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Hello, first post so please be gentle ;)

Can someone please explain in simple terms, the clinical significance of the difference between a diagnosis of plantar fasciitis and plantar fasciosis? (apart from not using corticosteroids in the absence of inflammation).

I'm trying to write an introduction to a 3rd year project proposal comparing 2 treatment modalities for proximal plantar fasciitis. While I don't want to get too caught up in this issue as a) it's outside the scope of the project and b) I have a very limited word count, I do believe the devil is in the detail, and I want to at least acknowledge this debate rather than just state that plantar fasciitis pain is due to inflammation at the origin of the plantar fascia and/or intrinsic muscles etc. Or should I just stick to this definition?

What I think i'm trying to get at is: would treatment along the lines of reducing the tensile stress on the tissues (plantar fascia and gastrocs eg. by night splint) still be indicated regardless if research discovers the condition is an 'osis' or a combination of 'osis' and 'itis'.

Sorry if it's an obvious question, i've read that many papers today i've managed to properly confuse myself. Which admittedly isn't that difficult :wacko:

 

A similar debate exists with Achilles tendonosis and tendonitis. I think in most patients the pathophysiology is degenerative so that 'osis' is more accurate a description. If there was an onset event then there could have been a rupture that would make the condition an 'itis'. As with many degenerative conditions there is an element of inflammation in combination with the degeneration that should be addressed for symptom relief.

In most cases of a rupture the primary aim is to reduce strain on the tissues by splinting/taping etc and to reduce inflammation eg RICE. Stretching and manipulation will often make the problem worse in the acute phase.

It should be acknowledged that most people use the term fasciitis when it is really fasciosis. True fasciitis is relatively rare but is very common as a diagnosis. Updating the terms like is happening with the Achilles is a good idea but is a long way from being universally accepted.

 

Thanks for your replies, most helpful.