Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- dor no calcanhar (aguda ou do tipo fisgada)
- dor aliviada com repouso
- discinesia pós-estática
- dor exacerbada à posição ortostática e em outras atividades da vida diária
Other diagnostic factors
- dor exacerbada ao andar descalço ou com calçados sem suporte
- dor melhorou com o uso de um anti-inflamatório não esteroidal (AINE)
- ausência de história de lesão aguda no calcanhar
- dor autolimitada
- dor calcânea unilateral
- teste de dorsiflexão-eversão positivo
- teste do efeito molinete positivo
- sinal de Tinel negativo
Risk factors
- Índice de massa corporal (IMC) elevado
- equino
- pés planos
- pés cavos
- idade >40 anos
- histórico de posição ortostática ou caminhar por tempos prolongados
- atletas, principalmente corredores
- estilo de vida sedentário
- usar sapatos impróprios ou excessivamente gastos
- aumentos ou mudanças na atividade física
Diagnostic investigations
1st investigations to order
- radiografia do pé
Investigations to consider
- cintilografia óssea com tecnécio (Tc-MDP [metilenodifosfonato] em 3 fases)
- RNM
- HLA (antígeno leucocitário) B27
- fator reumatoide
- ultrassonografia
Treatment algorithm
todos os pacientes
Contributors
Authors
Martha Anderson, DPM, FACFAS
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Schneider HP, Baca JM, Carpenter BB, et al. American College of Foot and Ankle Surgeons clinical consensus statement: diagnosis and treatment of adult acquired infracalcaneal heel pain. J Foot Ankle Surg. 2018 Mar-Apr;57(2):370-81.Full text Abstract
Rhim HC, Kwon J, Park J, et al. A systematic review of systematic reviews on the epidemiology, evaluation, and treatment of plantar fasciitis. Life (Basel). 2021 Nov 24;11(12).Full text Abstract
Koc TA Jr, Bise CG, Neville C, et al. Heel pain - plantar fasciitis: revision 2023. J Orthop Sports Phys Ther. 2023 Dec;53(12):CPG1-39.Full text Abstract
American College of Radiology. ACR appropriateness criteria: chronic foot pain. 2020 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Ruptura da fáscia plantar
- Síndrome do coxim gorduroso do calcanhar (atrofia do coxim adiposo)
- Fibromatose plantar proximal (doença de Ledderhose)
More DifferentialsGuidelines
- Heel pain - plantar fasciitis: revision 2023
- ACR appropriateness criteria: chronic foot pain
More GuidelinesPatient information
Obesidade - medicamentos e cirurgia
Obesidade - dieta e exercício
More Patient information
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer