Plantar Fascitis

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Patient Information

https://secureservercdn.net/198.71.233.138/c3i.9cb.myftpupload.com/wp-content/uploads/2019/12/heel-pain.pdf

https://www.bofas.org.uk/Patient-Information/Heel-Pain

http://www.patient.co.uk/pdf/4311.pdf

GP Information

Background Information

  • A condition caused by chronic overuse with resultant microtears in the origin of the plantar fascia. 90% resolve within 1 year without surgery.
  • Patients typically complain of sharp heel pain often on waking. Symptoms improve as they walk during the day.
  • Examination may reveal reproduction of symptoms with dorsiflexion of the toes and foot, with medial heel tenderness on palpation.

Investigation Guidelines

  • Diagnostics are not recommended in primary care.

Management Recommendations

The majority of cases may be successfully managed in primary care;

  • Provide advice regarding footwear – avoid completely flat or high heeled shoes. Avoid walking barefoot.
  • Weight-loss advice if appropriate.
  • NSAIDs, cooling.
  • Simple analgesics.
  • Calf muscle exercises / plantar fascia stretches.
  • ‘Off the shelf’ heel pad.

Referral Indications;

  • Diagnostic uncertainty.
  • Failure to improve with primary care management following a minimum of 6 weeks therapy.
  • Referral for physiotherapy / podiatry.
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