About Plantar Heel Pain

Plantar heel pain, most commonly attributed to plantar fasciopathy (historically referred to as plantar fasciitis), is a prevalent musculoskeletal condition affecting adults, particularly those with prolonged weight-bearing, walking, or running demands. It typically presents as localized pain at the plantar medial aspect of the calcaneus, often most pronounced with the first steps in the morning or after periods of inactivity.

The etiology of plantar heel pain is multifactorial and reflects an interaction between mechanical loading, tissue capacity, and individual risk factors. Contributing factors may include limited ankle dorsiflexion, altered foot biomechanics (e.g., excessive pronation), increased body mass, prolonged standing or running, footwear factors, and degenerative changes within the plantar fascia. Current evidence supports a predominantly degenerative rather than inflammatory process in most chronic presentations.

Symptoms can fluctuate over time and may significantly affect walking tolerance, occupational activities, and participation in sport or daily life. Clinical presentation and recovery are influenced by biological, mechanical, and contextual factors, and management should be guided by an individualized, function-focused approach rather than structural findings alone.

About CCG Care Pathways

Purpose

CCG is a knowledge translation resource of the Canadian Chiropractic Association. Its care pathways help chiropractors and other clinicians organize conservative care for musculoskeletal conditions. Each pathway outlines the main steps of the clinical encounter and supports decisions about assessment, care, monitoring, referral, co-management, and discharge. The pathways provide a structured approach to care, not a fixed prescription.

Development

Pathways draw on relevant clinical practice guidelines, systematic reviews, peer-reviewed literature, and safety or professional sources. These sources inform, but do not determine, pathway content. Their findings reflect the questions, populations, outcomes, methods, and judgments used and may not apply to every person. Condition-specific sources are identified by author or organization and year, with full citations in one reference list at the end of the pathway.

Principles of Care

Musculoskeletal conditions are shaped by physical, psychological, social, cultural, and environmental factors, so no single approach fits everyone. Good care is ethical, evidence-informed, person-centred, culturally responsive, and tailored to the patient’s goals, preferences, circumstances, and response. Shared decision-making and informed consent guide care. Education, active rehabilitation, and self-management support recovery, functioning, participation, and long-term health. Regular reassessment shows whether the plan is helping and when to continue, adapt, stop, refer, co-manage, or discharge.populations.

Pathway Flow at a Glance

The pathway follows a recurring clinical cycle: understand the person and their goals; screen for safety and referral needs; develop a working clinical profile; agree on a plan and relevant outcomes; provide care; reassess response and safety; and continue, adapt, stop, refer, co-manage, or discharge as appropriate.

Disclaimer

CCG care pathways support professional clinical judgment; they do not replace it or the advice of a qualified provider. They are not prescriptive, authoritative, or regulatory and are not intended for diagnosis or billing. Clinicians remain responsible for practicing within their competence and scope, meeting applicable legal and regulatory requirements, obtaining informed consent, recognizing emergencies, and arranging referral or co-management when needed.

Plantar Heel Pain Care Pathway

1. Record Keeping

Accurate, timely, and sufficiently detailed documentation supports safe, high-quality care. The record should reflect clinically relevant patient interactions, clinical reasoning, decisions, care provided, and progress over time. Documentation should meet the legal, regulatory, privacy, retention, and organizational requirements that apply where the clinician practices. A structured format, such as SOAP, may support consistency, clarity, and continuity and can be adapted to the encounter and practice setting.

Subjective: Record the patient’s concerns, symptoms, functioning and participation, goals, preferences, relevant history and context, and response or adverse effects from previous care.

Objective: Record relevant examination findings, outcome measures, diagnostic test results when available, and clinically important changes.

Assessment: Record the clinical interpretation of findings, working diagnosis or clinical profile, differential and safety considerations, relevant risk factors or modifiers, and the patient’s progress or response.

Plan: Record care provided or proposed, education and self-management, consent and patient decisions, changes to the plan, agreed outcomes and reassessment point, referrals or co-management, follow-up, and discharge planning.

Document at the time of the encounter or as soon as practicable. Corrections and additions should preserve the integrity of the record. Clear records support patient safety, shared decision-making, communication, continuity, and accountability.

