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by EBSCO Medical Review Board

Definition

Plantar fasciitis is inflammation of the thick band of tissue. The band runs the length of the bottom of the foot and connects to the heel bone.

Plantar Fasciitis
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Causes

The exact cause is not known. It is thought to be from repeat trauma from walking or running for long periods.

Risk Factors

This problem is most common in people who are 40 to 60 years old. Other things that may raise the risk are:

  • Obesity
  • Certain foot problems, such as a tight Achilles tendon, flat or high-arched feet, or an ankle that rolls inward too much
  • Running
  • Wearing poor or no footwear
  • Activity on hard surfaces
  • Spending a lot of time standing
  • Not stretching enough
  • Poor fitness

Symptoms

Problems may be:

  • Mild to severe pain on the sole of the foot near the heel
  • Pain that is worse in the morning or after rest
  • Pain that worsens with weight-bearing activity
  • Pain that gets better with rest

Diagnosis

The doctor will ask about symptoms and past health. A foot exam will be done. This will usually be enough make the diagnosis.

Treatment

That goal of treatment is to manage symptoms and give the foot time to heal. Options are:

  • Supportive care with rest and ice
  • A night splint to hold the foot in position while sleeping
  • Shoe inserts to support the foot
  • Medicines to ease pain and swelling
  • Physical therapy to improve function

People with severe problems may need:

  • Extracorporeal shock wave therapy
  • Surgery to release the plantar fascia

Prevention

To lower the risk of this problem:

  • Wear the right shoes for sports and activities
  • Stretch the Achilles tendon and plantar fascia
  • Slowly increase the intensity and duration of exercise
  • Stay at an appropriate weight

RESOURCES

American Academy of Physical Medicine and Rehabilitation  http://www.aapmr.org 

OrthoInfo—American Academy of Orthopaedic Surgeons  http://orthoinfo.org 

CANADIAN RESOURCES

Ontario Podiatric Medical Association  http://www.opma.ca 

Orthogate  http://www.orthogate.org 

References

David JA, Sankarapandian V, et al. Injected corticosteroids for treating plantar heel pain in adults. Cochrane Database of Syst Rev. 2017;(6):CD009348.

Derry S, Moore RA, et al. Topical NSAIDS for acute musculoskeletal pain in adults. Cochrane Database of Syst Rev. 2015;(6):CD007402.

Fraser JJ, Corbett R, et al. Does manual therapy improve pain and function in patients with plantar fasciitis? A systematic review. J Manual Manipul Ther.2017;0(0):1-11.

Ibrahim MI, Donatelli RA, et al. Long-term results of radial extracorporeal shock wave treatment for chronic plantar fasciopathy: A prospective, randomized, placebo-controlled trial with two years follow-up. J Orthop Res.2017;35:1532-1538.

Plantar fasciitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/plantar-fasciitis. Accessed February 22, 2021.

Plantar fasciitis and bone spurs. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00149. Accessed February 22, 2021.

Rasenberg N, Riel H, et al. Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis British J Sports Med 2018;52:1040-1046.

Schwartz EN, Su J. Plantar fasciitis: a concise review. Perm J. 2014 Winter;18(1):e105-107.

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