Table 3

Framework analysis of 40 patient survey responses yielding 8 subthemes

Theme 1: patient values
Subtheme Findings Illustrative quotes
Thoughts on condition causeFoot arch height; age; activity pattern; new load increase; long periods weight bearing; standing on hard surfaces; minimally supportive footwear; limb length asymmetry; rapidly changing load; altered gait; altered movement due to other conditions.Q: Walking on the outside edge of my foot when I was having pain in my second toe (PN).
Q: Heel spurs, arthritis.
Q: Long shifts on my feet in facilities with hard floors.
Q: Excess loads with inadequate progression.
Q: A number of contributory factors which is why is occurred now.
Thoughts on pathologyTissue irritation; degeneration; inflammation; tearing; inadequate tissue capacity; contracture.Q: Tissue band has become irritated through age/overuse.
Q: It feels like it is tearing. I think I have torn a ligament.
Q: Inflamed damaged PF which needs to heal/repair.
Q: Struggling to cope with the demand and non adapted tissue.
Q: Tendon contracture is wanting to happen all the time.
ExpectationsMore information; quick recovery-unrealised; exercise programme, especially foot strengthening; pain elimination; access to orthoses; specific treatments; better explanation of treatment/condition and causes.Q: Expected to get a steroid shot and was hoping for deep tissue manipulation to break down the scaring or thickening tissue. Wasn’t offered.
Q: I assumed wrongly I would need insoles. I expected to be back on my feet within a few weeks (very optimistic).
Q: As swift a recovery as possible, relief from the pain and programme of exercises to treat.
Needed improvementsFacilitation of earlier recognition by patients; better communication as adherence promotion.
Intervention strategy for pain; easier access to, and more information on, specific treatments; standardised treatment across sectors; clarity of treatment and expectations; reduced waiting times.
Q: Better understanding of symptoms and types of patients prone to PHP.
Q: More explanation for the mechanism of the symptoms in order to motivate me to do the exercise.
Q: Get rid of the pain forever.
Q: Standardised treatment from NHS across the country. I’ve gone private as Dr can’t refer.
Strengths of managementFrom no strengths to positive experiences; fast decisions; specific interventions; clear plan; individual preferences accounted for; detailed explanation; specific interventions.Q: Range of options considered and clearly explained.
Q: Spent time explaining in detail the condition/cause/treatment.
ExperienceRestricted activity; intermittent severe pain; reduced exercise; altered activity; morning pain; painful; emotionally affected; large impact on ADL; long, uncertain recovery.Q: It restricted the activities I wished to carry out.
Q: It’s very painful under my heel when I get up in the morning.
Q: Miserable 6 months. Had a huge impact on daily activities.
Q: Very long process and uncertain outcome.
Key informationTime course of recovery; self-management advice; how pain relief works; long-term effects; explanation of what was not done; unsure; statistics on usual timescales for effects.Q: What can I do to reduce my pain and improve function?
Q: Will pain reliever actually address the issue or just mask the pain?
Q: When they could make the pain go away?
Q: Expected outcome at the end of rehab.
Sources of informationRange of online methods predominated; clinicians, friends, magazines; lack of clear guidance.Q: I can google it all day, and there isn’t much out there.
Q: Patient groups on Facebook aren’t even very helpful, because everyone using them hasn’t found relief.
Q: Online forums, confusing as everyone’s cause is different therefore treatment different.
  • NHS, National Health Service; PHP, plantar heel pain.