Lived experience and attitudes of people with plantar heel pain: a qualitative exploration

Abstract

Background: Plantar heel pain is a common source of pain and disability. Evidence-based treatment decisions for people with plantar heel pain should be guided by the best available evidence, expert clinical reasoning, and consider the needs of the patient. Education is a key component of care for any patient and needs to be tailored to the patient and their condition. However, no previous work has identified, far less evaluated, the approaches and content required for optimal education for people with plantar heel pain. The aim of this study was to gather the patients' perspective regarding their lived experience, attitudes and educational needs in order to inform the content and provision of meaningful education delivery approaches.Methods: Using a qualitative descriptive design, semi-structured interviews were conducted with participants with a clinical diagnosis of plantar heel pain. A topic guide was utilised that focused on the experience of living with plantar heel pain and attitudes regarding treatment and educational needs. Interviews were audio recorded, transcribed verbatim and analysed using the Framework approach. Each transcription, and the initial findings, were reported back to participants to invite respondent validation.Results: Eighteen people with plantar heel pain were interviewed. Descriptive analysis revealed eight themes including perceptions of plantar heel pain, impact on self, dealing with plantar heel pain, source of information, patient needs, patient unmet needs, advice to others and interest in online education. Participants revealed doubt about the cause, treatment and prognosis of plantar heel pain. They also expressed a desire to have their pain eliminated and education individually tailored to their condition and needs. Respondent validation revealed that the transcripts were accurate, and participants were able to recognise their own experiences in the synthesised themes.Conclusion: Plantar heel pain has a negative impact on health-related quality of life. Participants wanted their pain eliminated and reported that their expectations and needs were frequently unmet. Health professionals have an important role to be responsive to the needs of the patient to improve their knowledge and influence pain and behaviour. Our study informs the content needed to help educate people with plantar heel pain.

Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values

“…Finally, the perceptions and experience of people with PHP identified gaps in the education and treatment they had received. Consistent with recent qualitative work, 60 participants highlighted a poor understanding of their condition, including the underlying pathology, causal factors, efficacy of various treatments, mechanisms behind interventions, knowledge regarding expectations of improvement and how to progress when treatment is failing. Clinicians must consider how education is being delivered to their patients to ensure there is clear guidance on treatment and behaviour change, fears are allayed and that learning is checked rather than simple information provision.…”

Conservative management of acute lower limb tendinopathies: A systematic review

“…Finally, we note that no study used education as an intervention, no outcomes for psychological factors were recorded, and little consideration of cognitive and contextual factors have been made (Mallows et al, 2016). Given the relevance of these issues to acute and persistent musculoskeletal conditions (Chester, Jerosch‐Herold, Lewis, & Shepstone, 2016; Cotchett et al, 2020; Turner, Malliaras, Goulis, & Mc Auliffe, 2020), there is a clear knowledge‐gap in this space for LLT and insights here are likely to have a favourable impact for reducing conversion to persistency from acute LLT.…”

Management of plantar heel pain in general practice in Australia

“…Therefore, there is a discordance between Australian GP management of plantar heel pain and guidance from clinical practice guidelines and existing evidence. This discordance may be partially explained by the unmet need for patients to have their pain reduced, which may lead to recommendations for the use of pain relieving medication (Cotchett et al., 2020).…”