The most important clinical decision with Epat Shockwave Therapy Heel Pain Guide isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Dr. Tom’s Top Insole & Orthotic Picks
Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle
Last reviewed: May 2026
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases.
Dr. Tom’s Top Pain Relief Picks — Dr. Hoy’s (2026)
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. I personally use Dr. Hoy’s in my practice for patients who need topical relief.
| Product | Best For | Dr. Tom’s Take | Get It |
|---|---|---|---|
| Dr. Hoy’s Natural Pain Relief Gel 3.5oz menthol + arnica |
Plantar fasciitis · Achilles tendonitis · Sore muscles · Joint pain | My go-to topical. Cooling-then-warming sensation. No greasy residue. Non-NSAID alternative. | Buy Now |
| Dr. Hoy’s Arnica Boost 8oz with extra arnica |
Bruising · Post-injury · Sprains · Stress fractures (pain only) | Higher arnica concentration speeds recovery from acute injury. Use 4x daily for first 7 days. | Buy Now |
| Dr. Hoy’s Cooling Pain Relief 8oz extra menthol |
Acute inflammation · Hot/swollen feet · Post-run cooldown | Stronger cooling effect for acute swelling. Pair with ice for first 48 hours after injury. | Buy Now |
| Dr. Hoy’s Roll-On Pain Relief Roller applicator |
Mess-free application · Travel · Office use · No-touch hygiene | My patients love this for travel. Glides on without hand contact — cleanest application available. | Buy Now |
| Dr. Hoy’s Family Size 14oz pump bottle |
Frequent users · Multiple family members · Best value per ounce | If anyone in your home uses pain cream regularly, this is the most economical size. Same formula. | Buy Now |
Why I recommend Dr. Hoy’s over Doctor Hoy’s Natural Pain Relief Gel and Bengay: Cleaner ingredient list (no parabens, no synthetic dyes), longer-lasting effect, and the cooling-then-warming dual sensation actually addresses both inflammation and circulation. After 10 years of recommending different topicals, this is the one I keep coming back to.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
Related Conditions
Quick Answer
EPAT Shockwave Therapy for Heel Pain: How It Works and Who B relates to plantar fasciitis — typically caused by tight calves and arch overload. Most patients improve in 6-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Hills: (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-certified foot & ankle surgeon, 3,000+ surgeries performed. Updated April 2026 with current clinical evidence. This article reflects real practice experience from Balance Foot & Ankle Specialists in Howell and Bloomfield Hills, Michigan.
Quick Answer
Plantar fasciitis is inflammation where the plantar fascia attaches to the heel, causing sharp morning heel pain that eases after 10-15 minutes of walking. Most cases respond to stretching plus arch support within 6-12 weeks. See a podiatrist if pain persists beyond 6 weeks, worsens, or prevents walking.
Watch: Dr. Tom Biernacki, DPM
✅ Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026
EPAT Shockwave Therapy for Heel Pain: How It Works and Who Benefits
EPAT (Extracorporeal Pulse Activation Technology) shockwave therapy is one of the most evidence-supported non-surgical treatments for chronic plantar fasciitis, Achilles tendinopathy, and other soft tissue conditions of the foot. For more information, see our complete guide to plantar fasciitis treatment. At Balance Foot & Ankle in Howell and Bloomfield Hills, Michigan, we offer EPAT as part of our advanced heel pain treatment program. Here’s a detailed look at how it works, what the research shows, and whether you’re a candidate.
What Is EPAT Shockwave Therapy?
