Articles

Plantar Fasciitis: Evaluation and Treatment

Neufeld, Steven K. MD; Cerrato, Rebecca MD

Dr. Neufeld is Founder and President, Orthopaedic Foot and Ankle Center of Washington, Arlington, VA. Dr. Cerrato is Foot and Ankle Fellow, Mercy Medical Center, Baltimore, MD.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Neufeld and Dr. Cerrato.

Reprint requests: Dr. Neufeld, Orthopaedic Foot and Ankle Center, Suite 300, 2445 Army Navy Drive, Arlington, VA 22206-8316.

Journal of the American Academy of Orthopaedic Surgeons 16(6):p 338-346, June 2008.

Abstract

Plantar fasciitis is the most common cause of plantar heel pain. Its characteristic features are pain and tenderness, predominately on the medial aspect of the calcaneus near the sole of the heel. Considering a complete differential diagnosis of plantar heel pain is important; a comprehensive history and physical examination guide accurate diagnosis. Many nonsurgical treatment modalities have been used in managing the disorder, including rest, massage, nonsteroidal anti-inflammatory drugs, night splints, heel cups/ pads, custom and off-the-shelf orthoses, injections, casts, and physical therapy measures such as shock wave therapy. Most reported treatment outcomes rely on anecdotal experience or combinations of multiple modalities. Nevertheless, nonsurgical management of plantar fasciitis is successful in approximately 90% of patients. Surgical treatment is considered in only a small subset of patients with persistent, severe symptoms refractory to nonsurgical intervention for at least 6 to 12 months.