Fascite plantare – Clinical review

Plantar fasciitis
John Orchard
BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6603 (Published 10 October 2012)

Plantar fasciitis unfortunately has the reputation of being a trivial condition clinically, in that it is described as benign and self limiting1 with limited evidence to support any of the common treatments. However, the medical profession is starting to appreciate that the greatest public health challenge in Western countries is physical inactivity. In this context, plantar fasciitis, which inhibits physical activity due to pain, can be given its due respect. Many patients who develop plantar fasciitis are already overweight. Once everyday walking becomes painful, the difficulty in losing weight is extreme and the risk of gaining further weight increases, contributing to a worsening of the condition. Since being inactive and overweight are major risk factors for many diseases, an efficient treatment paradigm for plantar fasciitis—as opposed to a “wait and see” approach—becomes essential.

This review aims to assist the clinician in prioritising the most promising treatment options for a specific patient, rather than providing a comprehensive list of all the options with little guidance as to where to start in an individual case.