Plantar Heel Pain In Adults Research Articles

Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors

BackgroundPlantar Heel Pain (PHP) is a common disorder with many treatment pathways and is not self-limiting, hence prognostic information concerning recovery or recalcitrance is needed to guide practice. In this systematic review, we investigate which prognostic factors are associated with favourable or unfavourable PHP outcomes.MethodsMEDLINE, Web of Science, EMBASE, Scopus and PubMed electronic bibliographic databases were searched for studies evaluating baseline patient characteristics associated with outcomes in prospective longitudinal cohorts or after specific interventions. Cohort, clinical prediction rule derivation and single arms of randomised controlled trials were included. Risk of bias was evaluated with method-specific tools and evidence certainty with GRADE.ResultsThe review included five studies which evaluated 98 variables in 811 participants. Prognostic factors could be categorised as demographics, pain, physical and activity-related. Three factors including sex and bilateral symptoms (HR: 0.49[0.30–0.80], 0.33[0.15–0.72], respectively) were associated with a poor outcome in a single cohort study. The remaining four studies reported twenty factors associated with a favourable outcome following shockwave therapy, anti-pronation taping and orthoses. Heel spur (AUC = 0.88[0.82–0.93]), ankle plantar-flexor strength (Likelihood ratio (LR): 2.17[1.20–3.95]) and response to taping (LR = 2.17[1.19–3.90]) were the strongest factors predicting medium-term improvement. Overall, the study quality was low. A gap map analysis revealed an absence of research that included psychosocial factors.ConclusionsA limited number of biomedical factors predict favourable or unfavourable PHP outcomes. High quality, adequately powered, prospective studies are required to better understand PHP recovery and should evaluate the prognostic value of a wide range of variables, including psychosocial factors.

Plantar Fasciitis: Orthobiologics

Plantar fasciitis (PF) is characterized by plantar medial heel pain, usually present in the morning at the first few steps. Obese individuals, who stand for prolonged periods and who walk on hard surfaces, typically suffer from PF, the most common cause of plantar heel pain in adults. The diagnosis can be achieved through patient clinical history and clinical findings. Stretching exercises, activity modification, and use of several analgesics resolve symptoms in over 80% of patients, while biomechanical factors can be corrected by insoles or various kinds of orthotics or night splints. In the outnumbered group of patients who develop intractable PF, other available strategies are extracorporeal shock wave therapy and corticosteroid injections. Surgical management of PF consists of plantar fascia release, but efficacy is still debated. In recent years, biological treatments have been getting popularity in many orthopedic conditions. How to cite this article: Tarulli FR, Aletto C, Maffulli N. Plantar Fasciitis: Orthobiologics. J Foot Ankle Surg (Asia Pacific) 2021;8(1):24–27.

Effectiveness of combined shockwave therapy and plantar fascia stretching interventions in treating plantar heel pain: a systematic review and meta-analysis protocol.

The objective of this review is to synthesize the best available evidence on the effectiveness of interventions that have used a combination of extracorporeal shockwave therapy and plantar fascia-specific stretching to treat plantar heel pain compared to any other non-surgical intervention. Recent evidence suggests combining shockwave therapy and plantar fascia stretching may be more effective than other treatments for plantar heel pain. However, no systematic reviews have been conducted on the topic and optimal treatment protocols and clinical recommendations are lacking. Randomized controlled trials assessing the effectiveness of combined shockwave therapy and plantar stretching for plantar heel pain in adults will be included. The authors will search a wide range of sources to identify both published and unpublished studies via EBSCOhost, including, but not limited to MEDLINE, SPORTDiscus, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and Allied and Complementary Medicine Database (AMED). Studies published in a language other than English will only be considered if a translation is available. The JBI systematic review methodology will be followed when conducting the review. Data synthesis will be conducted using meta-analysis or narrative synthesis, where appropriate. PROSPERO CRD42020171538.

Acupuncture and related interventions for treating plantar heel pain in adults

Acupuncture and related interventions for treating plantar heel pain in adults

Injected corticosteroids for treating plantar heel pain in adults.

Injected corticosteroids for treating plantar heel pain in adults.

