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Plantar Fasciitis

Authors: Deepika Singh, MD Author Information and Disclosures

Editors: Miguel C Fernandez, MD, FACEP, FAAEM, FACMT; Francisco Talavera, PharmD, PhD; Eric Legome, MD; John Halamka, MD; Rick Kulkarni, MD Editor Information

Last Updated: April 17, 2006

Synonyms and related keywords ›

Introduction

Background

Plantar fasciitis is the most common cause of heel pain for which professional care is sought. A variety of terms have been used to describe it including jogger's heel, tennis heel, Policeman's heel, and an outdated term, gonorrheal heel reflecting the old thought that it was somehow related to that sexually transmitted disease.

Pathophysiology

The plantar fascia originates on the medial tubercle of the calcaneus and fans out over the bottom of the foot to insert onto the proximal phalanges and the flexor tendon sheaths. It forms the longitudinal arch of the foot and functions as a shock-absorber as well an arch support. The term fasciitis may be somewhat of a misnomer since the disease is actually a degenerative process with or without inflammatory changes, which may include fibroblastic proliferation. This has been proven from biopsies of fascia from people undergoing surgery for plantar fascia release. It is commonly believed to be caused by repetitive microtrauma to the fascia.

Frequency:

  • In the US: Plantar fasciitis accounts for about 10% of runner-related injuries and 11-15% of all foot symptoms requiring professional care. It is thought to occur in 10% of the general population as well. It may present bilaterally in a third of cases.

Mortality/Morbidity: Plantar fascitis probably may lead to significant morbidity placing strict activity limitations on the patient. In addition, due to the pain in the foot leading to changes in patterns of bearing weight, associated additional injury to the hip and knee joints may also occur.

Race: Race and ethnicity play no role in the incidence of plantar fasciitis.

Sex: The condition occurs equally in both sexes in young people. Some studies show a peak incidence may occur in women aged 40-60 years.

Age: The condition can occur at any age. As mentioned, a peak incidence may occur in women aged 40-60 years.

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Bibliography

  1. Atkins D, Crawford F, Edwards J, Lambert M: A systematic review of treatments for the painful heel. Rheumatology (Oxford) 1999 Oct; 38(10): 968-73[Medline].
  2. Buchbinder R: Clinical practice. Plantar fasciitis. N Engl J Med 2004 May 20; 350(21): 2159-66[Medline].
  3. Cole C, Seto C, Gazewood J: Plantar fasciitis: evidence-based review of diagnosis and therapy. Am Fam Physician 2005 Dec 1; 72(11): 2237-42[Medline].
  4. Crawford F, Thomson C: Interventions for treating plantar heel pain. Cochrane Database Syst Rev 2003; CD000416[Medline].
  5. DiGiovanni BF, Nawoczenski DA, Lintal ME, et al: Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. J Bone Joint Surg Am 2003 Jul; 85-A(7): 1270-7[Medline].
  6. Hogan KA, Webb D, Shereff M: Endoscopic plantar fascia release. Foot Ankle Int 2004 Dec; 25(12): 875-81[Medline].
  7. Roxas M: Plantar fasciitis: diagnosis and therapeutic considerations. Altern Med Rev 2005 Jun; 10(2): 83-93[Medline].
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Synonyms And Related Keywords

plantar fasciitis, heel pain, jogger's heel, tennis heel, Policman's heel, bone spur, heel pain, pain on bottom of heel, exostosis, flat foot, highly-arched foot, excessively pronated foot, gait alteration, obesity, tight Achilles tendon, policeman's heel, pes planus, pes cavus

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Author Information and Disclosures

Author: Deepika Singh, MD, Staff Physician, Department of Emergency Medicine, Kings County Hospital Center

Coauthor(s): Mark A Silverberg, MD, FACEP, MMB, Assistant Professor of Emergency Medicine, State University of New York Downstate College of Medicine, Assistant Residency Director, Department of Emergency Medicine, Kings County Hospital; Leslie Milne, MD, Assistant Clinical Instructor, Department of Emergency Medicine, Harvard University School of Medicine

Deepika Singh, MD, is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, American Nurses Association, Emergency Medicine Residents' Association, and Sigma Theta Tau International

Editor Information

Editor(s): Miguel C Fernandez, MD, FACEP, FAAEM, FACMT, Associate Clinical Professor; Medical and Managing Director, South Texas Poison Center, Department of Surgery/Emergency Medicine and Toxicology, University of Texas Health Science Center at San Antonio; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Eric Legome, MD, Residency Director, Assistant Professor of Emergency Medicine, Department of Emergency Medicine New York University, New York University Hospital, Bellevue Hospital Center, Manhattan VA; John Halamka, MD, Chief Information Officer, CareGroup Healthcare System, Assistant Professor of Medicine, Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Assistant Professor of Medicine, Harvard Medical School; and Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital

 
 
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