26/10/2024
Plantar fasciitis is a common cause of heel pain among adults.
The plantar fascia includes 3 bands of tissue that support the arch of the foot and connect the heel bone to the toes. Heel pain due to plantar fasciitis is typically most severe when people take their first steps of the day, and it may worsen with prolonged standing. Although the cause of plantar fasciitis is not completely understood, it may be partly due to small tears in the plantar fascia resulting from repeated stress and strain on the foot.1
How Common Is Plantar Fasciitis and Who Is at Risk?
Plantar fasciitis accounts for more than 1 million US clinic visits per year and is most common in adults aged 45 to 64 years. People at higher risk of plantar fasciitis include those with overweight or obesity (defined as body mass index greater than 25), those whose work requires prolonged standing, and those with limited ability to move their toes upward toward their knee, known as decreased ankle dorsiflexion.
How Is Plantar Fasciitis Diagnosed?
Plantar fasciitis can be diagnosed in people who have characteristic symptoms of heel pain that can be felt when a clinician applies pressure to a certain area of the heel or gently pushes the toes upward toward the knee. People with an uncertain diagnosis or symptoms that do not improve with treatment may occasionally undergo ultrasound or magnetic resonance imaging of the ankle and foot.
How Is Plantar Fasciitis Treated?
People with plantar fasciitis should avoid activities that worsen their pain. Potential treatment options include
Stretching calf muscles and stretching and massaging the plantar fascia at home or during a physical therapy visit.
Using orthotics, which replace the shoe insole to decrease strain on the plantar fascia and reduce force on the foot when walking. Over-the-counter orthotics provide similar pain relief and are less expensive than custom-made orthotics.
Wearing a night splint to flex the ankle and extend the toes during sleep or at other times if not tolerated during sleep.
Receiving a corticosteroid injection in the inner area of the heel, which may provide pain relief for several weeks to months.
Receiving a heel injection of platelet-rich plasma, which is composed of certain components of the patient’s own blood and may provide longer-term pain relief than corticosteroid injections.
Undergoing extracorporeal shock wave therapy, which applies high-pressure sound waves to the plantar fascia and may provide more pain relief than corticosteroid injections.
Undergoing surgery on the plantar fascia or calf muscle if heel pain persists after nonsurgical treatments.
How Long Do Symptoms of Plantar Fasciitis Last?
Heel pain due to plantar fasciitis frequently goes away on its own, but it may last for months to years despite treatment. Up to 80% of patients may have persistent symptoms a year after diagnosis. At 15 years, up to 44% may have heel pain, although it is typically less severe than at the time of diagnosis.
The JAMA Patient Page Source:
https://jamanetwork.com/journals/jama/fullarticle/2823273
