 18th, 2026|Learning Centre|

Heel fat pad syndrome develops when the heel's natural shock absorber can no longer adequately protect the calcaneus from the repeated forces of walking, standing and running. This may occur because the fat pad has become thinner, damaged, displaced or less capable of absorbing impact. Rather than one single cause, heel fat pad syndrome usually develops [...]

What Are the Symptoms of Heel Fat Pad Syndrome?

By |2026-08-22T02:46:52+10:00August 18th, 2026|Learning Centre|

Heel fat pad syndrome often causes pain in almost the same location as plantar fasciosis, which is one of the reasons it is frequently overlooked. However, the pattern of symptoms is usually quite different. Recognising these differences is important because the treatment for heel fat pad syndrome focuses on protecting the heel's natural shock absorber rather [...]

How Is Heel Fat Pad Syndrome Diagnosed?

By |2026-08-22T02:46:52+10:00August 18th, 2026|Learning Centre|

Heel fat pad syndrome can usually be diagnosed by combining a careful clinical assessment with appropriate imaging. The challenge is that many patients are initially diagnosed with plantar fasciitis because pain beneath the heel is commonly assumed to originate from the plantar fascia. A thorough assessment is therefore essential to determine whether the pain is arising [...]

How Is Heel Fat Pad Syndrome Treated?

By |2026-08-22T02:46:52+10:00August 18th, 2026|Learning Centre|

The treatment of heel fat pad syndrome differs significantly from the treatment of plantar fasciosis because the problem is not inflammation or degeneration of the plantar fascia. Instead, the objective is to protect the heel's natural shock absorber, reduce repetitive impact through the calcaneus and address the factors that have contributed to deterioration of the fat [...]

What Are the Symptoms of Calcaneal Bone Marrow Oedema?

By |2026-08-22T02:46:51+10:00August 18th, 2026|Learning Centre|

One of the reasons calcaneal bone marrow oedema is frequently overlooked is that its symptoms often resemble those of plantar fasciosis. Both conditions can cause pain beneath the heel and difficulty walking. However, bone marrow oedema affects the heel bone itself, and this often produces a different pattern of symptoms that can provide important diagnostic clues. [...]

How Is Calcaneal Bone Marrow Oedema Diagnosed?

By |2026-08-22T02:46:51+10:00August 18th, 2026|Learning Centre|

Diagnosing calcaneal bone marrow oedema requires more than simply identifying pain beneath the heel. Because its symptoms overlap considerably with plantar fasciosis, Baxter's nerve entrapment and stress fractures, the diagnosis depends on combining a detailed clinical assessment with appropriate imaging. The goal is not only to identify bone marrow oedema but also to determine whether it [...]

How Is Calcaneal Bone Marrow Oedema Treated?

By |2026-08-22T02:46:51+10:00August 18th, 2026|Learning Centre|

The treatment of calcaneal bone marrow oedema is very different from the treatment of plantar fasciosis because the primary problem lies within the heel bone rather than the plantar fascia. The aim is to reduce excessive mechanical loading, allow the bone to heal and gradually restore its ability to tolerate normal activity. Successful treatment depends not [...]

What Does the Research Say About Calcaneal Bone Marrow Oedema?

By |2026-08-22T02:46:51+10:00August 18th, 2026|Learning Centre|

Calcaneal bone marrow oedema has received considerably less research attention than plantar fasciosis, despite being an important cause of persistent heel pain. Most published studies focus on MRI findings rather than individual treatment techniques, and much of the current understanding comes from research into bone stress injuries, plantar heel pain and sports medicine rather than studies [...]

When Is Surgery Appropriate for Calcaneal Bone Marrow Oedema?

By |2026-08-22T02:46:51+10:00August 18th, 2026|Learning Centre|

One of the first questions many patients ask after being told they have calcaneal bone marrow oedema is whether they need surgery. Fortunately, the answer is usually no. Unlike many structural disorders of the foot, calcaneal bone marrow oedema is most commonly managed successfully without an operation. In the vast majority of patients, the condition improves [...]

