The incidence of heel pain in the population

Dieter Fellner · Apr 11, 2007

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I am seeking information regarding the incidence of heel pain in the population, and related data e.g. treatment outcomes, conservative v surgical, recalcitrant cases, surgical conversion rates & outcomes etc.

Are there any reliable sources, is the information extrapolated or measured?

Anyone seen such data ?

Thanks!

Craig Payne · Apr 12, 2007

I do not think there is any good data...

15% of adults with foot problems (McCarthy & Gorecki, 1979)
Estimated 1 million patient visits per year are for plantar fasciitis (Riddle, 2004).
More than 2 million Americans seek treatment for plantar heel pain each year (eMedicne)
In both athletic and nonathletic populations, the rate is reported to be approximately 10% (eMedcine)

JFAR · Jul 29, 2008

21% of participants in this study reported heel pain:

Prevalence and correlates of foot pain in a population-based study: the North West Adelaide Health Study

Catherine L Hill , Tiffany K Gill , Hylton B Menz and Anne W Taylor

Journal of Foot and Ankle Research 2008, 1:2doi:10.1186/1757-1146-1-2

Published: 28 July 2008

Abstract (provisional)

Background
Few population-based studies have examined the prevalence of foot pain in the general community. The aims of this study were therefore to determine the prevalence, correlates and impact of foot pain in a population-based sample of people aged 18 years and over living in the northwest region of Adelaide, South Australia.

Methods
The North West Adelaide Health Study is a representative longitudinal cohort study of n=4,060 people randomly selected and recruited by telephone interview. The second stage of data collection on this cohort was undertaken between mid 2004 and early 2006. In this phase, information regarding the prevalence of musculoskeletal conditions was included. Overall, n=3,206 participants returned to the clinic during the second visit, and as part of the assessment were asked to report whether they had pain, aching or stiffness on most days in either of their feet. Data were also collected on body mass index (BMI); major medical conditions; other joint symptoms and health-related quality of life (the Medical Outcomes Study Short Form 36 [SF-36]).

Results
Overall, 17.4% (95% confidence interval 16.2 - 18.8) of participants indicated that they had foot pain, aching or stiffness in either of their feet. Females, those aged 50 years and over, classified as obese and who reported knee, hip and back pain were all significantly more likely to report foot pain. Respondents with foot pain scored lower on all domains of the SF-36 after adjustment for age, sex and BMI.

Conclusions
Foot pain affects nearly one in five of people in the community, is associated with increased age, female sex, obesity and pain in other body regions, and has a significant detrimental impact on health-related quality of life.

NewsBot · Dec 1, 2009

The Incidence of Plantar Fasciitis in the United States Military
Captain Danielle L. Scher, Lieutenant Colonel Philip J. Belmont, Jr., Major Russell Bear, Sally B. Mountcastle, Justin D. Orr, and Major Brett D. Owens
The Journal of Bone and Joint Surgery (American). 2009;91:2867-2872.

Background: Although plantar fasciitis is the most common cause of heel pain, little has been reported on the incidence rates of this disorder. We sought to determine the incidence rate and demographic risk factors of plantar fasciitis in an ethnically diverse and physically active population of United States military service members.

Methods: A query was performed with use of the Defense Medical Epidemiology Database for the International Classification of Diseases, Ninth Revision, Clinical Modification, code for plantar fasciitis (728.71). Multivariate Poisson regression analysis was used to estimate the rate of plantar fasciitis per 1000 person-years, while controlling for sex, race, rank, service, and age.

Results: The overall unadjusted incidence rate of plantar fasciitis was 10.5 per 1000 person-years. Compared with men, women had a significantly increased adjusted incidence rate ratio for plantar fasciitis of 1.96 (95% confidence interval, 1.94 to 1.99). The adjusted incidence rate ratio for black service members compared with white service members was 1.12 (95% confidence interval, 1.09 to 1.12). With junior officers as the referent category, junior enlisted, senior enlisted, and senior officer rank groups had a significantly increased adjusted incidence rate ratio for plantar fasciitis: 1.20 (95% confidence interval, 1.18 to 1.23), 1.19 (95% confidence interval, 1.17 to 1.22), and 1.56 (95% confidence interval, 1.52 to 1.61), respectively. Compared with service members in the Air Force, those in the Army and Marines had a significantly increased adjusted incidence rate ratio for plantar fasciitis of 1.85 (95% confidence interval, 1.82 to 1.87) and 1.28 (95% confidence interval, 1.25 to 1.30), respectively. The adjusted incidence rate ratio for the age group of forty years old or more compared with the twenty to twenty-four-year-old group was 3.42 (95% confidence interval, 3.34 to 3.51).

