For over 16 years, Wendy lived with a constant ache down her right leg — classic sciatica. Like so many Melburnians, she loved getting out for long walks, but the nerve pain would flare up every time she tried. It wore her down, slowly but surely.
She did what most people would do — booked in with a physio, tried custom orthotics, and even bought every recommended gadget you could think of. Some helped a little, but nothing brought lasting relief. And then about a year ago, things got worse: her foot started hurting too. At first, everyone assumed it was just more referred pain from her back. But Wendy wasn’t so sure.
When she first came to Well Heeled Podiatry, she was tired. Tired of chasing appointments. Tired of feeling like no one had a full picture of what was going on. She told me, “It’s like I’ve been walking around in someone else’s shoes for years.” That stuck with me.
So we started with what we always do — a proper, thorough assessment. No rushing. No cookie-cutter solutions.
Seeing the Whole Picture, Not Just the Pain
During her first session, I watched Wendy walk, stand, and shift her weight. She had classic signs of long-standing compensations — favouring one leg, subtle pelvic tilt, altered gait. But what jumped out most was where she pointed to when she described the foot pain: right under the ball of the foot, at the third metatarsal.
Straight away, I thought, “This doesn’t line up with sciatica alone.”
She’d also been wearing orthotics from a previous podiatrist and using a toe separator between her third and fourth toes. It gave her short-term relief, sure, but something didn’t sit right. I referred her for an MRI, suspecting something deeper in the forefoot.
And there it was — a plantar plate tear.
Quick Foot Fact: What’s the Plantar Plate?
The plantar plate is a strong ligament under the ball of the foot that helps stabilise your toes. When it tears (usually from long-term overload or faulty gait), it can feel like a sharp, nagging pain, almost like you’re walking on a pebble. It’s often misdiagnosed — especially when back or nerve issues are also in play.
Unpacking the Foot Fix — Orthotics, Education, and Small Changes That Mattered
When we reviewed Wendy’s MRI results together, she looked relieved. Not because a tear sounded like good news — but because, finally, she had a clear answer.
Her plantar plate had copped it. And not just a mild irritation either — it was inflamed, strained, and likely worsening every time she walked with that toe separator in place. She admitted she’d been using it daily for months. “It’s the only thing that’s kept me sane,” she said.
But in this case, it was doing more harm than good.
Teaching, Not Just Treating
I told Wendy something I often share with patients: “Relief doesn’t always mean recovery.” That toe separator was masking symptoms while quietly aggravating the tear underneath.
So we worked together to gradually stop its use. We didn’t just yank it away and say, “Good luck.” We created a mini plan:
- Weaned off the separator over 2 weeks.
- Added gentle toe strengthening and taping techniques to support the joint.
- Adjusted her footwear to reduce movement and pressure in the forefoot.
That kind of education — the why behind every step — is something I take seriously. Most people don’t want to just be told what to do. They want to understand how it all fits together.
New Orthotics, Done Right
Wendy’s old orthotics had been built around the idea that her sciatica was the root cause. But with the plantar plate tear confirmed, we needed a whole new design.
During her biomechanical assessment, I also picked up on something she’d never been told before: a leg length difference of 0.8cm. Now, that might not sound like much, but over thousands of steps, it adds up — shifting load, straining tissues, and knocking out spinal alignment.
So we built her new orthotics with:
- Plantar plate offloading padding — to reduce pressure under the 3rd met head.
- A subtle heel lift on the shorter side — to even up her pelvis and spine.
- Midfoot stabilisation support — to correct the way she loaded through stance.
Checklist: What We Changed in Wendy’s Daily Setup
| Change | Purpose |
| Removed toe separator | Stopped aggravating the tear |
| New orthotics with met pad and heel lift | Offloaded injury, corrected leg imbalance |
| Updated footwear with stiffer forefoot sole | Reduced joint bend and pain |
| Foot-strengthening exercises | Rebuilt intrinsic support |
From Foot Fix to Full-Body Relief — The Sciatica Disappears
Wendy came back in after a few weeks with a look I’ve come to recognise in clinic — a mix of disbelief and hope. She sat down, took off her shoe, and said:
“Monique… the foot’s feeling miles better, but guess what? The sciatica’s gone. Like, completely gone.”
I paused for a second. Sixteen years of nerve pain — just gone? But as we talked more, it made sense.
It Wasn’t Just the Foot — It Was the Foundation
When we corrected Wendy’s leg length difference and realigned how her feet hit the ground, it changed everything upstream. Her pelvis stopped tilting, her lower back stopped compensating, and the constant nerve irritation through her glute and leg settled right down.
This is the kind of thing I’ve seen time and again, especially in long-standing cases where patients have been passed between specialists. Everyone treats their one area, but no one zooms out to look at the body as a whole system.
Wendy’s back pain wasn’t just a “back issue.” It was a mechanical chain reaction, starting from her feet.
What Shockwave Therapy Added to the Mix
Alongside the orthotic changes, Wendy also completed a course of shockwave therapy — five sessions in total — focused right on the plantar plate tear. This helped:
- Break down scar tissue
- Reduce inflammation
- Stimulate local circulation and healing
She felt a noticeable difference after just three sessions. By session five, we were mostly fine-tuning.
