Cognitive Functional Therapy for Plantar Heel Pain: A Case Series

BACKGROUND: Plantar heel pain is a prevalent musculoskeletal condition frequently associated with persistent pain, disability, and biopsychosocial contributors. Although guideline-based care has evolved, management often remains centered on passive and tissue-focused strategies, which may not fully address mechanisms underlying chronic pain.

CASE PRESENTATION: This case series describes three individuals with plantar heel pain managed using Cognitive Functional Therapy (CFT), a person-centered biopsychosocial approach integrating physical, cognitive, emotional, behavioral, and lifestyle factors within clinical decision making.

OUTCOME AND FOLLOW-UP: All patients demonstrated clinically meaningful improvements in pain, foot and ankle function, and disability. Reductions in kinesiophobia and pain catastrophizing were observed and largely sustained up to 24 weeks. One individual experienced symptom recurrence associated with increased psychosocial stress and reduced physical activity.

DISCUSSION: These cases highlight the importance of multidimensional assessment and intervention in individuals with plantar heel pain. The findings illustrate the potential clinical relevance of Cognitive Functional Therapy for addressing pain-related beliefs, behaviors, and functional limitations beyond tissue-focused care.