EPAT delivers radial acoustic pressure waves (sound waves) to the affected tissue. These waves stimulate the body’s natural healing response in degenerated tendons and fascia through several mechanisms:
- Neovascularization: EPAT stimulates formation of new blood vessels in hypovascular tissue (like the plantar fascia and Achilles tendon midsubstance), restoring the nutrient supply that chronic degenerative tissue desperately needs
- Growth factor release: Acoustic waves trigger release of TGF-β1, VEGF, and other growth factors that initiate collagen regeneration
- Calcification disruption: High-intensity shockwaves mechanically fragment calcific deposits within tendons and fascia
- Hyperstimulation analgesia: Repeated stimulation of nociceptors temporarily desensitizes pain pathways, providing immediate pain reduction
The net result: tissue that has been “stuck” in a chronic degenerative state for months or years is reset into an active healing phase.
EPAT vs. Traditional ESWT: What’s the Difference?
Traditional focused ESWT (Extracorporeal Shock Wave Therapy) uses converging high-intensity sound waves that require local anesthetic before treatment due to the level of discomfort. EPAT uses radial (diverging) pressure waves at lower intensity — no anesthesia is required, and treatment, while not painless, is well-tolerated by most patients. The evidence base is strong for both; EPAT’s easier tolerability makes it the preferred modality for outpatient podiatric use.
What Does the Research Show?
EPAT/ESWT has some of the strongest evidence of any non-surgical intervention for chronic plantar fasciitis:
- Multiple Level I and Level II studies demonstrate 75–85% success rates (≥50% pain reduction) in patients with chronic plantar fasciitis who failed 3–6 months of conservative treatment
- A landmark 2002 JAMA study (Ogden et al.) showed ESWT superior to placebo for chronic plantar fasciitis unresponsive to 6 months of conservative treatment
- Meta-analyses consistently show ESWT superior to corticosteroid injection at 6 and 12 months, with better durability and no risk of fascia rupture
- For Achilles tendinopathy, EPAT plus eccentric exercise is superior to eccentric exercise alone in multiple RCTs
Who Is a Good Candidate for EPAT?
EPAT is most effective for patients who have had symptoms for at least 3–4 months and have tried conservative treatment (stretching, orthotics, NSAIDs, physical therapy) without adequate relief. It is FDA-cleared for musculoskeletal conditions and appropriate for most adults. Contraindications include:
- Pregnancy
- Active infection at the treatment site
- Blood clotting disorders or anticoagulation therapy
- Active cancer in the treatment area
- Cortisone injection within 6 weeks at the treatment site (increased soft tissue disruption risk)
What to Expect: The EPAT Treatment Protocol
At Balance Foot & Ankle, our standard EPAT protocol is 3 sessions over 3 weeks, each lasting approximately 5–10 minutes. The treatment head is applied to the affected area with ultrasound gel and moved in a circular pattern while delivering pressure waves. Intensity is calibrated to patient tolerance — most describe it as a deep tapping or pressure sensation. There is typically no downtime; most patients drive themselves home and return to normal low-impact activity the same day.
Important: Avoid NSAIDs (ibuprofen, naproxen) for 2 weeks after each EPAT session. These drugs suppress the inflammatory response that EPAT is deliberately triggering as part of the healing cascade. Taking NSAIDs around EPAT sessions actively undermines the treatment.
Improvement is gradual. Most patients notice meaningful pain reduction by week 4–6 after starting treatment. The full effect continues to develop over 3 months as neovascularization and collagen remodeling complete. It is not uncommon to feel a temporary increase in soreness in the days following each session — this is the induced inflammatory response and is expected.
If you’ve been dealing with chronic heel pain or Achilles tendinopathy and haven’t found relief with conventional treatment, EPAT shockwave therapy may be the next step. Contact Balance Foot & Ankle at (810) 206-1402 to discuss whether you’re a candidate. Our plantar fasciitis treatment program combines EPAT with custom orthotics and MLS laser therapy for maximum effectiveness.
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Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Hills Office
43494 Woodward Ave, #208
Bloomfield Hills, MI 48302
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Your Board-Certified Podiatrists
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Same-week appointments available at both locations.
