Plantar fasciitis

Last reviewed: 25 Apr 2022
Last updated: 27 Nov 2019

Summary

Definition

History and exam

Key diagnostic factors

  • heel pain (stabbing or knife-like)
  • pain relieved with rest
  • poststatic dyskinesia
More key diagnostic factors

Other diagnostic factors

  • pain exacerbated by walking barefoot
  • pain improved with nonsteroidal anti-inflammatory drug (NSAID) use
  • no history of acute injury to the heel
  • self-limiting pain
  • unilateral heel pain
  • positive dorsiflexion-eversion test
  • positive Windlass test
  • negative Tinel sign
Other diagnostic factors

Risk factors

  • obesity
  • equinus
  • pes planus
  • pes cavus
  • age >40 years old
  • history of prolonged standing
  • runners
More risk factors

Diagnostic investigations

1st investigations to order

  • foot x-ray
More 1st investigations to order

Investigations to consider

  • technetium (Tc-MDP 3-phase) bone scan
  • MRI
  • HLA-B27
  • rheumatoid factor
More investigations to consider

Emerging tests

  • ultrasound

Treatment algorithm

ONGOING

all patients

Contributors

Authors

Martha Anderson, DPM, FACFAS
Martha Anderson

Podiatric Foot and Ankle Surgeon

Private Practice

Foot and Ankle Wellness Center

Podiatric Foot and Ankle Surgeon

Department of Surgery

Grady Memorial Hospital

Delaware

OH

Disclosures

MA declares that she has no competing interests.

Acknowledgements

Dr Martha Anderson would like to gratefully acknowledge Dr Georgeanne Botek, the previous contributor to this topic. GB declares that she has no competing interests.

Peer reviewers

Mark A. Hardy, DPM, FACFAS

Director

Foot and Ankle Trauma Service

Kaiser Permanente

Cleveland

OH

Disclosures

MAH declares that he has no competing interests.

Molly Judge, DPM, FACFAS

Board Certified in Reconstructive Rear foot and Ankle Surgery

Department of Surgery

St. Vincent Charity Hospital

Cleveland

OH

Disclosures

MJ declares that she has no competing interests.

Patrick J. McKee, DPM

Program Director

Podiatric Residency

Cleveland Clinic

Cleveland

OH

Disclosures

PJM declares that he has no competing interests.

  • Plantar fasciitis images
  • Differentials

    • Plantar fascia rupture
    • Inferior calcaneal bursitis
    • Calcaneal contusion
    More Differentials
  • Guidelines

    • ACR appropriateness criteria: chronic foot pain
    • Heel pain: plantar fasciitis
    More Guidelines
  • Patient leaflets

    Heel pain (plantar fasciitis)

    Obesity - drugs and surgery

    More Patient leaflets
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