Plantar fasciitis in primary care: a review

Abstract

Plantar fasciitis is a commonly occurring form of heel pain that affects many people once in their lifetime. Plantar heel pain is not inflammatory because it develops due to a gradual degenerative process. In most cases, plantar fasciitis affects runners, but sedentary people are also at risk. The condition occurs when repetitive microtrauma to the plantar fascia occurs, resulting in severe pain localized to the plantar foot and medial heel that interferes with daily life activities. The common risk factors contributing to plantar fasciitis include standing or sitting for prolonged periods, increased body mass index, and limited ankle dorsiflexion. In 80% of the cases, the symptoms of acute plantar fasciitis improve within a year of proper treatment. A clinical diagnosis is required to detect the symptoms of plantar fasciitis, which include nonradiating, dull, and aching pain experienced in the medioplantar surface of the foot. The pain is mostly experienced in the morning, but it also worsens at the day's end. Besides physical examination and patient's medical history, ultrasonography is a valuable diagnostic tool for diagnosing plantar fasciitis. Usually, a physician starts the treatment by stretching the plantar fascia, ice massaging, and prescribing nonsteroidal anti-inflammatory drugs. Other treatment modalities include orthoses and night splints. If a patient is diagnosed with recalcitrant plantar fasciitis, surgical procedures, corticosteroid injections, and extracorporeal shockwave therapy become necessary. If a patient with plantar fasciitis continues to experience pain that limits the function of plantar fascia and activity, then the condition is treated with endoscopic fasciotomy.