What Is Heel Fat Pad Syndrome?

By |2026-08-22T02:46:51+10:00August 18th, 2026|Learning Centre|

Heel fat pad syndrome is one of the most commonly overlooked causes of chronic heel pain. Although many people assume pain beneath the heel is caused by plantar fasciitis or plantar fasciosis, the heel fat pad itself can become injured, thin, displaced or less effective at absorbing shock. When this occurs, every step places increased pressure [...]

What Is Ultrasound-Guided Hydrodissection for Baxter’s Nerve Entrapment?

By |2026-08-22T02:46:50+10:00August 18th, 2026|Learning Centre|

Ultrasound-guided hydrodissection is a minimally invasive procedure used to treat certain nerve entrapment conditions, including carefully selected cases of Baxter's nerve entrapment. Rather than treating the plantar fascia itself, the aim of hydrodissection is to improve the movement of the irritated nerve by gently separating it from the surrounding tissues that may be causing compression or [...]

What Does the Research Say About Ultrasound-Guided Hydrodissection?

By |2026-08-22T02:46:50+10:00August 18th, 2026|Learning Centre|

Ultrasound-guided hydrodissection has become an increasingly popular treatment for peripheral nerve entrapments over the past decade. While the technique is well established for conditions such as carpal tunnel syndrome, research specifically examining Baxter's nerve entrapment remains limited. This is largely because Baxter's nerve entrapment is frequently underdiagnosed and often grouped together with other causes of chronic [...]

When Is Surgery Appropriate for Baxter’s Nerve Entrapment?

By |2026-08-22T02:46:50+10:00August 18th, 2026|Learning Centre|

Fortunately, only a small proportion of patients with Baxter's nerve entrapment require surgery. Most people improve with an accurate diagnosis, appropriate rehabilitation, footwear modification, load management and, where indicated, treatments such as ultrasound-guided hydrodissection. Surgery is generally considered only when symptoms remain significant despite a comprehensive programme of evidence-based non-surgical care. The most important factor before [...]

What Is Calcaneal Bone Marrow Oedema?

By |2026-08-22T02:46:50+10:00August 18th, 2026|Learning Centre|

When most people think about heel pain, they immediately think of plantar fasciitis or plantar fasciosis. However, not every painful heel originates from the plantar fascia. One of the most commonly overlooked causes of persistent heel pain is calcaneal bone marrow oedema, sometimes referred to as a bone stress reaction within the heel bone. Bone marrow [...]

What Causes Calcaneal Bone Marrow Oedema?

By |2026-08-22T02:46:50+10:00August 18th, 2026|Learning Centre|

Calcaneal bone marrow oedema develops when the heel bone is subjected to more mechanical stress than it can safely tolerate. Rather than being a disease itself, bone marrow oedema represents the bone's biological response to excessive loading. Increased fluid accumulates within the bone marrow as part of the body's reaction to microscopic bone injury, often before [...]

What Is Baxter’s Nerve Entrapment?

By |2026-08-22T02:46:49+10:00August 18th, 2026|Learning Centre|

When people develop persistent pain on the inside or underneath the heel, the diagnosis is often assumed to be plantar fasciitis. While plantar fasciosis is certainly one of the most common causes of heel pain, it is not the only possibility. One condition that is frequently overlooked is Baxter's nerve entrapment, a disorder that can produce [...]

Why Is Baxter’s Nerve Entrapment Often Misdiagnosed as Plantar Fasciitis?

By |2026-08-22T02:46:49+10:00August 18th, 2026|Learning Centre|

One of the greatest challenges in managing chronic heel pain is that several different conditions can produce remarkably similar symptoms. As plantar fasciitis is by far the most common diagnosis associated with pain beneath the heel, it is understandable that many patients—and sometimes even healthcare professionals—initially assume that every painful heel is caused by the plantar [...]

What Are the Symptoms of Baxter’s Nerve Entrapment?

