Plantar Fasciitis: Diagnosis and Conservative Management

Gill, Lowell H.

doi:10.5435/00124635-199703000-00006

Cited by 164 publications

(120 citation statements)

References 23 publications

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“…31,34 This inflammatory response has been classified as an overuse syndrome resulting in microtears of the plantar fascia at its origin. 5,10 Waugh 40 has suggested that accepted inflammatory conditions, such as epicondylitis, may be more accurately referred to as chronic pain syndromes. Therefore, individuals suffering from what has traditionally been referred to as plantar fasciitis may be more accurately described as suffering from plantar heel pain.…”

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confidence: 99%

“…Patients initially presenting with plantar heel pain typically complain of pain during the first few steps they take in the morning and/or their first few steps after prolonged rest. 5,10,31 Individuals most prone to plantar heel pain are middle-aged women, obese individuals, athletes, and male runners. 10,31,34 The 2 most common underlying causes of plantar heel pain, degenerative and mechanical, are believed to result from years of overuse and trauma.…”

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confidence: 99%

“…1,[4][5][6][9][10][11]13,18,22,23,28,31,33,36,38,39,41,42 Numerous nonsurgical treatments have been used to relieve the symptoms associated with heel pain. These include rest, 6,10 exercise (stretching and strengthening), 6,32,28,38 external support (orthotics, night splints, and taping), 9,10,11,16,[21][22][23]33,39,41 and modalities (cryotherapy, ultrasound with and without phonophoresis, electrical stimulation, whirlpool, and administration of nonsteroidal anti-inflammatory medications through iontophoresis or injections). [4][5][6]10,13,18 Davis et al 6 determined that 89% of patients had some pain relief after 12 months of nonsurgical treatment.…”

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Randomized Controlled Trial of Calcaneal Taping, Sham Taping, and Plantar Fascia Stretching for the Short-Term Management of Plantar Heel Pain

Hyland¹,

Webber-Gaffney²,

Cohen³

et al. 2006

J Orthop Sports Phys Ther

121

149

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Study Design: Prospective, experimental, randomized, single-factor, pretest/posttest design. Objectives: To examine the effects of a calcaneal and Achilles-tendon-taping technique, utilizing only 4 pieces of tape and not involving the medial arch, on the symptoms of plantar heel pain. Background: Plantar fasciitis is one of the most common causes of heel and foot pain. Physical therapists have applied many techniques in an attempt to relieve the symptoms of plantar heel pain, including various taping methods for which there is little existing evidence. Methods and Measures: Subjects (n = 41) were randomly assigned into 4 groups: (1) stretching of the plantar fascia, (2) calcaneal taping, (3) control (no treatment), and (4) sham taping. A visual analog scale (VAS) for pain and a patient-specific functional scale (PSFS) for functional activities were measured pretreatment and after 1 week of treatment (posttreatment). Results: A significant difference was found posttreatment among the groups for the VAS (P Ͻ .001). Specifically, significant differences were found between stretching and calcaneal taping (mean ± SD, 4.6 ± 0.7 versus 2.7 ± 1.8; P = .006), stretching and control (mean ± SD, 4.6 ± 0.7 versus 6.2 ± 1.0; P = .026), calcaneal taping and control (mean ± SD, 2.7 ± 1.8 versus 6.2 ± 1.0; P Ͻ .001), and calcaneal taping and sham taping (mean ± SD, 2.7 ± 1.8 versus 6.0 ± 0.9; P Ͻ .001). No significant difference among groups was found for posttreatment PSFS (P = .078). Conclusions: Calcaneal taping was shown to be a more effective tool for the relief of plantar heel pain than stretching, sham taping, or no treatment.

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Randomized Controlled Trial of Calcaneal Taping, Sham Taping, and Plantar Fascia Stretching for the Short-Term Management of Plantar Heel Pain

Hyland¹,

Webber-Gaffney²,

Cohen³

et al. 2006

J Orthop Sports Phys Ther

121

149

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“…The end result, found pathologically, is a loss of collagen fibers and an increase in the vascularity and connective tissue matrix with chronic inflammatory changes. 7 Diagnostic testing should be reserved for cases in which the diagnosis is unclear in patients who have failed to respond to appropriate treatment. Treatment typically proceeds in a stepwise fashion with more conservative, noninvasive mechanical approaches used initially.…”