2. Informed Consent

Definition: A continuing process in which a capable patient, or an authorized substitute decision-maker when required, voluntarily agrees to a proposed examination or intervention after receiving and understanding the information needed to make an informed choice.
Key Aspects:
- Prior to interaction: Obtain consent before beginning an examination, procedure, or treatment, except where applicable law permits otherwise. Explain what is proposed and why. Revisit consent when the plan or material information changes.
- Voluntarily and specific: must be voluntary and specific to the proposed care. Consider the patient’s capacity for the decision at the time it is required and follow applicable requirements for substitute decision-making when the patient lacks capacity. The patient may ask questions, refuse, place limits on, or withdraw consent.
- Transparent process: Use honest, plain, and accessible communication. Offer interpretation or other communication support when needed and consider language, culture, health literacy, disability, and prior trauma. Written or digital information may support but does not replace discussion.
- Patient understanding and agreement:
  - Diagnosis/prognosis: Explain relevant findings, the clinical impression or working diagnosis, important uncertainty, and the expected course in understandable language.
  - Treatment plan: Discuss the nature and purpose of proposed care, expected benefits, material risks and side effects, burdens, reasonable alternatives, the option of no intervention, and the likely consequences of accepting or declining.
  - Questions: Invite questions, explore goals and preferences, allow appropriate time for a decision, and confirm understanding, for example using teach-back.
- Documentation: Record the consent discussion and decision, including material information provided, questions, capacity or substitute decision-maker where relevant, consent, refusal, limits or withdrawal, and any need to revisit consent. Follow documentation requirements applicable to the jurisdiction and practice setting.

3. Health History

Apply cultural awareness and trauma-informed care principles.
Sociodemographic information: Age, gender, sex, race/ethnicity.
Main complaint: Location, onset, duration, and nature of heel pain; pattern of symptoms (e.g., pain with first steps in the morning or after rest); aggravating and easing factors; impact on walking, standing, work, sport, and daily activities.
Body systems: Neurologic, cardiovascular, genitourinary, gastrointestinal, musculoskeletal, bone density, eyes/ears/nose/throat, respiratory, skin, mental health, reproductive.
Health, lifestyle, and history: Past medical conditions, medications and supplements, prior lower-limb injury or surgery, physical activity and exercise history, occupational standing or walking demands, footwear use, recent changes in training or activity levels, sleep quality, and body weight history.
Social determinants of health: Employment, childcare, education, nutrition, housing, domestic violence, child maltreatment, discrimination, social isolation.
Previous treatments and responses: Prior conservative or medical treatments, adherence, perceived benefit, and adverse effects.
Beliefs and expectations: Understanding of plantar heel pain, expectations regarding recovery, concerns about persistence or recurrence, and confidence in activity or return to function.
Flag considerations: Screen for red flags, orange flags, and psychosocial (yellow) factors.

Outcomes Assessments: Prioritize outcome measures that align with the individual’s goals, clinical presentation, and functional demands.

Pain: Use pain scales (e.g., NRS) and diagrams.
Function and Participation: Evaluate impact on daily activities (PSFS, WHODAS, LEFS, FFI).
Recovery: Use self-rated recovery scales.
Quality of life: Assess using tools such as SF-12.
Work/school status: Ability to perform daily activities, including standing and walking tolerance.
Individual goals: Set SMART goals (Specific, Measurable, Achievable, Relevant, Timely).
Patient feedback: Patient-reported experience, satisfaction, and perceived impact of care.

4. Red Flags : Differential Diagnosis Requiring Medical Referral

ACTION: Refer immediately to emergency care:

Suspected fracture: Acute heel pain following trauma, inability to bear weight, marked swelling or deformity. Consider application of the Ottawa ankle rules.
Infection: Signs of local or systemic infection, including severe pain, warmth, erythema, fever, or rapidly worsening symptoms.
Acute neurovascular compromise: Progressive numbness, weakness, or vascular symptoms affecting the foot.

ACTION: Refer to appropriate medical provider:

alcaneal stress fracture: Persistent focal heel pain with activity-related worsening and inadequate response to initial conservative care, particularly following recent changes in load or in individuals with reduced bone density. May be associated with localized tenderness or pain with medial–lateral compression of the calcaneus.
Inflammatory arthropathy: Features suggestive of systemic inflammatory disease (e.g., bilateral heel pain, morning stiffness >30 minutes, multiple joint involvement, known inflammatory arthritis such as rheumatoid arthritis, reactive arthritis, or psoriatic arthritis).
Neurologic causes: Suspected nerve entrapment (e.g., tarsal tunnel syndrome) presenting with burning pain, paresthesia, or nocturnal symptoms.
Tumor or other serious pathology: Unexplained night pain, systemic symptoms (e.g., weight loss), or progressive symptoms inconsistent with typical plantar heel pain.
Pediatric presentations: In children or adolescents, consider calcaneal apophysitis (Sever’s disease), particularly when heel pain worsens after running, jumping, or sports participation.

