Plantar fasciitis

Background

• Most common cause of heel pain
• Due to inflammation of the plantar aponeurosis (ususally from overuse)
• 80% of cases resolve spontaneously within 1yr

Clinical Features

Deep anatomy of the sole with physical findings.

• Pain on the plantar surface of the foot
  • Worsened upon arising in the morning and after activity
  • Worsened with dorsiflexion of toes
• TTP at anterior medial aspect of calcaneus
• Pain reproduced with toe dorsiflexion

Differential Diagnosis

Foot diagnoses

Acute

• Foot and toe fractures
• Subtalar dislocation
• Metatarsophalangeal joint sprain (turf toe)
• Acute arterial ischemia
• Calcaneal bursitis

Subacute/Chronic

• Diabetic foot infection
• Peripheral artery disease
• Plantar fasciitis
• Trench foot
• Ingrown toenail
• Paronychia
• Tinea pedis
• Morton's neuroma
• Diabetic neuropathy

Evaluation

• Usually clinical

Management

• Rest, ice, NSAIDs, heel/arch support inserts
• Refer to PCP, podiatrist, or orthopedist for follow-up care

Disposition

• Outpatient treatment

See Also

• Foot Diagnoses