Plantar frasciitis Flashcards
1
Q
Define plantar fasciitis.
A
Plantar fasciitis is an acute or chronic pain in the inferior heel at the attachment of the medial band of the plantar fascia to the medial calcaneal tubercle.
2
Q
What are the features of PF? When is pain worst?
A
- Pain worst in first few steps after getting out of bed and after periods of rest
- Heel pain (stabbing or knife like)
- Pain relieved with rest
- Post-static dyskinesia
- Exacerbated with walking barefoot
- Improved with NSAIDs
- No injury necessary
- Self-limiting (6-18months)
3
Q
What is the epidemiology of PF?
A
40-60yo
Bilateral in a third
F=M
4
Q
What are the risk factors for PF?
A
- Running
- Obeisty
- Equinus presence
- 40-60yo
- Pes planus or cavus
- Prolonged standing
5
Q
What are the findings on examination in PF?
A
Focal, pin-point tenderness on palpation of the plantar central or medial calcaneum, in the proximal third of the plantar fascia
6
Q
How is PF diagnosed?
A
Clinically
Investigations may be done if there is doubt about diagnosis e.g.
- XR foot - exclude fracture
- Bloods - HLA-B27, RF
7
Q
What is the management of PF?
A
- NSAIDs
- Stretching achilles and plantar fascia
- Rest
- Weight reduction
- Foot orthotics
- Mechanical support e.g. Low-Dye taping to support the arch
- Corticosteroid injections for short term relief
If these do not work after 6-12 months:
- ESWT
- Surgery - partial plantar fascia release with nerve release
8
Q
Where is pain worst in PF?
A
Around the medial calcaneal tuberosity