O35. Population Prevalence and Associations of Plantar Heel Pain in Adults Aged 50 Years and Over: Cross-Sectional Findings from the Clinical Assessment Study of the Foot

O35. Population Prevalence and Associations of Plantar Heel Pain in Adults Aged 50 Years and Over: Cross-Sectional Findings from the Clinical Assessment Study of the Foot

Acupuncture and related interventions for treating plantar heel pain in adults

Acupuncture and related interventions for treating plantar heel pain in adults

WITHDRAWN. Interventions for treating plantar heel pain.

Ten percent of people may experience pain under the heel (plantar heel pain) at some time. Injections, insoles, heel pads, strapping and surgery have been common forms of treatment offered. The absolute and relative effectiveness of these interventions are poorly understood. The objective of this review was to identify and evaluate the evidence for effectiveness of treatments for plantar heel pain. We searched the Cochrane Bone, Joint and Muscle Trauma Group specialised register (September 2002), the Cochrane Central Register of Controlled Trials Register (The Cochrane Library issue 3, 2002), MEDLINE (1966 to September 2002), EMBASE (1988 to September 2002) and reference lists of articles and dissertations. Four podiatry journals were handsearched to 1998. We contacted all UK schools of podiatry to identify dissertations on the management of heel pain, and investigators in the field to identify unpublished data or research in progress. No language restrictions were applied. Randomised and quasi-randomised trials of interventions for plantar heel pain in adults. Two reviewers independently evaluated randomised controlled trials for inclusion, extracted data and assessed trial quality. Additional information was obtained by direct contact with investigators. No poolable data were identified. Where measures of variance were available we have calculated the weighted mean differences based on visual analogue scale (VAS) scores. Nineteen randomised trials involving 1626 participants were included. Trial quality was generally poor, and pooling of data was not conducted. All trials measured heel pain as the primary outcome. Seven trials evaluated interventions against placebo/dummy or no treatment. There was limited evidence for the effectiveness of topical corticosteroid administered by iontophoresis, i.e. using an electric current, in reducing pain. There was some evidence for the effectiveness of injected corticosteroid providing temporary relief of pain. There was conflicting evidence for the effectiveness of low energy extracorporeal shock wave therapy in reducing night pain, resting pain and pressure pain in the short term (6 and 12 weeks) and therefore its effectiveness remains equivocal. In individuals with chronic pain (longer than six months), there was limited evidence for the effectiveness of dorsiflexion night splints in reducing pain. There was no evidence to support the effectiveness of therapeutic ultrasound, low-intensity laser therapy, exposure to an electron generating device or insoles with magnetic foil. No randomised trials evaluating surgery, or radiotherapy against a randomly allocated control population were identified. There was limited evidence for the superiority of corticosteroid injections over orthotic devices. Although there is limited evidence for the effectiveness of local corticosteroid therapy, the effectiveness of other frequently employed treatments in altering the clinical course of plantar heel pain has not been established in randomised controlled trials.At the moment there is limited evidence upon which to base clinical practice. Treatments that are used to reduce heel pain seem to bring only marginal gains over no treatment and control therapies such as stretching exercises. Steroid injections are a popular method of treating the condition but only seem to be useful in the short term and only to a small degree. Orthoses should be cautiously prescribed for those patients who stand for long periods; there is limited evidence that stretching exercises and heel pads are associated with better outcomes than custom made orthoses in people who stand for more than eight hours per day.Well designed and conducted randomised trials are required.

Value of Radiographs in the Initial Evaluation of Nontraumatic Adult Heel Pain

Adult patients with nontraumatic plantar heel pain often present to orthopaedic surgeons for evaluation. A thorough history and physical examination are often sufficient for diagnosis, yet radiographs usually are ordered during the initial evaluation. The purpose of this study was to evaluate the value and cost-effectiveness of these radiographs. A retrospective chart and radiographic review of 157 consecutive adults (215 heels) presenting with nontraumatic heel pain was done to evaluate the utility of routine radiographs in the initial evaluation. The most common diagnosis was plantar fasciitis (80.9%, 174 of 215). Radiographs were normal in (17.2%, 37 of 215), and incidental radiographic findings were observed in 81.4% (175 of 215). The most common incidental findings were plantar calcaneal spurs (59.5%, 128 of 215) and Achilles spurs (46.5%, 100 of 215). Only (2%, 4 of 215) of all patients had abnormal findings that prompted further evaluation. Routine radiographs are of limited value in the initial evaluation of nontraumatic plantar heel pain in adults and were not necessary in the initial evaluation. Radiographs should be reserved for patients who do not improve as expected or present with an unusual history or confounding physical findings.