By |2026-08-22T02:46:49+10:00August 18th, 2026|Learning Centre|

Baxter's nerve entrapment can be one of the most difficult causes of heel pain to recognise because its symptoms often overlap with those of plantar fasciosis. While both conditions commonly cause pain around the inside of the heel, Baxter's nerve entrapment is a problem affecting a nerve rather than the plantar fascia. Understanding the pattern of [...]

How Is Baxter’s Nerve Entrapment Diagnosed?

By |2026-08-22T02:46:50+10:00August 18th, 2026|Learning Centre|

Diagnosing Baxter's nerve entrapment can be challenging because there is no single test that definitively confirms the condition. Instead, the diagnosis is made by carefully combining the patient's history, clinical examination and appropriate imaging while excluding other common causes of heel pain. This systematic approach is important because several conditions may produce very similar symptoms. The [...]

How Is Baxter’s Nerve Entrapment Treated Without Surgery?

By |2026-08-22T02:46:50+10:00August 18th, 2026|Learning Centre|

The good news is that most patients with Baxter's nerve entrapment do not immediately require surgery. As with many nerve compression conditions elsewhere in the body, treatment usually begins by identifying and reducing the factors that are irritating the nerve while allowing the surrounding tissues to recover. The most appropriate treatment depends on the severity of [...]

Why Don’t Orthotics Always Work on Their Own?

By |2026-08-22T02:46:48+10:00August 18th, 2026|Learning Centre|

Orthotic therapy is one of the most commonly prescribed treatments for plantar heel pain. Many patients are told that orthotics will 'fix' their problem, while others become discouraged when they continue to experience pain despite wearing custom devices. The reality is more nuanced. Orthotics can play an important role in managing plantar fasciosis, but they are [...]

Why Stretching Alone May Not Be Enough

By |2026-08-22T02:46:48+10:00August 18th, 2026|Learning Centre|

Stretching is one of the most frequently recommended treatments for heel pain and, for many people, it forms an important part of recovery. However, patients with long-standing plantar fasciosis are often surprised when diligent stretching fails to resolve their symptoms completely. This does not necessarily mean they have been stretching incorrectly. More commonly, it reflects the [...]

What Does the Research Say About Shockwave Therapy?

By |2026-08-22T02:46:48+10:00August 18th, 2026|Learning Centre|

Extracorporeal shockwave therapy (ESWT) is one of the most commonly recommended treatments for chronic plantar fasciosis. It has been studied extensively and, for carefully selected patients, can reduce pain and improve function. However, it is not a universal solution and understanding its role within an overall treatment plan is important. Shockwave therapy delivers high-energy acoustic waves [...]

When Are Regenerative Injections Considered?

By |2026-08-22T02:46:48+10:00August 18th, 2026|Learning Centre|

Regenerative injections may be considered for patients with chronic plantar fasciosis who have not improved sufficiently despite an accurate diagnosis and a well-conducted programme of conservative treatment. They are not usually the first treatment for new heel pain, and they should not be used as a substitute for appropriate rehabilitation, footwear advice, load management, strengthening or [...]

When Is Surgery Appropriate for Chronic Plantar Fasciosis?

By |2026-08-22T02:46:48+10:00August 18th, 2026|Learning Centre|

Fortunately, most people with plantar fasciosis do not require surgery. The majority of patients improve with an accurate diagnosis, education, progressive rehabilitation, appropriate footwear, activity modification and, where indicated, treatments such as shockwave therapy or regenerative injections. Surgery is generally reserved for the small proportion of patients whose symptoms remain severe despite a comprehensive programme of [...]

What Is Plantar Fasciosis?

By |2026-08-22T02:46:48+10:00August 18th, 2026|Learning Centre|

Plantar fasciosis is one of the most common causes of chronic heel pain, yet it remains widely misunderstood. Many people are familiar with the term plantar fasciitis, which implies inflammation of the plantar fascia. While inflammation may play a role during the early stages of injury, long-standing heel pain often represents a different biological process. In [...]

Why Does the Plantar Fascia Fail to Heal?