In-Office Treatment at Balance Foot & Ankle
If home care isn’t resolving your heel pain, a visit with a board-certified podiatrist is the fastest path to accurate diagnosis and a personalized plan. At Balance Foot & Ankle Specialists, Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin offer same-day and next-day appointments at both our Howell and Bloomfield Hills offices. We perform on-site diagnostic ultrasound, digital X-ray, conservative care, advanced regenerative treatments, and minimally invasive surgery when indicated.
Call (810) 206-1402 or request an appointment online. Most insurance plans accepted, including Medicare, Blue Cross Blue Shield, Aetna, Cigna, and United Healthcare.
Differential Diagnosis: What Else Could It Be?
Several conditions share symptoms with Plantar Fasciitis and are commonly misdiagnosed in the first office visit. Considering these alternatives is part of every Balance Foot & Ankle exam:
- Baxter’s neuropathy. Compressed first branch of lateral plantar nerve — burning medial heel pain rather than first-step sharpness.
- Calcaneal stress fracture. Squeeze test of the heel reproduces pain anywhere; PF is reproduced only at the medial-plantar attachment.
- Heel spur (incidental). Spurs show on X-ray but rarely cause pain on their own — treat the fascia, not the spur.
If your symptoms don’t fit the textbook pattern, ask your podiatrist which differentials they ruled out — that conversation often shortcuts months of trial-and-error treatment.
In Our Clinic
In our Balance Foot & Ankle clinic, the typical plantar fasciitis patient is a 40- to 60-year-old who noticed sharp heel pain on their very first steps in the morning or after sitting at a desk. Many arrive having already tried cheap shoe-store inserts and a week of ice without relief. On exam, we palpate the medial calcaneal tubercle, check for a positive windlass test, and rule out Baxter’s neuropathy and calcaneal stress fractures. Most of our plantar fasciitis patients respond to a custom orthotic + eccentric calf loading + night splinting protocol within 6–12 weeks — without injections or surgery.
Most Common Mistake We See
The most common mistake we see is: Stretching aggressively before the fascia warms up. Fix: apply heat or move the foot through gentle circles for 3-5 minutes before your first morning steps, then stretch.
Warning Signs That Need Same-Day Care
Seek immediate evaluation at Balance Foot & Ankle if you experience any of the following:
- Unable to bear weight on the heel
- Bruising or visible swelling around the heel
- Constant rest or night pain in the heel
- No improvement after 6 weeks of home care
Call (810) 206-1402 — same-day and next-day appointments at our Howell and Bloomfield Hills offices.
More Podiatrist-Recommended Plantar Fasciitis Essentials
Best Night Splint
Keeps fascia stretched overnight — the #1 intervention for morning heel pain.
Top Podiatrist-Recommended Insole
Deep heel cup + arch support unloads the plantar fascia all day.
Plantar Fasciitis Compression Sock
Arch support + circulation boost — reduces morning heel pain and swelling.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
If morning heel pain has persisted more than 6 weeks, home care alone rarely fixes it. At Balance Foot & Ankle, we combine in-office ultrasound diagnostics, custom orthotics, and — when needed — shockwave or PRP to resolve plantar fasciitis that hasn’t responded to stretching and inserts. Most patients are walking pain-free within 4-8 weeks of starting a structured plan.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Pros & Cons of Conservative Care for plantar fasciitis
Advantages
- ✓ Conservative care resolves 90%+ of cases
- ✓ Multiple home treatment options
- ✓ Strong evidence base
- ✓ Imaging often not required
Considerations
- ✗ Recovery takes 6-12 weeks
- ✗ Mistakes prolong recovery
- ✗ Untreated can become chronic
- ✗ Can mimic other conditions
In This Article
- Quick Answer
- What Is EPAT Shockwave Therapy?
- EPAT vs. Traditional ESWT: What’s the Difference?
- What Does the Research Show?
- Who Is a Good Candidate for EPAT?
- What to Expect: The EPAT Treatment Protocol
- In-Office Treatment at Balance Foot & Ankle
- Differential Diagnosis: What Else Could It Be?
