The role of night splints in reducing plantar fasciitis pain is inconclusive.īased on inconsistent, limited-quality studiesĮxtracorporeal shock wave therapy may have a role in chronic plantar fasciitis that does not respond to conservative therapies.īased on inconsistent evidence and a meta-analysisĬorticosteroid injections may provide, at best, short-term relief for acute and chronic plantar fasciitis.īased on a Cochrane review of low-quality studiesīurning over the inferomedial aspect of the calcaneus Plantar fascia stretches are effective for reducing heel pain.īased on small, limited-quality randomized controlled trialsįoot orthoses (prefabricated or custom) may reduce heel pain for up to 12 weeks, but the benefit is generally not clinically meaningful in the long term.īased on moderate-quality evidence from a systematic review and meta-analysis Ultrasonography and magnetic resonance imaging are diagnostic options in patients with chronic heel pain despite conservative measures.īased on systematic reviews of disease-oriented evidence Endoscopic fasciotomy may be required in patients who continue to have pain that limits activity and function despite exhausting nonoperative treatment options. Recalcitrant plantar fasciitis can be treated with injections, extracorporeal shock wave therapy, or surgical procedures, although evidence is lacking. Many standard treatments such as night splints and orthoses have not shown benefit over placebo. Treatment should start with stretching of the plantar fascia, ice massage, and nonsteroidal anti-inflammatory drugs. Ultrasonography is a reasonable and inexpensive diagnostic tool for patients with pain that persists beyond three months despite treatment. Physical examination findings are often limited to tenderness to palpation of the proximal plantar fascial insertion at the anteromedial calcaneus. Symptoms are stabbing, nonradiating pain first thing in the morning in the proximal medioplantar surface of the foot the pain becomes worse at the end of the day. Plantar fasciitis is predominantly a clinical diagnosis. With proper treatment, 80% of patients with plantar fasciitis improve within 12 months. Plantar fasciitis is common in runners but can also affect sedentary people. Risk factors include limited ankle dorsiflexion, increased body mass index, and standing for prolonged periods of time. Plantar fasciopathy is an appropriate descriptor because the condition is not inflammatory. Plantar fasciitis is a common problem that one in 10 people will experience in their lifetime.
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