J Korean Foot Ankle Soc.  2016 Sep;20(3):93-99. 10.14193/jkfas.2016.20.3.93.

The Diagnosis and Treatment of Plantar Fasciitis

• Eun IS

• KMID: 2351412
• DOI: http://doi.org/10.14193/jkfas.2016.20.3.93

Abstract

Plantar fasciitis is the most common cause of heel pain. The diagnosis of plantar fasciitis is primarily based on the presentation of symptoms and physical examination. Patients usually complain of heel pain at the medial calcaneal tubercle when taking their first step in the morning or when walking after resting. Diagnostic imaging is rarely required for the initial diagnosis of plantar fasciitis; however, it can be used for differential diagnosis. Conservative treatments, such as stretching, rest, ice massage, oral analgesics, foot orthotics, use of night splint, and corticosteroid injection, may be effective. The majority of patients report improvement with conservative treatments, and those who show no response from conservative treatments for a duration of six months or longer can consider extracorporeal shock wave therapy or surgery.

Keyword

Heel pain; Plantar fasciitis; Extracorporeal shock wave therapy; Steroid injection

MeSH Terms

Analgesics
Diagnosis*
Diagnosis, Differential
Diagnostic Imaging
Fasciitis, Plantar*
Foot
Heel
Humans
Ice
Massage
Physical Examination
Shock
Splints
Walking
Analgesics
Ice

Figure

• 

  Figure 1. Image shows the plantar fascia attaching proximally to the medial calcaneal tubercle and extending distally into the base of the periosteum of the proximal phalanx of each toe and the metatarsal heads (A) and undergoing tension during the latter weight-bearing stage and, as the metatarsophalangeal joints undergo dorsiflexion, applying a tractional force at its point of insertion on the calcaneus (B). Revised from the article of Hicks (J Anat. 1954;88:25-30).4)

• 

  Figure 2. Tenderness point of heel pain. (A) Sole of foot. (B) Medial aspect of foot. ① Heel pad atrophy. ② Plantar fasciitis. ③ Baxter nerve entrapment. ④ Calcaneal stress fracture. ⑤ Tarsal tunnel syndrome.

• 

  Figure 3. Treatment algorithm for patients with plantar fasciitis.

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  Figure 4. Plantar fascia-specific stretch is performed by dorsiflexing the toes with one hand and palpating the plantar fascia with the other hand to ensure that it is taut.

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  Figure 5. Ice massage method, which involves rolling a frozen can under the foot.

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