Diagnosis and management of plantar fasciitis in primary care

Abstract

Plantar fasciitis (PF) is a common overuse injury that occurs as a result of repetitive traction forces on the plantar fascia at its origin over the distal calcaneus. It accounts for 8–10% of running related injuries and 80% of heel pain, and is commonly seen in primary care.1,2 Individuals with pes planus (flat foot) and pes cavus (high arch) deformity are at increased risk of developing PF, as are individuals who wear poorly supporting footwear and who undertake excessive walking or weight bearing activity (often job-related such as ‘policeman’s heel’). Previous heel pain and a high body mass index are also risk factors for plantar fasciitis. It commonly occurs in middle-aged individuals with an equal preponderance in males and females and has a lifetime prevalence of 10%.2 Heel pain tends to develop insidiously and characteristically affects the medial aspect of the heel, radiating into the arch of the foot. Pain tends to be worse in the morning with maximal discomfort on the initial steps after getting out of …