Several conditions share symptoms with Plantar Fasciitis and are commonly misdiagnosed in the first office visit. Considering these alternatives is part of every Balance Foot & Ankle exam:Baxter’s neuropathy. Compressed first branch of lateral plantar nerve — burning medial heel pain rather than first-step sharpness.
Calcaneal stress fracture. Squeeze test of the heel reproduces pain anywhere; PF is reproduced only at the medial-plantar attachment.
Heel spur (incidental). Spurs show on X-ray but rarely cause pain on their own — treat the fascia, not the spur.If your symptoms don’t fit the textbook pattern, ask your podiatrist which differentials they ruled out — that conversation often shortcuts months of trial-and-error treatment.
In Our Clinic
In our Balance Foot & Ankle clinic, the typical plantar fasciitis patient is a 40- to 60-year-old who noticed sharp heel pain on their very first steps in the morning or after sitting at a desk. Many arrive having already tried cheap shoe-store inserts and a week of ice without relief. On exam, we palpate the medial calcaneal tubercle, check for a positive windlass test, and rule out Baxter’s neuropathy and calcaneal stress fractures. Most of our plantar fasciitis patients respond to a custom orthotic + eccentric calf loading + night splinting protocol within 6–12 weeks — without injections or surgery.Most Common Mistake We See
- Warning Signs That Need Same-Day Care
Dr. Tom’s Recommended Products for plantar fasciitis
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
PowerStep Pinnacle Maxx Dr. Tom’s Pick
Best for: High-arch support to offload plantar fascia
Strassburg Sock Dr. Tom’s Pick
Best for: Overnight stretch for morning pain relief
Hoka Bondi 9 Dr. Tom’s Pick
Best for: Max cushion + rocker sole for daily relief
TriggerPoint Footballer Dr. Tom’s Pick
Best for: Plantar fascia release + stretching
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Hills. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
Book Today — Same-Day Appointments Available
Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Hills, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)
If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.
Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed for 30+ days minimum. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
4.5
(28,341+ reviews)
Dr. Tom’s most-prescribed OTC orthotic. Lateral wedge corrects overpronation that causes 90% of foot pain. Deep heel cradle stabilizes the ankle. Built by podiatrists, used by patients worldwide.
- Lateral wedge corrects pronation
- Deep heel cradle stabilizes ankle
- Dual-density EVA — comfort + support
- Trim-to-fit any shoe
- Used by 10,000+ podiatrists
- Trim-to-size required
- 5-7 day break-in for some
This single insole eliminates plantar fasciitis pain in 60% of patients within 2 weeks. The lateral wedge is the active ingredient — it stops the overpronation that causes the fascia to overstretch with every step. Pair with a max-cushion shoe for compound effect.
CURREX RunProDr. Tom’s #1 Brand
4.4
(4,000+ reviews)
3 arch heights for custom fit (Low/Med/High). Carbon-reinforced heel + dynamic forefoot — the closest OTC orthotic to a $500 custom orthotic. Engineered in Germany.
- 3 arch heights for custom fit
- Carbon-reinforced heel cup
- Dynamic forefoot zone
- Premium German engineering
- Sport-specific support
- Pricier than PowerStep
- 7-10 day break-in
Choose your arch height from a wet-foot test (low/med/high). Wrong arch = re-injury. For runners, athletes, or anyone who failed standard insoles — this is the closest you can get to custom orthotics without paying $500. The carbon heel is what professional athletes use.
Dr. Hoy’s Natural Pain Relief GelDr. Tom’s #1 Brand
4.6
(5,500+ reviews)
Menthol-based natural pain relief — Dr. Tom’s #1 brand for fast relief without greasy residue. Safe for diabetics + daily use. Cleaner formula than Voltaren or Biofreeze.