Conclusions: Female sex; black race; junior enlisted, senior enlisted, and senior officer rank groups; service in the Army or Marines; and increasing age are all risk factors for plantar fasciitis.
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LER · May 4, 2010

The epidemiology of plantar fasciitis

Interesting article in the April issue of Lower Extremity Review on the importance of practitioner familiarity with the diagnosis of plantar fasciitis and the associated risk factors. http://lowerextremityreview.com/article/the-epidemiology-of-plantar-fasciitis

Carsten · May 6, 2010

have a look of the article " High Prevalence of Foot Problems in the Danish Population: - A Survey of Causes and Associations." It was published in The Foot and you can find it at
http://dx.doi.org/10.1016/j.foot.2010.03.002

NewsBot · May 23, 2019

Prevalence and incidence rate of lower-extremity tendinopathies in a Danish general practice: a registry-based study
Henrik Riel, Cassandra Frydendal Lindstrøm, Michael Skovdal Rathleff, Martin Bach Jensen and Jens Lykkegaard Olesen
BMC Musculoskeletal Disorders201920:239

Background
Tendinopathies of the lower extremity (e.g. Achilles, patellar, and plantar heel pain) are common in both general and sporting populations. However, the prevalence and incidence in Danish general practice is unknown. The aim was to determine the prevalence and incidence rate of lower-extremity tendinopathies in a Danish general practice.

Methods
In this registry-based study, we extracted data from the electronic patient files of all patients in a single Danish general practice. The practice included 8836 patients. We searched ICPC-2 codes to identify patients with either of the following lower-extremity tendinopathies: plantar heel pain; Achilles tendinopathy; patellar tendinopathy; greater trochanteric pain syndrome or adductor tendinopathy. We defined an incident and prevalent case as a patient with a consultation because of tendinopathy in 2016 only. A prevalent, but not incident case was a patient with consultations in both 2015 and 2016. Incidence and prevalence were expressed as the number of patients with a tendinopathy per 1000 registered patients.

Results
The prevalence and incidence rate were 16.6 and 7.9 per 1000 registered patients, respectively. Plantar heel pain was the most prevalent tendinopathy and accounted for 39% of lower-extremity tendinopathies. Patients with tendinopathies were significantly older than all registered patients (46.0 years (95%CI: 43.3;48.7) versus 38.8 years (95%CI: 38.4;39.3), respectively).

Conclusions
Lower-extremity tendinopathies, especially plantar heel pain, had a high prevalence and incidence rate in a Danish general practice. In a typical general practice with 5000 patients, general practitioners should expect to see more than 80 patients with a lower-extremity tendinopathy every year.
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Dieter Fellner · May 24, 2019

Thanks y'all .... my post from 2007. At this time I don't remember why I thought I needed to know :confused:

NewsBot · Jul 21, 2019

Plantar heel pain in middle-aged and older adults: population prevalence, associations with health status and lifestyle factors, and frequency of healthcare use
Martin J. Thomas, Rebecca Whittle, Hylton B. Menz, Trishna Rathod-Mistry, Michelle Marshall and Edward Roddy
BMC Musculoskeletal Disorders201920:337

Background
The objectives of this study were to estimate the population prevalence and distribution of plantar heel pain in mid-to-older age groups, examine associations with selected health status and lifestyle factors, and report the frequency of healthcare use.

Methods
Adults aged ≥50 years registered with four general practices were mailed a health survey (n = 5109 responders). Plantar heel pain in the last month was defined by self-reported shading on a foot manikin, and was defined as disabling if at least one of the function items of the Manchester Foot Pain and Disability Index were also reported. Population prevalence estimates and associations between plantar heel pain and demographic characteristics, health status measures and lifestyle factors were estimated using multiple imputation and weighted logistic regression. Healthcare professional consultation was summarised as the 12-month period prevalence of foot pain-related consultation.

Results
The population prevalence of plantar heel pain was 9.6% (95% CI: 8.8, 10.5) and 7.9% (7.1, 8.7) for disabling plantar heel pain. Occurrence was slightly higher in females, comparable across age-groups, and significantly higher in those with intermediate/routine and manual occupations. Plantar heel pain was associated with physical and mental impairment, more anxiety and depression, being overweight, a low previous use of high-heeled footwear, and lower levels of physical activity and participation. The 12-month period prevalence of foot pain-related consultation with a general practitioner, physiotherapist or podiatrist/chiropodist was 43.0, 15.1 and 32.8%, respectively.

Conclusions
Plantar heel pain is a common, disabling symptom among adults aged 50 years and over. Observed patterns of association indicate that in addition to focused foot-specific management, primary care interventions should also target more general physical and psychological factors that could potentially act as barriers to treatment adherence and recovery.
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NewsBot · Oct 25, 2019

Incidence, prevalence, and management of plantar heel pain: a retrospective cohort study in Dutch primary care.
Rasenberg N et al
Br J Gen Pract. 2019 Oct 21

BACKGROUND:
Plantar heel pain (PHP) is a common cause of foot complaints in general practice. However, information on the occurrence and practical management is scarce.

AIM:
The aim of this study was to determine the incidence and prevalence of PHP in Dutch primary care and to gain insight into the types of treatments provided to patients with PHP in primary care.

DESIGN AND SETTING:
A cohort study was conducted using a healthcare database containing the electronic general practice medical records of approximately 1.9 million patients throughout the Netherlands.