Section: Plantar Fasciitismentioning

confidence: 99%

Common Foot Disorders

Ayub¹,

Yale²

2005

Clinical Medicine & Research

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Pat ients often seek advice first from their primary care physicians regarding the diagnosis and treatment of their foot problems. The role of the physician is to recognize and treat the underlying condition, prevent further injury or deformities, and educate the patient about his/her disease. In order for this to occur, physicians require a basic understanding of the anatomy, pathophysiology, and biomechanics of the foot. This article focuses on three of the most common conditions of the foot seen by primary care physicians in the ambulatory setting: bunion, plantar fasciitis, and Morton's neuroma. Evaluation of Foot DisordersEvaluation begins by taking a thorough history which includes questions regarding the quality, location, radiation, severity, duration, and exacerbating and/or relieving factors related to the pain. A family history of congenital or acquired disorders of the foot should be sought. Additional information should include a history of previous injuries, occupational and recreational activities, and any recent changes in the type or amount of activity. The physician should also inquire about the effectiveness of current or previous treatment(s). Observation of the patient's gait and foot position and inspection of his/her footwear should be performed since tight fitting shoes may exacerbate the foot condition, and modifications may prevent further injury. Common Foot DisordersBunion Bunion is derived from the Latin word meaning turnip. It is a bursa sac that develops over the first metatarsophalangeal (MTP) joint as a result of a hallux valgus deformity of this joint. Hallux valgus refers to the lateral deviation of the first toe. However, in common parlance, "bunion" has come to denote any bump or associated deformity of the first MTP joint with deviation of the lateral great toe. Bunions can be primary in the absence of any known underlying diseases or secondary to a variety of metabolic, structural or inflammatory disorders.The pathophysiology of bunions is poorly understood, but is thought to be secondary to both hereditary and environmental factors. The fact that bunions occur commonly in families suggests a genetic predisposition from ligamentous laxity and hyperpronation of the foot. The higher incidence in women compared to men is

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“…A combination of causative factors may be present, or the true cause may remain obscure. [4] Conservative management is the mainstream treatment option for plantar fasciitis. Various options such as Orthoses, night splints, specific plantar fascia stretching regimen, oral nonsteroidal anti-inflammatory agents, local injections, extracorporeal shockwave therapy, and low-level laser therapy all have been reported to be successful.…”

Section: Introductionmentioning

confidence: 99%

Plantar fasciitis treatment: What is better, oral nonsteroidal anti-inflammatory agents or locally injectable steroid?

Mittal¹,

Js²,

Ashok³

et al. 2018

Int. J. Orthop. Sci.

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Plantar fasciitis is the one of the most common causes of painful heel in adults. It is assumed to be caused by inflammation and is typically precipitated by biomechanical stress. Conservative management is the mainstream treatment option for plantar fasciitis like non steroidal anti-inflammatory drugs (NSAIDs), steroid injections, PRP injection, stretching exercises. There is no consensus on the efficacy of any particular conservative treatment regimen. This study was taken with objective to compare the efficacy of NSAID and local steroid injection in treating plantar fasciitis. Method: Sixty patients were randomized into 2 groups, group I patients were treat with oral NSAIDs and group II patients were treated with local steroid injection. Patients of both groups are given common supportive measures such as soft heel and advised same stretching exercises. The patients were evaluated using VAS score for pain assessment at pre-treatment stage, 1 week, 2 weeks, 4 weeks, 2 months and 3 months. Results: 60 patients were randomized into 2 groups, both groups had similar demographics. The VAS scores at pre treatment level in group I was 6.60±1.14 and in group II was 6.46±1.05. The VAS score reduced to 3.10±1.18 in group II after injection and in group I reduced to 4.9±1.33 after a starting oral NSAIDs. The VAS scores consistently reduced in both the groups till 4 weeks of follow up but group II VAS scores were always lower than group I (p-value < 0.001). After 4 weeks, a trend towards increase in VAS scores was noted in both groups, patients had complaints of relapse of pain or increase in intensity of it. Conclusion : With this study we concluded that as compared to NSAIDs the use of local injection of steroid gives better and more sustained pain relief with fewer complications and lesser recurrences of heel pain in cases of plantar fasciitis.

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Plantar Fasciitis: Diagnosis and Conservative Management

Cited by 164 publications

References 23 publications

Randomized Controlled Trial of Calcaneal Taping, Sham Taping, and Plantar Fascia Stretching for the Short-Term Management of Plantar Heel Pain

Randomized Controlled Trial of Calcaneal Taping, Sham Taping, and Plantar Fascia Stretching for the Short-Term Management of Plantar Heel Pain

Common Foot Disorders

Plantar fasciitis treatment: What is better, oral nonsteroidal anti-inflammatory agents or locally injectable steroid?

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