The Shoe Shift That Helped
We also swapped her shoes for a model with:
- A stiffer forefoot rocker sole, which reduced bending at the joint
- A firm heel counter for stability
- Removable insoles to accommodate her custom orthotics
I often say to patients: “Shoes are like tyres on a car — if they’re worn out or the wrong type, even the best orthotics can’t help.” In Wendy’s case, the right shoe was the final piece of the puzzle.
Then Came the Walks
Wendy sent me an email a month later. She’d just done the full Bay Trail walk with her daughter — around 7km — without a single flare-up. “First time in years,” she wrote.
No sciatica. No foot pain. Just a peaceful walk, sunshine, and a proper sense of freedom.
What Wendy’s Story Teaches Us — And Why It’s Not Just About Feet
Wendy’s case is one I still think about, because it’s a textbook example of why podiatry should never be treated as “just feet.” Our feet are our foundation. If something’s off down there — even by a few millimetres — the ripple effects can be huge.
Here’s what I want other patients to know from Wendy’s experience.
Key Lessons from Wendy’s Recovery
1. Treat the Cause, Not Just the Symptom
Wendy’s foot pain was real. Her sciatica was real. But the solution wasn’t in treating them separately — it was in understanding how they were connected. Her case reminds us how important it is to assess the body holistically.
2. Orthotics Must Be Built Around the Whole Person
We didn’t just hand Wendy a generic arch support. Her orthotics were made with:
- Plantar plate offloading
- Pelvic alignment correction
- Gait redistribution
This tailored approach is what made the difference.
3. Shockwave Therapy Speeds Up Recovery
Soft tissue injuries like plantar plate tears can take ages to heal — especially if you’re walking on them daily. Shockwave helped Wendy get back on her feet faster and with less pain.
4. The Right Shoe Can Make or Break Your Progress
No orthotic works in a worn-out or unsupportive shoe. For Wendy, a stiffer-soled walking shoe with enough depth made her orthotics work the way they were meant to.
5. Education = Empowerment
Wendy wasn’t just handed a treatment plan — she was part of the process. We explained every step so she could feel confident and supported, not just “told what to do.”
Wendy’s Rehab Timeline (Approx.)
| Week | Focus |
| Week 1 | Full assessment, MRI referral, toe separator phase-out starts |
| Week 2 | Custom orthotics ordered, footwear reviewed |
| Week 3 | First shockwave session, orthotics dispensed |
| Week 4–6 | Weekly shockwave continues, start rehab exercises |
| Week 7 | Sciatica completely resolved |
| Week 8+ | Back to long-distance walking pain-free |
A Word from Me
As a podiatrist who’s seen hundreds of complex musculoskeletal cases, I can tell you this: healing isn’t always about where it hurts — it’s about what’s causing the hurt in the first place.
If you’re someone who’s been stuck in a loop — maybe you’ve tried physios, chiro, even injections — and you’re still dealing with long-standing pain, don’t write it off as “something you’ll just have to live with.”
Whether it’s your feet, your knees, or your back — there’s almost always something else we can explore. Often, it’s that one overlooked piece that makes everything else fall into place.
Frequently Asked Questions About Sciatic Nerve Pain and Podiatry Care
What Is Sciatica, And How Does It Affect Foot Health?
Sciatica is pain that radiates along the sciatic nerve, which extends from the lower back down through the hips and legs. It often causes discomfort in the lower back, legs, and feet. Sciatic pain can result in numbness, tingling, or weakness in the affected leg, and in some cases, it can impact foot health by causing difficulties with walking and standing comfortably. It’s important to address sciatic pain promptly to prevent it from affecting your daily life, including your foot health.
How Can A Podiatrist Help With Sciatic Nerve Pain?
A podiatrist can play a crucial role in treating sciatic nerve pain, especially when it affects the feet. They assess your foot alignment, posture, and gait to identify any imbalances that may be contributing to nerve discomfort. Podiatrists can also provide treatments like custom orthotics to correct alignment and reduce pressure on the sciatic nerve. Additionally, they may recommend exercises, stretches, and lifestyle changes to complement the treatment and improve overall well-being.
What Are Custom Orthotics, And How Can They Help With Sciatica?
Custom orthotics are specialised insoles designed to provide personalised support for your feet. They can help alleviate pressure on the sciatic nerve by improving foot alignment and posture. By supporting the arch and correcting misalignments, custom orthotics can reduce the strain on your legs and lower back, providing significant relief from sciatica-related pain. A podiatrist can assess your feet and recommend the right orthotics for your specific needs.
Can I Treat Sciatic Nerve Pain At Home, Or Do I Need Professional Help?
While some basic measures, such as stretching, applying heat or cold, and using over-the-counter pain relievers, can help manage sciatic pain at home, it’s important to seek professional help if the pain persists. A podiatrist can evaluate the underlying causes of your pain and offer more targeted solutions, such as orthotics, foot care advice, and exercises. Professional care ensures that you address the root cause of the problem and avoid potential long-term issues.
When Should I See A Podiatrist For Sciatic Nerve Pain?
If you experience persistent or worsening pain, numbness, or weakness in your legs or feet due to sciatica, it’s a good idea to see a podiatrist. Early intervention can help prevent the condition from progressing and affecting your quality of life. If your pain is interfering with your ability to walk, stand, or perform daily activities, seeking professional help is essential to finding a comprehensive and effective treatment plan tailored to your needs.
