Back to A-Z


Plantar Fasciitis

Clinical features of plantar fasciitis:

Most affected individuals complain of pain along the plantar surface of the foot but also Heel pain. The pain is worsened by pressure on the bottom of the foot (i.e., walking, running, palpation). It is also worse with the first steps taken after getting out of bed in the morning. There is tenderness to palpation at the attachment site of the plantar fascia to the inferior aspect of the calcaneus. Predisposing factors include obesity, pes planus, pes cavus, short Achilles tendon, and standing/running on hard surfaces.

Radiographic features:

Ultrasound: often the initial imaging modality of choice. Ultrasound typically shows increased thickness and a hypoechoic fascia. You may also detect other enthesopathy signs or partial tears

Plain film features are non-specific but may show an show an associated plantar calcaneal spur = enthesophyte, although this is also seen in asymptomatic individuals.

MRI: Signal characteristics of affected tissues include:

• T1/PD: intermediate signal

• T2: high signal

• STIR: very sensitive in the detection of both fascial and perifascial edema, which appear as poorly marginated areas of high signal intensity


Therapy:

Edukation

Strengthening Training

- Stretching exercises of the plantar fascia and Achilles tendon

- Avoid weight bearing exercises

- Fascia mobilization, stretching, acupuncture, radiofrequency ablation

Stretching

Shoe insoles

Taping

Night positioning splint

Irradiation

ESWT- Extracorporeal shock wave therapy: maximum improvement approx. 3 months after treatment

Injections: Hyaluronic acid, PRP , Botox

Dehydrated Amniotic Membrane

Hyperosmolar dextrose



Pubmed

UpToDate

Images


Web:

WebMD

Runnersworld

MayoClinic

Schulthess Klinik (German)

eMedicineHealth