METHOD:
A search algorithm was defined and used to identify cases of PHP from January 2013 to December 2016. Descriptive statistics were used to obtain the incidence and prevalence. Data on the management of PHP were manually validated in a random sample of 1000 patients.

RESULTS:
The overall incidence of PHP was 3.83 cases (95% confidence interval [CI] = 3.77 to 3.89) per 1000 patient-years, the incidence in females was 4.64 (95% CI = 4.55 to 4.72), and 2.98 (95% CI = 2.91 to 3.05) in males. The overall prevalence of PHP was 0.4374% (95% CI = 0.4369 to 0.4378%). Incidence of PHP peaked in September and October of each calendar year. The most commonly applied strategies were a wait-and-see policy (18.0%, n = 168), use of non-steroidal anti-inflammatory drugs (NSAIDs) (19.9%, n = 186), referral to a paramedical podiatric specialist (19.7%, n = 184), and advice to wear insoles (16.4%, n = 153). Treatment strategies varied greatly among GPs.

CONCLUSION:
There was large variation in treatment strategies of GPs for patients with PHP. GPs should be aware of conflicting evidence for interventions, such as insoles, and focus more on exercises for which there is evidence for effectiveness.
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NewsBot · Jan 17, 2023

Prevalence of Plantar Heel Pain Among School Teachers in Medina Region, Saudi Arabia: A Cross-Sectional Study
Yousef Alrashidi et al
Cureus. 2022 Nov 23;14(11):e31821

Background Plantar heel pain (PHP) can be a common medical complaint among people with both sedentary and active lifestyles due to varied causes. It can affect the quality of life and result in significant disability. Despite many studies on PHP, few have focused on a specific population, such as school teachers. School teachers represent a significant proportion of the population of Medina, and addressing such a complaint and its possible relevant factors, which are most likely to be common among them due to their comparable job duties, will aid us in determining the relationships between personal characteristics, work-related factors, and PHP, as well as in formulating management plans. This study aims to identify the prevalence of PHP and its determinants among school teachers in the Medina region of Saudi Arabia. Methodology This cross-sectional study aims to identify the prevalence of PHP in school teachers. It was conducted in the Medina region of Saudi Arabia. A self-administered, online, validated questionnaire was created and used for data collection. Consent was taken from all participants before answering the questionnaire. Participation was voluntary, and all participants could withdraw from the study at any time. Data were kept confidential and only accessible by the primary investigator, co-investigators, and the statistician; hence, secondary and tertiary blinding was not done. Results Among those who reported PHP, the highest prevalence was among those who did not exercise regularly (94.7%), followed by middle-aged women (64.3%) and those with a high body mass index (44.5%), previous foot problems (43.2%), and chronic medical diseases (41.9%). PHP was less prevalent in male teachers, those with normal body mass index, and those who spent less time standing, had no previous foot problems, and exercised regularly. Most (88.1%) participants with PHP had other musculoskeletal pain, particularly in the lower back (62.6%) and knee (40.1%). Conclusions Teachers can be apprised about the importance of consuming a well-balanced diet and exercising regularly to maintain a healthy weight. We advocate educational programs as they can assist people to understand the need to obtain medical help when they are experiencing pain.
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NewsBot · Sep 28, 2023

PREVALENCE OF HEEL PAIN AND IT’S FUNCTIONAL IMPAIRMENT AMONG WORKING WOMEN
Anusha Singh, Dr. Sanghamitra Jena (PT)
Source

Introduction: Heel pain is a broad terminology describing pain and discomfort experienced in or around the base of the foot. There are several other terms to describe heel pain, notably jogger's heel, gonorrheal heel, tennis heel, PF, and policeman's heel. Heel discomfort can be brought on by a range of bone diseases, systemic diseases, and soft tissue disorders. Examination of the bottom leg's history and clinical condition are used to narrow the differential diagnosis and determine the anatomic cause of the heel discomfort.

Methodology: A population-based cross-sectional approach was carried out. The research targeted working women who were suffering from heel pain among multiple working centres in the Delhi-NCR area. A 200 population of working women aged between 20 to 50 years were sampled that fulfilled the inclusion criteria. A self- administrated questionnaire was circulated in the google form that consists of demographic details, NPRS and FADI scale to find out intensity of pain and associated functional impairements among women with heel pain.

Results: Women experiencing heel pain weigh between 61.35 ±10.93 kg on average. 91.5 % said they'd had heel discomfort in the previous several weeks, while 8.5% claimed they hadn't. As an outcome, the mean NPRS score is 5.92± 2.470 and average FADI score was 64.89 ±1.236 out of a possible 104 points. A strong correlation was found between age, weight, NPRS and FADI score. A strong negative correlation of FADI final score with NPRS was seen (r = -5.85)

Conclusion: The majority of working women reported experiencing heel discomfort, especially in the last several weeks or months. Teaching, nursing, and housekeeping were the three most prevalent occupations. Responders reported moderate to somewhat severe pain, which was accompanied by functional impairment when trying everyday tasks. The substantial negative correlation between FADI and NPRS is another finding of our study
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