- 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.
- Diagnostics are not recommended in primary care.
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.
- Diagnostic uncertainty.
- Failure to improve with primary care management following a minimum of 6 weeks therapy.
- Referral for physiotherapy / podiatry.