5. Orange Flags: Symptoms of Psychiatric Disorders Requiring Referral

Orange Flags are signs that a mental health or substance use concern may require emergency or timely assessment or shared care, and may change whether and how MSK care proceeds. They are not diagnoses. Ask directly and respectfully when concern arises, considering immediate safety, severity, change from usual, daily functioning and context. Psychosocial factors that may affect recovery but do not require separate mental health or medical assessment are addressed under Yellow Flags.

ACTION: Arrange emergency assessment now when there is immediate danger or an urgent medical need:

Suicide, self-harm or harm to others: current intent or plan, a recent attempt, inability to stay safe, or behaviour suggesting an immediate risk of serious harm.
Severe change in mental state: extreme agitation, confusion, disorganization, possible psychosis or mania with impaired judgment or unsafe behaviour, or inability to meet basic needs when this creates immediate danger.
Substance-related or medical emergency: suspected overdose, severe intoxication, dangerous withdrawal, delirium or another sudden change requiring urgent medical care.

When immediate safety is uncertain, do not leave the person alone while help is arranged. Follow local emergency procedures and call 9-1-1 for immediate danger or urgent medical need. If the person is thinking about suicide, call or text 9-8-8: Suicide Crisis Helpline with them or support them to do so.

If violence, abuse or exploitation is disclosed or suspected, support immediate safety and follow applicable safety and reporting requirements.

ACTION: Arrange prompt medical or mental health assessment when there is:

Suicide or self-harm thoughts: thoughts without immediate danger.
Substantial symptoms or effects: severe, persistent or worsening symptoms of depression, anxiety, trauma, possible psychosis or mania, eating problems or substance use that substantially affect daily life, decision-making or safe participation in care.
Other reasons for assessment: a marked change from usual behaviour or functioning; concern about medication or substance effects; a presentation outside the clinician’s competence; or a request for help.

Agree with the patient on who will be contacted, how soon and what to do if the situation worsens. Confirm that the person has connected with the service when clinically important.

ACTION: Adapt and coordinate MSK care:

Safe care: care may continue when it is safe and acceptable and does not delay needed assessment. Adapt communication, examination and care; obtain ongoing consent; and coordinate with other providers with the patient’s permission.
Continue the MSK assessment: do not assume that a mental health or substance use concern explains the MSK presentation. Continue to consider physical causes and the patient’s account.
Questionnaires: they may support conversation and monitoring, but do not establish a diagnosis or replace direct questions, clinical judgment or action.
Acceptable support: ask what type of help is acceptable and whether language, cultural, family, community or other supports are important to the patient.

ACTION: Document and follow up:

Record the concern; relevant questions and the patient’s responses; the safety decision and reasons; actions, advice and referrals; communication and consent; follow-up; and any unresolved concern. Follow applicable privacy, safety and reporting requirements.

For provincial, territorial and national services, see Mental health support: Get help (Public Health Agency of Canada 2026).

6. Yellow Flags: Factors that May Affect Recovery or Participation

Yellow Flags are personal, social, work, school, healthcare, environmental or structural factors that may influence symptoms, functioning, participation or response to care. They are contextual, not diagnoses or certain predictions, and do not mean that symptoms are psychological. They guide how care is tailored and do not by themselves require urgent referral. Explore them through conversation and ongoing outcome review, with attention to the patient’s priorities, strengths and circumstances. A separate Yellow Flag score is not required. New or worsening signs of serious physical illness follow the Red Flag process. Mental health or substance use concerns that need separate assessment, or any immediate safety concern, follow the Orange Flag process and applicable emergency or safeguarding procedures.

