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Recent updates in the management of plantar fasciitis

Schippert, David W; DiGiovanni, Benedict F; Baumhauer, Judith F; Flemister, Adolph S

doi: 10.1097/BCO.0b013e318199da68
SPECIAL FOCUS: Foot and Ankle

Proximal plantar fasciitis is the most common cause of plantar heel pain and can be quite debilitating. Usually it is diagnosed clinically and is self-limited. Historically, little high quality evidence has been available to guide treatment of chronic plantar fasciitis. Nonoperative methods are the first line of treatment, and surgery is reserved only for those in whom an optimized nonoperative treatment regimen has failed. Nonoperative treatments include stretching, orthotics, casting, anti-inflammatories, steroid injections and extracorporeal shock wave therapy. Recent Level I and II studies have demonstrated the benefits of including a plantar fascia specific stretch in nonoperative protocols. Surgical options are many, but consistent, high-quality evidence to guide treatment is lacking. This article will briefly review the anatomy, etiology and diagnosis of plantar fasciitis while focusing on nonoperative and operative treatments. The most recent literature will be reviewed to help guide the selection of optimal therapeutic regimens.

Correspondence to Benedict F. DiGiovanni, MD, Division of Foot and Ankle Surgery, Associate Professor of Orthopaedics, Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 665, Rochester, NY 14642 Tel: +585 273 16111; fax: 585 756 4725; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.