By |2026-08-22T02:46:48+10:00August 18th, 2026|Learning Centre|

One of the most common questions I hear from patients is, 'Why hasn't my plantar fascia healed?' Most soft tissue injuries improve with time, but the plantar fascia is exposed to thousands of loading cycles every day. When the stress placed upon the tissue continually exceeds its ability to recover, healing may stall and chronic plantar [...]

What Happens to the Plantar Fascia Under the Microscope?

By |2026-08-22T02:46:48+10:00August 18th, 2026|Learning Centre|

One of the reasons our understanding of chronic heel pain has changed is because researchers have examined plantar fascia tissue under the microscope. These studies have shown that many patients with long-standing heel pain do not have ongoing inflammation. Instead, the tissue demonstrates changes consistent with degeneration and failed healing. This evidence has helped shift the [...]

What Are the Symptoms of Plantar Fasciosis?

By |2026-08-22T02:46:48+10:00August 18th, 2026|Learning Centre|

Plantar fasciosis is the most common cause of chronic pain beneath the heel, but its symptoms can vary considerably from one person to another. While many patients experience the classic pattern of first-step pain in the morning, others describe aching after prolonged standing, pain during exercise or discomfort that gradually worsens throughout the day. Understanding these [...]

How Is Plantar Fasciosis Diagnosed?

By |2026-08-22T02:46:48+10:00August 18th, 2026|Learning Centre|

Accurately diagnosing plantar fasciosis involves much more than confirming that the heel is painful. Although the condition is common, several other disorders can produce similar symptoms, and more than one condition may be present at the same time. A comprehensive assessment is therefore essential before deciding on the most appropriate treatment. The diagnostic process begins with [...]

What Is Bone Marrow Oedema of the Heel?

By |2026-08-22T02:46:46+10:00August 18th, 2026|Learning Centre|

Bone marrow oedema (BMO) describes increased fluid within the bone marrow and is a finding seen on magnetic resonance imaging (MRI). When it occurs within the calcaneus, or heel bone, it may contribute to persistent heel pain. Although many patients have never heard of bone marrow oedema, it is an important diagnosis because it cannot usually [...]

How Is Baxter’s Nerve Entrapment Diagnosed?

By |2026-08-22T02:46:46+10:00August 18th, 2026|Learning Centre|

Baxter's nerve entrapment is an under-recognised cause of chronic heel pain and is frequently mistaken for plantar fasciitis because the symptoms can overlap. In some patients, both conditions occur together, making diagnosis even more challenging. Establishing the correct diagnosis is important because treatment directed only at the plantar fascia may not relieve pain if the nerve [...]

What Happens During a Specialist Heel Pain Assessment?

By |2026-08-22T02:46:46+10:00August 18th, 2026|Learning Centre|

Many patients arrive feeling anxious because they have already seen several health professionals without finding a lasting solution. A specialist heel pain assessment is different because its primary aim is not to recommend a treatment immediately, but to understand why the pain has persisted and to establish the most accurate diagnosis possible. The consultation begins with [...]

Why Imaging Alone Doesn’t Make the Diagnosis

By |2026-08-22T02:46:46+10:00August 18th, 2026|Learning Centre|

Modern imaging has transformed the assessment of chronic heel pain, but it also has the potential to be misunderstood. Many patients believe that the scan itself provides the diagnosis. In reality, imaging is only one part of the diagnostic process. The patient's history, physical examination and imaging findings must all agree before a confident diagnosis can [...]

Putting the Diagnosis Together: Creating the Right Treatment Plan

By |2026-08-22T02:46:46+10:00August 18th, 2026|Learning Centre|

After completing a comprehensive assessment, the next step is not simply selecting a treatment—it is developing the right treatment plan for the individual patient. Two people with similar heel pain may require very different management because their diagnosis, lifestyle, activity level, health and treatment goals are rarely identical. The foundation of every treatment plan is an [...]