Explore relevant factors:

Understanding, expectations and healthcare experiences: concerns about injury or damage, uncertainty, recovery expectations, confidence, conflicting advice, previous dismissal or harm, and trust in care.
Responses to symptoms and activity: worry, fear, avoidance, cycles of doing too much and then needing prolonged rest, difficulty pacing, coping, sleep, confidence in self-management, and return to meaningful activities.
Emotional and life context: distress, low mood, anxiety, grief, trauma, caregiving, relationship change, job loss or other major events. Ask permission before sensitive questions and limit discussion to what is relevant and acceptable to the patient.
Relationships, culture and strengths: supportive relationships, isolation, family and community roles, cultural or spiritual practices, identity, preferences, language and other sources of resilience.
Work, school and administrative context: physical and psychosocial demands, control, satisfaction, job security, accommodations, return concerns, and compensation, insurance or legal processes. Explore these neutrally and in context.
Social and structural conditions: consider social and structural determinants of health (Public Health Agency of Canada 2026), including income, housing, food security, transportation, childcare, access and cost of care, discrimination, racism, colonialism, neighbourhood and workplace conditions, and physical or digital accessibility.

ACTION: Respond with the patient:

Ask, do not assume: use open questions to understand what helps, what gets in the way, what matters and what feels feasible. Ask about strengths and protective factors, not only difficulties. Do not treat a person’s circumstances, culture or choices as a deficit.
Plan together: integrate relevant findings into shared goals, education, self-management, physical activity or exercise, and participation in meaningful activities. Adapt communication, setting, pace, cost and access where possible.
Connect and coordinate: with the patient’s consent, consider appropriate clinical, social, workplace, school, community, Indigenous or culturally specific supports. Clarify who will do what and follow up when the connection is important to the plan.
Review response to care: reassess the patient’s account and the pathway’s selected outcomes at clinically relevant points. If progress differs from expected, review the clinical impression, care plan, access and other barriers; do not automatically attribute the outcome to Yellow Flags.
Document: record relevant factors and strengths, the patient’s priorities and preferences, agreed actions, consent, referrals or coordination, follow-up, and any change requiring the Orange Flag process.

7. Physical Examination

The physical examination should be guided by the individual’s history, symptom behavior, and functional limitations, and interpreted in the context of clinical presentation.

Observation and gait
- Standing posture and foot alignment (e.g., rearfoot position, medial arch height).
- Gait pattern, including antalgic strategies, shortened stance phase, or avoidance of heel strike.
- Footwear inspection for wear patterns and adequacy of support.
Palpation
- Localized tenderness at the plantar medial calcaneal tubercle.
- Assessment of plantar fascia thickness or sensitivity along its course.
- Palpation of surrounding soft tissues to identify alternative or contributing pain sources.
Range of motion
- Ankle dorsiflexion and plantarflexion, both weight-bearing and non–weight-bearing as appropriate.
- First metatarsophalangeal joint motion.
- Assessment of calf muscle flexibility.
Strength and motor control
- Lower-limb strength, particularly ankle plantarflexors and intrinsic foot musculature.
- Functional control during single-leg stance or controlled loading tasks.
Neurological screening
- Sensation, reflexes, and motor function as indicated to exclude neurologic contributors (e.g., tarsal tunnel syndrome, lumbar referral).
Provocative and functional tests
- Symptom reproduction with first-step loading or sustained standing.
- Pain response during heel raise or controlled loading of the plantar fascia.
- Functional tasks relevant to the individual’s goals (e.g., walking tolerance, stair negotiation).
Advanced Diagnostics: Radiography may identify bone spur or possibly calcaneal stress fracture. However, in most cases, imaging is not initially recommended in the absence of red flags or neurologic symptoms.

8. Clinical Presentations for Plantar Heel Pain

Plantar heel pain most commonly presents as localized pain at the plantar medial aspect of the heel, often most noticeable with the first steps taken in the morning or after periods of prolonged sitting or inactivity. Symptoms typically improve with initial movement but may worsen with prolonged weight-bearing, walking, or standing as the day progresses.

Common clinical features include:

Reduced tolerance for occupational or recreational activities requiring sustained weight-bearing
Insidious or gradual onset of heel pain, though symptoms may follow changes in activity or loading
Sharp, aching, or burning pain localized to the plantar medial calcaneal region
Pain reproduced with initial weight-bearing after rest (“first-step pain”)
Increased pain with prolonged standing, walking, or running
Symptom aggravation with barefoot walking or unsupportive footwear
Reduced tolerance for occupational or recreational activities requiring sustained weight-bearing

Clinical presentation may vary across individuals and over time. While plantar fasciopathy is the most common diagnosis, plantar heel pain represents a spectrum of conditions, and symptom severity does not necessarily correlate with imaging findings.

