Management of Plantar Fasciitis Evolving

NewsBot · Feb 10, 2012

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Management of Plantar Fasciitis Evolving; Exciting new treatment methods are on the horizon
BRETT R. FIN
J Musculoskel Med. 2012;29:16-20

Initial treatment of patients with plantar fasciitis is based on an understanding of the functions of the plantar fascia and the methods for reducing stress applied to it. The differential diagnosis of heel pain may be narrowed by carefully identifying the area of tenderness. There is little scientific evidence to indicate that traditional approaches to treatment substantially improve patients’ long-term outcome, but spontaneous improvement and resolution are common. A rational approach to treatment begins with identifying the possible causes of connective tissue irritation. If specific problems can be identified, a strategy designed to correct these factors should be planned. Surgical release is indicated for severe plantar fascial pain after prolonged attempts at nonoperative treatment. Many intriguing new approaches to treatment-resistant plantar fasciitis are under investigation.
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Admin2 · Feb 10, 2012

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Other threads tagged with plantar fasciitis

David Wedemeyer · Feb 10, 2012

There is little scientific evidence to indicate that traditional approaches to treatment substantially improve patients’ long-term outcome.
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Strongly disagree based on experience.

The natural history of plantar fasciitis is unknown. Nearly all accepted conservative therapies yield a high success rate.
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Although a multifactorial complaint, a large percentage of acute PF patient's that I have seen exhibit increased load on the medial plantar fascia due to faulty biomechanics.

A rational approach to management of plantar fasciitis begins with identification of the possible causes of the connective tissue irritation. If specific problems can be identified, a strategy designed to correct these factors should be planned.
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You mean such as support/offloading of the PF? Can you think of anything shown to achieve this in clinics all over the world...Beuhller?

Although plantar fasciitis may lead to considerable and prolonged pain in a few cases, it often improves spontaneously. Therefore, large, well-controlled trials are necessary before new thera-pies should be adopted as standard practice. Although many promising treatments for plantar fasciitis are on the horizon, widespread use of these modalities should be reserved to controlled clinical trials until their usefulness is proved definitively.
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First a distinction between fasciitis and fasciosis needs to be made. Acute vs. chronic should be paramount and patients treated conservatively prior to considering all of the invasive "experimental" procedures the author lists. Just m .02 cents

NewsBot · Apr 15, 2014

Effectiveness of different physical therapy in conservative treatment of plantar fasciitis: systematic review.
Díaz López AM, Guzmán Carrasco P.
Rev Esp Salud Publica. 2014 Feb;88(1):157-78.

Background: Plantar fasciitis is the most common disease of non-traumatic pain in the ankle-foot. It is more common in women aged 40-70 years and diffuse progressive start the foot or ankle that gradually worsens preventing progress. The aim of this work is to determine whether different physical therapies used in the conservative treatment of plantar fasciitis of at least one month duration in adults are effective individually and / or in combination. Methods: A systematic review databases in The Cochrane Library, Medline, Lilacs, IBECS, IME, PEDro and ENFISPO no date restriction, in Spanish and English languages. Randomized controlled trials were included of adult patients diagnosed with plantar fasciitis, intervention studies, prospective and systematic reviews. Assessment of study eligibility was developed by two reviewers independently and unblinded standardized. To classify, we used the PEDro scale critical, form of methodological quality plus a critical review of each summary and if this was not conclusive assessment of the full text. Results: 32 full-text articles were reviewed. Most used techniques are the stretches and shock waves, although the best results are obtained by combining several techniques. Shock waves are effective when other techniques have failed. Conclusion: Physical therapies used in the various studies have proven effective to varying degrees either to reduce pain or relieve the symptoms of plantar fasciitis.
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