- Degenerative change of plantar fascia at origin on medial tuberosity of calcaneus
- Pain on plantar surface, usually at calcaneal insertion of plantar fascia upon weight-bearing, especially in morning or on initiation of walking after prolonged rest
- Also referred to as: plantar fasciopathy, plantar heel pain syndrome, plantar fasciosis, painful heel syndrome
Estimated 1 million patient visits yearly in the United States
- Most common cause of plantar heel pain
- Lifetime: 10–15% of population
- Peak incidence between ages 40 and 60 years, earlier peak in runners
Etiology and Pathophysiology
- Repetitive microtrauma and collagen degeneration of plantar fascia
- Chronic degenerative change (-osis/-opathy rather than -itis) of plantar fascia generally at insertion on medial tuberosity of calcaneus
- Age (>40 to 60 years)
- Female, pregnancy
- Obesity (BMI >30)
- Pes planus (flat feet), pes cavus (high arch), overpronation, leg length discrepancy
- Hamstring, calf, and Achilles tightness
- Calf and intrinsic foot muscle weakness
- Decreased ankle range of motion with dorsiflexion (equinus or tight heel cord; <15 degrees of dorsiflexion)
- Systemic connective tissue disorders
- Dancers, runners, court sport athletes
- Occupations with prolonged standing, especially on hard surfaces (nurses, letter carriers, warehouse/factory workers)
- Overuse and rapid increase in activities involving repetitive loading
- Maintain normal body weight.
- Avoid training errors (increasing intensity, distance, duration, and frequency of high-impact activities too rapidly); avoid overtraining.
- Proper footwear (appropriate cushion/arch support)
- Runners should replace footwear every 250 to 500 miles.
Commonly Associated Conditions
- Usually isolated
- Heel spurs commonly seen but are not a marker of severity nor pathognomonic and surgical removal of unclear benefit
- Posterior tibial neuropathy
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Domino, Frank J., et al., editors. "Plantar Fasciitis." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116462/all/Plantar_Fasciitis.
Plantar Fasciitis. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116462/all/Plantar_Fasciitis. Accessed May 28, 2023.
Plantar Fasciitis. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116462/all/Plantar_Fasciitis
Plantar Fasciitis [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 28]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116462/all/Plantar_Fasciitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Plantar Fasciitis ID - 116462 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116462/all/Plantar_Fasciitis PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -