Plantar fasciitis | |
---|---|
Other names | Plantar fasciosis, plantar fasciopathy, jogger's heel, heel spur syndrome[1] |
Most common areas of pain in plantar fasciitis | |
Specialty | Orthopedics, sports medicine, plastic surgery, podiatry |
Symptoms | Pain in the heel and bottom of the foot[2] |
Usual onset | Gradual[3] |
Causes | Unclear[2] |
Risk factors | Overuse (long periods of standing), obesity, inward rolling of the foot[2][4] |
Diagnostic method | Based on symptoms, ultrasound[2] |
Differential diagnosis | Osteoarthritis, ankylosing spondylitis, heel pad syndrome, reactive arthritis[5][6] |
Treatment | Conservative management[4][7] |
Frequency | ~4%[2][5] |
Plantar fasciitis or plantar heel pain is a disorder of the plantar fascia, which is the connective tissue that supports the arch of the foot.[2] It results in pain in the heel and bottom of the foot that is usually most severe with the first steps of the day or following a period of rest.[2][4] Pain is also frequently brought on by bending the foot and toes up towards the shin.[3][4] The pain typically comes on gradually, and it affects both feet in about one-third of cases.[2][3]
The cause of plantar fasciitis is not entirely clear.[2] Risk factors include overuse, such as from long periods of standing, an increase in exercise, and obesity.[2][4] It is also associated with inward rolling of the foot, a tight Achilles tendon, and a sedentary lifestyle.[2][4] It is unclear if heel spurs have a role in causing plantar fasciitis even though they are commonly present in people who have the condition.[2] Plantar fasciitis is a disorder of the insertion site of the ligament on the bone characterized by micro tears, breakdown of collagen, and scarring.[2] Since inflammation plays either a lesser or no role, a review proposed it be renamed plantar fasciosis.[2][8] The presentation of the symptoms is generally the basis for diagnosis; with ultrasound sometimes being useful if there is uncertainty.[2] Other conditions with similar symptoms include osteoarthritis, ankylosing spondylitis, heel pad syndrome, and reactive arthritis.[5][6]
Most cases of plantar fasciitis resolve with time and conservative methods of treatment.[4][7] For the first few weeks, those affected are usually advised to rest, change their activities, take pain medications, and stretch.[4] If this is not sufficient, physiotherapy, orthotics, splinting, or steroid injections may be options.[4] If these measures are not effective, additional measures may include extracorporeal shockwave therapy or surgery.[4]
Between 4% and 7% of the general population has heel pain at any given time: about 80% of these are due to plantar fasciitis.[2][5] Approximately 10% of people have the disorder at some point during their life.[9] It becomes more common with age.[2] It is unclear if one sex is more affected than the other.[2]
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