INTRODUCTION​

• Plantar fasciitis is the most common cause of plantar heel pain

• It is characterized by inflammation of the origin of the plantar fascia and surrounding perifascial structures in the inside of the heel/foot

• The word fasciitis implies an inflammatory process; however, histologic evidence does not support this concept and suggests more of a degenerative process without inflammation 

• 80% of heel pain is plantar fasciitis

CAUSES​

• Although not clearly defined, it is thought to be secondary to repetitive microtrauma at the origin of the plantar fascia

SIGNS AND SYMPTOMS

• Pain in the sole of the heel and inside of the foot

• Tenderness of the sole of the foot

• Pain is often worse with first few steps in the morning and also worse with continued weight bearing

TREATMENT​​

• Treatment of plantar fasciitis is usually multimodal and involves trying multiple different modalities 

• The first line of treatment usually a period of rest and can involve a course of physical therapy or a home exercise program focused on stretching of the achilles tendon and plantar fascia

• Anti-inflammatories such as ibuprofen are oftentimes helpful as an adjunct to other treatments

• Night splints

• Custom and over the counter orthotics and heel cups have been shown to help

• Shockwave therapy has shown good results in some studies

• Steroid injections are not recommended due to risk of achilles rupture 

• Plantar fasciitis that has failed conservative management may be treated with Platelet Rich Plasma (PRP) as there is growing evidence that this may help improve pain and avoid surgery 

• Surgery is reserved for cases that don’t improve after a minimum 6 month course of conservative management if symptoms are significantly affecting activities of daily living and quality of life. 

PREVENTION  ​​

• The best way to prevent this condition is to avoid repetitive activities that overload the achilles tendon and plantar fascia