Outcome of Nonsurgical Treatment for Plantar Fasciitis

Abstract

Four hundred eleven patients with a clinical diagnosis of plantar fasciitis were assessed for predisposing factors. Each patient completed an outcomes assessment survey instrument that ranked effectiveness of various nonsurgical treatment modalities. Listed in descending order of effectiveness, the treatment modalities assessed were short leg walking cast, steroid injection, rest, ice, runner's shoe, crepe-soled shoe, aspirin or nonsteroidal anti-inflammatory drug, heel cushion, low-profile plastic heel cup, heat, and Tuli's heel cup. Treatment with a cast ranked the best. The Tuli's heel cup ranked the poorest. Most of the treatments were found to be unpredictable or minimally effective. The ineffectiveness of nonsurgical treatments noted in this outcomes study is at variance with most published clinical studies in which generally favorable results are reported after nonsurgical treatment for plantar fasciitis.

Evaluation of the Results of Endoscopic Release of Plantar Fascia in Cases of Resistant Chronic Heel Pain

“…It is estimated that 1 in 10 people will develop heel pain in their life time (Toomey, 2009). It accounts for about 10 percent of injuries that occur in runners (Ozdemir et al, 2005;Toomey, 2009;Taunton et al, 2002;Gill, 1996;Prichasuk & Subhadrabandhu, 1994;Rano et al, 2001;Riddle et al, 2003;Kulkarni, 2004) and is common among military personnel (Prichasuk & Subhadrabandhu, 1994). The predominance of the condition according to sex varies from one study to another (Gill, 1996;Riddle, Pulisic, Pidcoe, & Johnson, 2003;Furey, 1975).…”

“…The condition is bilateral in up to a third of cases (Prichasuk & Subhadrabandhu, 1994;Rano et al, 2001;Riddle et al, 2003;Furey, 1975). Studies have identified risk factors that seem to be associated with plantar fasciitis such as obesity, occupations that require prolonged standing, pes planus (excessive pronation of the foot), limited first metatarsophalangeal joint range of motion, leg length discrepancy, reduced heel pad thickness, reduced calf muscles strength and inferior calcaneal exostoses (Toomey, 2009;Taunton et al, 2002;Gill, 1996;Prichasuk & Subhadrabandhu, 1994;Rano et al, 2001;Riddle et al, 2003).…”

“…It accounts for about 10 percent of injuries that occur in runners (Ozdemir et al, 2005;Toomey, 2009;Taunton et al, 2002;Gill, 1996;Prichasuk & Subhadrabandhu, 1994;Rano et al, 2001;Riddle et al, 2003;Kulkarni, 2004) and is common among military personnel (Prichasuk & Subhadrabandhu, 1994). The predominance of the condition according to sex varies from one study to another (Gill, 1996;Riddle, Pulisic, Pidcoe, & Johnson, 2003;Furey, 1975). The condition is bilateral in up to a third of cases (Prichasuk & Subhadrabandhu, 1994;Rano et al, 2001;Riddle et al, 2003;Furey, 1975).…”

“…Nonsurgical measures include, but are not limited to, rest, icing, stretching, nonsteroidal anti-inflammatory drugs (NSAIDs), shoe modification, orthoses, physical therapy, weight loss, corticosteroid injection, night splinting, and heel pads (Kulkarni, 2004). In 5-10% of cases of plantar fasciitis, surgery may be required (Gill, 1996;Furey, 1975;Davis, Severud, & Baxter, 1974;Miyamoto, Takao, & Uchio, 2010). It is reserved for those in whom a thorough 6 months of conservative treatment has failed.…”

“…Other less common causes include plantar fascia rupture, fat pad atrophy, fat pad contusion, calcaneal stress fracture, entrapment of the first branch of the lateral plantar nerve, calcaneal apophysitis (Sever's disease), tumor (e.g., osteoid osteoma), tarsal tunnel syndrome, gout, inflammatory arthropathies (e.g., psoriatic arthritis), spondyloarthropathies (e.g., Reiter syndrome), infection, radiculopathy, neuropathy, inappropriate shoe fit and foreign body reaction. (Rome, 2005;Ozdemir et al, 2005;Toomey, 2009;Taunton, Ryan, Clement, McKenzie, Lloyd-Smith, & Zumbo, 2002;Gill, 1996;Prichasuk & Subhadrabandhu, 1994;Rano, Fallat, & Savoy-Moore, 2001;Riddle, Pulisic, Pidcoe, & Johnson, 2003;Kulkarni, 2004) …”