Diagnosis is primarily clinical and should be based on the pattern of symptoms, functional impact, and response to loading, interpreted in conjunction with findings from the history and physical examination.

9. Conservative Treatment Considerations for Plantar Heel Pain

Approach to Treatment

The treatments outlined in this section reflect core domains of care consistently identified across high-quality clinical practice guidelines and established clinical practices. These include interventions shown to improve patient-important outcomes such as pain, function, and quality of life. Management plans should be tailored to the individual’s needs, goals, and preferences, taking into account clinical presentation, response to care, and contextual factors.

Not all domains need to be included in every care plan or at every stage of recovery. Clinicians are expected to apply professional judgment in selecting the most relevant components based on the clinical context.

This pathway is not prescriptive, nor does it list every possible intervention. Readers are encouraged to consult individual guidelines for specific treatment protocols, dosage, and condition-specific considerations.

While a range of other interventions may be in use, such as passive physical modalities, these have mixed or limited evidence of clinical benefit and are therefore not recommended for routine use. If applied, such therapies should be used as adjuncts to the core, evidence-based components of care, and not as standalone treatment.

Core approach (Morrissey 2021)

A core, multimodal approach should be considered early in care and applied in combination, with monitoring of response over time. These strategies are commonly implemented concurrently over several weeks before considering additional interventions for individuals with persistent symptoms.

Plantar fascia stretching: May be combined with stretching of the posterior calf musculature (gastrocnemius and soleus).
Taping: Low-Dye or anti-pronation taping techniques may be used to provide short-term symptom relief and guide response to foot support strategies.
Load management: Modify activities to reduce excessive or sustained plantar loading, including breaking up prolonged standing and reducing high-impact or stretch-loading activities (e.g., running) in more active populations.
Pain education: Provide clear explanations regarding the relationship between pain, tissue load tolerance, and tissue state, alongside realistic expectations that prognosis is generally favourable but recovery may be gradual.
Address related factors: Consider contributing factors such as elevated body mass, physical deconditioning, or occupational demands.
Footwear considerations: Encourage supportive, comfortable footwear with appropriate cushioning and rearfoot-to-forefoot drop, taking into account social acceptability and daily use.

Manual Therapy (Koc 2023; Morrissey 2021)

May include joint mobilization and soft-tissue techniques directed at the foot, ankle, and lower limb.
Manual therapy should be used as an adjunct to exercise and load-based interventions to support pain reduction and functional improvement.

Dry Needling (Morrissey 2021)

May be considered as an adjunctive intervention in selected individuals.
Should not be used as a standalone treatment and should be integrated into a broader, active care plan.

Extracorporeal Shockwave Therapy (Morrissey 2021; Koc 2023)

May be considered for individuals with persistent plantar heel pain who have not responded adequately to an initial period of conservative management.
Use should be guided by symptom duration, patient preference, and availability

Foot Orthoses (Morrissey 2021; Koc 2023) f

Prefabricated or custom foot orthoses may be considered for individuals with persistent symptoms, particularly when there is a positive response to taping.
Orthoses may support the medial longitudinal arch and provide heel cushioning.
Selection should prioritize comfort, tolerance, and functional response.

Muscle-specific interventions (Morrissey 2021)

Treatment may include interventions targeting the gastrocnemius, soleus, and intrinsic plantar foot muscles.
These approaches should be delivered in conjunction with other core interventions rather than in isolation.

10. Risk and Prognostic Factors for Plantar Heel Pain

(Koc 2023; Babatunde 2019; Morrissey 2021)

The development, persistence, and recovery of plantar heel pain are influenced by a combination of mechanical, biological, psychological, and contextual factors. Identification of these factors supports individualized care planning, expectation setting, and monitoring of recovery over time.

Risk factors

Mechanical and loading factors
- Sudden increases in walking, running, or standing demands
- Prolonged periods of static weight-bearing
- Limited ankle dorsiflexion or calf muscle tightness
- Altered foot biomechanics (e.g., excessive pronation or reduced load distribution capacity)
Body composition and health-related factors
- Elevated body mass index
- Reduced physical conditioning
- Comorbid metabolic conditions
Footwear and environmental factors
- Inadequate cushioning or support
- Prolonged barefoot walking on hard surfaces
- Occupational footwear requirements that limit shock absorption
Activity and occupational demands
- Occupations requiring prolonged standing or walking
- Recreational or athletic activities involving repetitive impact loading
Psychological and social factors
- Fear of movement or pain-related worry
- Low confidence in recovery
- Limited access to supportive footwear, orthoses, or care
- Work-related constraints affecting load modification

