Plantar Fasciopathy
Plantar Fasciopathy
Plantar fasciopathy (PF) is an acute or chronic, painful disorder of the plantar fascia that spans between the medial calcaneal tubercle and the proximal phalanges of the toes.
Pathology
It is the most common cause of plantar heel pain and accounts for approximately 11-15% of foot symptoms presenting to clinicians.
DIAGNOSIS AND TREATMENT
The main clinical symptom is heel pain, particularly in the morning or after a period of rest. Often patients report improvement of pain after walking. Pain is usually located at the origin of the plantar fascia, i.e., at the medial calcaneal tubercle. Passive dorsiflexion of the toes may aggravate the pain in some patients, particularly in those with chronic PF. Patients suffering from chronic PF may also present with heel pad swelling. Chronic PF is associated with degenerative changes in the fascia. Athletes and the elderly commonly present to clinicians with PF.
Accordingly, the disease is better characterised as “plantar fasciopathy” rather than “plantar fasciitis”, resembling the situation in overuse tendon problems which do not involve inflammation.
‘In the United States, more than two million individuals are treated for PF on an annual basis. Up to 10% of the population will experience plantar heel pain during the course of a lifetime.’
Patients not responding to conservative treatment for six months (between 10% and 20% of all patients) shall then undergo shock wave therapy.