Why an Accurate Diagnosis Is the Most Important Step in Treating Chronic Heel Pain

By |2026-08-22T02:46:46+10:00August 18th, 2026|Learning Centre|

One of the most common misconceptions about chronic heel pain is that the most important decision is choosing the right treatment. In reality, the most important decision is establishing the correct diagnosis. Every treatment—whether stretching, orthotic therapy, shockwave therapy, regenerative injections, hydrodissection or surgery—depends on understanding which structure is responsible for the patient's symptoms. Many people [...]

How Does Diagnostic Ultrasound Help Diagnose Heel Pain?

By |2026-08-22T02:46:46+10:00August 18th, 2026|Learning Centre|

Diagnostic ultrasound has become one of the most valuable imaging tools for assessing chronic heel pain because it allows the plantar fascia and surrounding soft tissues to be examined in real time. Unlike static imaging, ultrasound enables the clinician to assess tissue structure while correlating the findings with the patient's symptoms during the consultation. For patients [...]

When Is an MRI Recommended for Heel Pain?

By |2026-08-22T02:46:46+10:00August 18th, 2026|Learning Centre|

Magnetic resonance imaging (MRI) is one of the most detailed imaging investigations available for assessing chronic heel pain. Although many patients believe an MRI should be the first test performed, this is rarely necessary. Most cases of plantar heel pain can initially be assessed through a careful history, physical examination and, where appropriate, diagnostic ultrasound. MRI [...]

Do I Need an X-ray for Heel Pain?

By |2026-08-22T02:46:46+10:00August 18th, 2026|Learning Centre|

One of the most common questions patients ask is whether they need an X-ray to diagnose their heel pain. The answer depends on the suspected cause of the symptoms. Although X-rays remain an important investigation in some situations, they are not the best test for every patient with chronic heel pain because they primarily show bones [...]

Are Heel Spurs Really Causing My Pain?

By |2026-08-22T02:46:46+10:00August 18th, 2026|Learning Centre|

One of the most common misconceptions about heel pain is that the heel spur is the cause of the symptoms. Many patients are understandably concerned when an X-ray reports a heel spur, believing it must be responsible for the pain. However, current evidence suggests that heel spurs are often an incidental finding and, by themselves, do [...]

How Is an Ingrown Toenail Diagnosed?

By |2026-08-22T02:47:00+10:00July 24th, 2026|Learning Centre|

Diagnosis Usually Starts with Listening Although an ingrown toenail often appears obvious, making the correct diagnosis involves much more than simply looking at the nail. The consultation usually begins with understanding your history. Important questions include: When did the pain begin?Has it happened before?Have you had previous nail surgery?Have antibiotics been prescribed?Has there been drainage or [...]

When Should You See a Surgical Podiatrist?

By |2026-08-22T02:47:00+10:00July 24th, 2026|Learning Centre|

Not every ingrown toenail requires surgery. Many mild cases can improve with conservative treatment when recognised early. However, there comes a point where repeated self-treatment, repeated antibiotics or repeated nail trimming simply delays definitive management. Signs You Should Be Assessed You should consider seeing a surgical podiatrist if: The pain is becoming worse.Walking is becoming difficult.The [...]

Is It Really an Infection?

By |2026-08-22T02:47:00+10:00July 24th, 2026|Learning Centre|

Is It Really an Infection? One of the biggest misconceptions about ingrown toenails is that they are primarily infections. In most cases, they are not. An ingrown toenail usually begins as a mechanical problem. The edge of the nail grows into the surrounding skin, causing repeated injury every time you walk. The body's response to this [...]

What Happens If You Ignore an Ingrown Toenail?

By |2026-08-22T02:47:00+10:00July 24th, 2026|Learning Centre|

What Happens If You Ignore an Ingrown Toenail? Many people hope an ingrown toenail will eventually "grow out" by itself. Unfortunately, this is uncommon once the nail edge has already penetrated the surrounding skin. Every step places pressure on the nail, pushing the sharp edge further into the tissue. The body's natural response is inflammation, swelling [...]

Why Do Ingrown Toenails Become Infected?

