Heel pain clinic with Mr Paul Hamilton, Consultant Orthopaedic Surgeon

Spire St Anthony’s Hospital now has a dedicated team offering focused individualised treatment of heel pain (plantar fasciitis and Achilles tendinopathy). We offer a multidisciplinary approach using modern techniques to evaluate and treat the condition, which often has a considerable impact on patients’ lives.

Led by Mr Paul Hamilton Consultant Orthopaedic Surgeon - with an interest in foot and ankle conditions, the clinic offers a complete assessment at your first visit, including a focused assessment by a senior physiotherapist. An individualised treatment plan can then be put in place, which may include physiotherapy, insoles, podiatric assessment, gait analysis, image-guided injections, extra-corporeal shockwave therapy and, occasionally, surgical procedures.

The aim of the clinic is to provide a personalised approach to treating these common conditions that can greatly affect quality of life. Whether you are an athlete or live a more sedentary lifestyle, we aim to return you to your previous level of activity as quickly as possible.

The clinic runs on a Monday evening and usually involves consultant and physiotherapy assessment, with X-ray and ultrasound if required.

Details about heel pain

What is heel pain?

There are two main conditions associated with heel pain:

1. Plantar fasciitis or policeman’s heel is pain under the foot near the heel. It originates from a strong band of fibrous tissue that runs from the heel to the toes known as the plantar fascia. Symptoms are often worse first thing in the morning or after sitting for periods, and improve after ‘stretching’ the plantar fascia. The pain often returns after standing for long periods.

2. Achilles tendinopathy is pain at the back of the heel, either where the Achilles inserts (insertional) or just above this area (non-insertional). The pain is often worse first thing in the morning and may be associated with a lump and swelling.

How does heel pain occur?

The exact reason why it occurs is unknown but the process probably relates to increased or abnormal loading of the tendon or fascia, leading to degeneration. If this fails to resolve quickly the condition can become chronic and can often last for many months. Heel pain is associated with a sudden increase in activity, being overweight, a flat or high-arched foot, or a tight calf muscle. It is also associated with some generalised conditions such as rheumatoid arthritis and occasionally medication.

How can heel pain be treated?

An assessment will allow an individualised treatment protocol. Initial treatment should always involve physiotherapy focusing on calf stretches and possibly insoles. In some individuals a formal gait analysis with custom insoles may be appropriate. This will be successful in the majority of patients. If there is failure to progress after two to three months we can offer several treatments including injections, extracorporeal shockwave therapy and surgical stretching of the calf. These can be used in combination if required.

Specific treatments


Although stretching alone can help treat these conditions, we recommend assessment and treatment via a trained physiotherapist. They can guide you through appropriate exercises and rehabilitation, not only to treat the

condition but also to prevent recurrence. They may also be able to assist you in providing simple insoles and night splints, giving guidance on shoe wear and advice on activities you should be undertaking and avoiding.

Podiatric assessment

For those in need of more custom-made insoles an assessment can be made by our podiatrist. The consultation usually includes formal biomechanical evaluation with gait analysis.

Extra-corporeal shockwave therapy

Shockwave therapy involves three sessions at one to two-weekly intervals lasting about 5–10 minutes. It is thought to act by creating an inflammation that promotes healing of the injured tissue. You may experience some bruising, numbness, swelling and redness after each session. Strenuous exercise should be avoided for 48 hours. It is recommended to continue physiotherapy for this time.

Injection therapy

Injections can be used to treat both plantar fasciitis and Achilles tendinopathy. Although both use a small amount of steroid, they are thought to act in different ways. Strenuous activity should be avoided for six weeks if you have undergone an injection around your Achilles. It is recommended to continue physiotherapy for this time.

Surgical calf stretching

In cases where the calf muscle is very tight, shockwave therapy or injection therapy may not work alone. In these cases surgical calf stretching may be recommended. This involves a day-case procedure where a small incision is made behind the knee. You will be able to walk out of hospital and can continue physiotherapy at two weeks.

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Insured Patients
Simply visit your GP and ask them to refer you to a consultant who practises at Spire St Anthony's Hospital hospital. Your GP will write a letter of referral and then either you or your GP can contact us to arrange your first out-patient appointment on 020 8335 4678/9.

Self Pay Patients
For most self-pay treatments, you’ll need a GP referral letter to bring to your first appointment. Simply call us on 020 8335 4646 or email us on info@spirestanthonys.com to request a guide price or to discuss your personal situation.

About Mr Paul Hamilton

Mr Paul D Hamilton Orthopaedic surgery Consultant, Sutton, private hospital specialist.
Mr Paul Hamilton is a consultant orthopaedic surgeon specialising in all adult foot and ankle surgery and trauma surgery.

Paul qualified from St Bartholomew’s and the Royal London Hospital Medical College and went on to complete his orthopaedic training in London. He has had extensive training in foot and ankle surgery and completed three UK based fellowships with world-renowned surgeons as well as a travelling fellowship to Boston, USA.

Paul has a keen interest in teaching and he currently examines on the MSc in trauma and orthopaedics at Brighton University and teaches on several FRCS (Tr and Orth) courses. He has completed a Postgraduate Diploma in trauma and orthopaedics. Click here to read more

© Spire Healthcare Group plc (2016)