Plantar fasciitis
A common cause of heel pain from plantar fascia disorder.
Plantar fasciitis is a disorder of the plantar fascia, the connective tissue that supports the arch of the foot. It results in pain in the heel and bottom of the foot, most severe with the first steps of the day or after rest, and affects both feet in about one-third of cases. The condition is common, with between 4% and 7% of people experiencing heel pain at any given time, about 80% of which is due to plantar fasciitis.
- prevalence
- 4–7% of people have heel pain at any time; ~80% due to plantar fasciitis
- lifetime_risk
- Approximately 10% of people have the disorder at some point
- age_relation
- Becomes more common with age
- sex_distribution
- Unclear whether one sex is more affected than the other
- bilateral_cases
- Affects both feet in about one-third of cases
- obesity_association
- Obesity seen in 70% of individuals who present with plantar fasciitis
Lore & Background
Plantar fasciitis is characterized by pain in the heel and bottom of the foot, typically sharp and unilateral in 70% of cases. Pain is most intense during the first steps after getting out of bed or after prolonged sitting, and it improves with walking. The cause is not clear, but risk factors include overuse, prolonged standing, obesity, flat feet, tight calf muscles, and inappropriate footwear. Heel spurs are commonly present but are not the direct cause of pain.
Reader's Guide
The disorder involves micro tears, collagen breakdown, and scarring at the insertion site of the plantar fascia on the heel bone. Inflammation plays a lesser or no role, leading some to propose renaming it plantar fasciosis. Diagnosis is generally based on symptoms and clinical examination; imaging is not routinely indicated. Most cases resolve with time and conservative treatment, such as rest, stretching, and supportive insoles. About 90% improve within six months with conservative care. For persistent cases, extracorporeal shockwave therapy or surgery may be considered. The condition is non-inflammatory and associated with biomechanical imbalances.
Did You Know?
- Pain is usually most severe with the first steps of the day or after a period of rest.
- Heel spurs are present in up to 50% of patients but are not the cause of pain.
- Obesity is seen in 70% of individuals who present with plantar fasciitis.
- About 90% of cases improve within six months with conservative treatment.
More in Overuse injuries 1-24
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