By |2026-08-22T02:47:00+10:00July 24th, 2026|Learning Centre|

Infection Is Usually a Secondary Problem One of the biggest misconceptions about ingrown toenails is that infection is the primary problem. In reality, infection is usually a consequence of the nail growing into the skin, not the original cause. Think of it like repeatedly scratching your skin with a sharp object. Eventually, bacteria that normally live [...]

Who Gets Ingrown Toenails?

By |2026-08-22T02:47:00+10:00July 24th, 2026|Learning Centre|

One of the reassuring things about ingrown toenails is that they are extremely common. They affect people of all ages, occupations and activity levels. Whether you are a teenager playing weekend sport, a tradesperson wearing safety boots, an office worker or a retiree, an ingrown toenail can develop if the conditions are right. Although anyone can [...]

Why Do Ingrown Toenails Occur?

By |2026-08-22T02:46:59+10:00July 24th, 2026|Learning Centre|

One of the biggest misconceptions about ingrown toenails is that they are always caused by cutting the nail incorrectly. While poor nail trimming can certainly contribute in some cases, modern research and clinical experience show that the development of an ingrown toenail is usually far more complex. In most patients, several factors combine to place excessive [...]

What Is an Ingrown Toenail?

By |2026-08-22T02:46:58+10:00July 24th, 2026|Learning Centre|

An ingrown toenail, medically known as onychocryptosis, occurs when the edge of the toenail presses into or penetrates the surrounding skin. This repeated mechanical irritation causes inflammation, pain and swelling. If the skin becomes damaged, bacteria can enter the area and produce a secondary infection. Although an ingrown toenail can affect any toe, it most commonly [...]

When Should I Seek a Second Opinion for Heel Pain?

By |2026-08-22T02:46:45+10:00July 24th, 2026|Learning Centre|

Most episodes of heel pain improve with appropriate early management. However, if your symptoms continue despite treatment, it is reasonable to ask whether the diagnosis is correct or whether another opinion may be helpful. Seeking a second opinion does not necessarily mean previous treatment was inappropriate. It simply recognises that persistent heel pain can be complex [...]

Can More Than One Condition Be Causing My Heel Pain?

By |2026-08-22T02:46:45+10:00July 24th, 2026|Learning Centre|

Many people assume there is a single explanation for their heel pain. In reality, chronic heel pain is often multifactorial, meaning more than one condition may be contributing to the symptoms at the same time. This is one reason some treatments provide only partial relief. If one problem improves while another remains untreated, the pain may [...]

What Are the Most Common Causes of Chronic Heel Pain?

By |2026-08-22T02:46:45+10:00July 24th, 2026|Learning Centre|

Chronic heel pain is not a single diagnosis. It is a symptom that can arise from several different conditions, and in many patients more than one problem may be present at the same time. Understanding the underlying cause is one of the most important steps in developing an effective treatment plan. Assuming that every patient has [...]

Can Heel Pain Become Permanent?

By |2026-08-22T02:46:45+10:00July 24th, 2026|Learning Centre|

Many people worry that because their heel pain has lasted for months or even years, they will have to live with it forever. While chronic heel pain can become persistent if the underlying cause is not identified and treated appropriately, this does not mean it is inevitably permanent. Most patients can still improve, even after prolonged [...]

Why Does My Heel Pain Keep Coming Back?

By |2026-08-22T02:46:45+10:00July 24th, 2026|Learning Centre|

One of the most frustrating aspects of chronic heel pain is that it often improves for a period of time before returning. Many people experience temporary relief after wearing orthotics, completing stretching exercises, resting, receiving an injection or undergoing shockwave therapy, only for the pain to recur weeks or months later. This does not necessarily mean [...]

Why Does My Heel Hurt Most First Thing in the Morning?

By |2026-08-22T02:46:44+10:00July 24th, 2026|Learning Centre|

One of the hallmark symptoms of plantar fascia disorders is pain with the first few steps out of bed in the morning. Many patients describe taking several painful steps before the foot gradually loosens and becomes more comfortable. Although this pattern is strongly associated with plantar fasciitis and plantar fasciosis, it is not unique to these [...]