‘Collapsed arches’, ‘ripped plantar fasciae’, and ‘heel spurs’: The painful language of plantar heel pain

Abstract

The words spoken by clinicians can profoundly impact a person’s preception of their body. Words may influence pain, as pain is a measure of perceived threat. Words such as tear, rupture, degeneration, instability, and damage may increase perceived threat. Similarly, pathologising ‘abnormal’ anatomical variation may leave people feeling vulnerable and fragile. This article aimed to explore the potential consequences of particular words and narratives commonly used to describe plantar heel pain and justify interventions used to treat plantar heel pain. Drawing on the existing body of pain-science research, the authors argue that some of the language and narratives used in the literature and practice may potentially be threat invoking/nocebic. In addition, we argue that justifying interventions such as orthoses by stating that they normalise foot function may leave patients feeling broken, deficient, and abnormal. In response, we provide several recommendations for clinicians to help them avoid invoking threat when describing plantar heel pain and justifying interventions for it.