- Menthol-based natural formula
- No greasy residue
- Safe for diabetics
- Fast cooling relief — 5-10 minutes
- Cleaner ingredient list than Biofreeze
- Pricier than Biofreeze
- Strong menthol scent at first
Apply to plantar fascia + calves before bed. Combined with stretching, eliminates morning fascia pain. The clean formula means you can use it daily long-term — Voltaren has 30-day limits, Dr. Hoy’s doesn’t.
What is Heel pain?
Heel pain is a common foot/ankle condition that affects mobility and quality of life. Understanding the underlying cause is the first step in successful treatment. Our podiatrists at Balance Foot & Ankle perform a hands-on biomechanical exam, review your activity history, and use diagnostic imaging when appropriate to identify the root cause—not just treat the symptom. Many patients have been told to “rest and ice” without a deeper diagnostic workup; our approach is different.
Symptoms and warning signs
Common signs of heel pain include pain that worsens with activity, morning stiffness, swelling, tenderness when palpated, and difficulty bearing weight. If you experience sudden severe pain, inability to walk, visible deformity, numbness or color change, contact our office the same day or visit urgent care—these can signal a more serious injury such as a fracture, tendon rupture, or vascular compromise. Diabetics with any foot wound should seek same-day care.
Conservative treatment options
Most cases of heel pain respond to non-surgical care: structured rest, supportive footwear changes, custom orthotics, targeted stretching and strengthening protocols, anti-inflammatory medications when medically appropriate, and in-office procedures such as ultrasound-guided injections. We also offer advanced therapies including MLS laser therapy, EPAT/shockwave, regenerative injections, and image-guided procedures. Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step.
When is surgery considered?
Surgery is reserved for cases that fail 3-6 months of well-structured conservative care, when there is structural pathology (severe deformity, complete tear, advanced arthritis), or when imaging shows damage that will not heal without intervention. Our surgeons have performed 3,000+ foot and ankle procedures and prioritize minimally-invasive techniques whenever appropriate. We discuss recovery timelines, return-to-activity milestones, and realistic outcome expectations before any procedure is scheduled.
Recovery timeline and prevention
Recovery from heel pain varies based on severity and chosen treatment path. Conservative cases often improve within 4-8 weeks with consistent adherence to the protocol. Post-procedural recovery may range from a few days (in-office procedures) to several months (reconstructive surgery). Long-term prevention involves footwear assessment, activity modification, structured strengthening, and regular check-ins with your podiatrist if you have a history of recurrence. We provide written home-exercise plans and digital follow-up support.
Ready to feel better?
Same-week appointments available in Howell and Bloomfield Hills, Michigan.
🏥 Dr. Biernacki’s Recommended Products (Save 30% – Foundation Wellness)
👉 PowerStep Pinnacle Insoles — #1 podiatrist-recommended for heel pain & plantar fasciitis.
👉 Doctor Hoy’s Natural Pain Relief Gel — Topical pain relief for heel & arch pain.
Frequently Asked Questions
How long does plantar fasciitis take to heal?
Most plantar fasciitis cases resolve within 6–12 months with consistent treatment. In our clinic, patients who begin care within the first 8 weeks see 80% improvement by month 3. Chronic cases — pain lasting over a year — typically require PRP injections or surgical intervention, but fewer than 5% of our patients reach that point. Starting treatment early is the single biggest factor in shortening recovery.
Why is plantar fasciitis pain worst in the morning?
Overnight, the plantar fascia contracts in a shortened position. Your first steps stretch it abruptly, causing micro-tears at the heel attachment and sharp pain. This ‘first-step pain’ that eases after 10–15 minutes is the hallmark diagnostic sign. If your pain worsens throughout the day rather than improving, a different diagnosis — stress fracture, fat pad atrophy, or nerve entrapment — should be explored.
Can I walk or run with plantar fasciitis?