Prognostic considerations

Plantar heel pain is often self-limiting, though recovery timelines are variable and may extend over several months.
Many individuals experience meaningful improvement with appropriately matched conservative care.
Slower recovery or persistent symptoms are more likely in the presence of:
- Longer symptom duration at presentation
- High baseline pain or functional limitation
- Continued exposure to aggravating loads without adequate modification
- Elevated body mass or reduced physical capacity
- Psychosocial barriers affecting adherence or confidence
Early education, realistic expectation setting, and engagement in load-based rehabilitation are associated with more favourable outcomes.

11. Ongoing Follow-up

Ongoing follow-up is a shared review of whether the plan remains safe, useful, acceptable and aligned with the patient’s goals. The timing of review should reflect symptoms, risk, the care being tried, goals and access rather than a fixed visit schedule.

Review symptoms and safety: ask what has changed in symptoms, functioning and daily activities; review adverse effects; and check for new or worsening Red Flags and relevant Orange or Yellow Flag concerns. Arrange earlier or urgent assessment when the findings require it.
Review outcomes: repeat the small set chosen at baseline and use the same measures when possible. These may include the Patient-Specific Functional Scale, WHODAS 2.0, quality of life using the patient’s own rating or a measure such as WHOQOL-BREF, symptom impact, participation and the patient’s own assessment of change. Interpret measures with the patient and alongside what has changed in daily life rather than relying on a score alone.
Review goals, preferences and consent: ask whether care remains acceptable, feasible and worthwhile; revisit goals and priorities; and confirm consent when the plan or circumstances change.
Adapt care: continue what is useful and acceptable, and change, pause or stop what is not. If progress is not sufficient from the patient’s perspective, review the clinical impression, the fit and amount of care, barriers to participation, other health or social factors and whether other expertise is needed.
Support self-management and participation: review the strategies the patient is using, including physical activity or exercise, symptom management, pacing and participation in work, school, caregiving, recreation or community life. Ask what is helping and which barriers can be addressed.
Referral and co-management: arrange emergency assessment for Red Flags requiring urgent care. Consider referral or co-management when findings or needs are beyond the clinician’s role, the patient’s condition is worsening, progress remains insufficient after the plan has been reviewed, or the patient requests another opinion.
Plan the next step: agree whether to continue, change the interval between visits, move toward more self-directed care, or apply the Criteria for Discharge section.

12. Criteria for Discharge

Discharge is a shared decision about ending or transferring a course of care. It does not require complete symptom resolution, a normal outcome score or a fixed number of visits.

When discharge may be appropriate: consider discharge when the patient’s goals have been met to a degree they consider satisfactory; the patient feels able to manage with less or no clinician involvement; the patient chooses to end care; continued care is not providing enough benefit to justify its burden, cost or time; or care is being transferred to another provider.
Reassess before discharge: review symptoms, functioning, participation, selected outcomes, goals, adverse effects, confidence and preferences. Check for new or worsening Red Flags and any Orange or Yellow Flag concerns that still require action. If the condition is worsening or a safety concern remains, arrange the required assessment or referral rather than routine discharge.
When progress has slowed: review the clinical impression, response to care, goals, barriers and access, other health or social factors, and other reasonable options before deciding with the patient whether to continue, change or end care.
Plan after discharge: agree on self-management, physical activity or exercise, symptom management, pacing and participation in work, school, caregiving, recreation or community life. Explain which changes should prompt earlier or urgent assessment and when and where to seek care.
Future access to care: explain how the patient can return if symptoms recur, functioning declines, or goals or demands change. Any planned future review or supportive care should have an agreed purpose, expected benefit and review point.
Referral or transfer: explain the reason, share a relevant summary with the patient’s consent, and clarify who will address outstanding concerns when possible. Avoid an unintended gap in care when safety or ongoing needs remain.
If the patient ends care or does not return: respect the patient’s right to stop. Record what is known and unknown about the outcome, advice or referral offered, attempts to communicate when clinically warranted, and any unresolved safety concern. Follow applicable record keeping and communication requirements.
Documentation: record the reason care ended, the patient’s status and selected outcomes, goals and preferences, unresolved concerns, advice and self-management plan, referral or transfer details, and how to seek care again if needed.

Plantar Heel Pain