You can often continue with modifications, especially in early-stage cases. Reduce mileage by 30–50%, avoid hills and speed work, and run on softer surfaces. Add aggressive calf stretching before and after. If pain exceeds 4/10 during activity, stop — pushing through moderate-to-severe pain causes scar tissue formation that can double your recovery time. We reassess runners every 3 weeks to adjust the plan.
Does plantar fasciitis require surgery?
Surgery is required in fewer than 5% of cases. We exhaust conservative options first: custom orthotics, physical therapy, night splints, corticosteroid injections, and shockwave therapy. If those fail after 6–12 months of consistent treatment, plantar fascia release or PRP is considered. In our practice, patients who follow a structured protocol almost never reach surgery.
What shoes help plantar fasciitis the most?
The three features that matter most: firm arch support (not soft cushioning — soft foam collapses under load), a slight heel elevation of 8–12mm to reduce fascia tension, and a wide, deep toe box. Motion-control and stability shoes outperform neutral cushioned shoes for most plantar fasciitis patients. Avoid flat shoes, flip-flops, and going barefoot on hard floors entirely.
Do I need custom orthotics, or will store-bought insoles work?
For mild-to-moderate plantar fasciitis, high-quality OTC insoles (Superfeet, Powerstep) work well for about 60% of patients. Custom orthotics are worth it when: your arch collapse is severe, OTC insoles haven’t helped after 8 weeks, or you have a secondary issue like leg-length discrepancy or overpronation driving the problem. We cast custom orthotics in-office when clinically indicated — typically covered by most PPO plans.
Is plantar fasciitis the same as a heel spur?
No — they’re related but different. A heel spur is a bony calcium deposit that forms on the bottom of the heel bone; plantar fasciitis is inflammation of the fascia ligament. About 70% of patients with plantar fasciitis have a heel spur on X-ray, but the spur is rarely the source of pain. Treating the fascia inflammation resolves symptoms in most cases without removing the spur.
What stretches actually work for plantar fasciitis?
The two most evidence-supported stretches: (1) Seated towel stretch — loop a towel around your foot, pull toes toward you, hold 30 seconds, repeat 3x before getting out of bed. (2) Calf-wall stretch with a straight knee and a bent knee — targets both the gastrocnemius and soleus. Research shows stretching 3x daily reduces symptoms significantly within 8 weeks. The Strassburg sock worn overnight is the highest-impact passive stretch available.
Can plantar fasciitis come back after it heals?
Yes — recurrence rate is 15–25% in the first year without maintenance. The three biggest recurrence triggers: returning to the shoes that caused the problem, stopping stretching when pain disappears, and sudden increases in activity. Patients who continue daily stretching, wear supportive footwear consistently, and use orthotics long-term have recurrence rates under 5% in our practice.
When should I see a podiatrist for heel pain?
See a podiatrist if: pain is severe and limits daily walking, pain hasn’t improved after 4 weeks of rest and stretching, pain is getting progressively worse, you’re having pain at night or at rest, or the pain is on the back or side of your heel rather than the bottom. Night and resting pain can indicate stress fractures, nerve compression, or Achilles pathology — conditions that need imaging to rule out.
What’s the difference between plantar fasciitis and tarsal tunnel syndrome?
Both cause heel pain but feel different. Plantar fasciitis pain is sharp, focal, and worst with first steps. Tarsal tunnel pain is burning, tingling, or electric — often radiating into the arch and toes — and worsens with prolonged standing. Tarsal tunnel is nerve compression (like carpal tunnel in the wrist); plantar fasciitis is ligament degeneration. A nerve conduction study and Tinel’s sign test differentiate them. Misdiagnosis is common — about 20% of chronic plantar fasciitis cases are actually tarsal tunnel.
Ready for Expert Care?
Same-day appointments in Howell & Bloomfield Hills, MI.
4.9★ | 1,123 Reviews | 3,000+ Surgeries
Or call: (810) 206-1402
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views and almost 1 million subscribers on youtube.