Risk Factors and Treatment Effectiveness in the Recovery and Recurrence of Plantar Fasciitis: A Single-Center Study...

Plantar fasciitis is a frequent cause of heel pain, and local evidence describing risk factors, recurrence patterns, and treatment outcomes in Saudi Arabia remains limited.

The objective of the study is to investigate the epidemiology, risk factors, treatment types and outcomes, recurrence rates, and recovery patterns of plantar fasciitis at King Saud Medical City in Riyadh, Saudi Arabia.

A retrospective cohort study was conducted at King Saud Medical City in Riyadh, Saudi Arabia, from May 1, 2023, to November 28, 2025. Due to limited follow-up documentation in routine hospital records, data were collected using structured telephone interviews, while the hospital electronic medical record system was used to confirm eligibility by verifying the diagnosis of plantar fasciitis and to obtain updated contact information; verbal consent was obtained prior to interviews. A total of 121 adult patients were identified; 10 were included in a pilot phase and excluded, leaving 111 eligible patients, of whom 93 completed interviews and were included in the final dataset. Responses were entered into a structured electronic form during interviews and exported for cleaning and verification prior to analysis. Categorical variables were summarized using frequencies and percentages, and ordinal outcomes were summarized using medians and interquartile ranges; associations were evaluated using the Chi-squared test, with statistical significance set at a probability value less than 0.05.

Among 93 participants, the largest age group was 51 to 60 years (29 (31.18%)), and women comprised 51 (54.84%). Sedentary occupation (73 (78.49%)) and physical inactivity based on World Health Organization recommendations (69 (74.19%)) were common. Most participants reported a single episode over the previous two years (76 (81.72%)), while recurrence occurred in 17 (18.28%). Symptom duration in the first episode was predominantly acute (72 (77.40%)), with fewer subacute (17 (18.30%)) and chronic (4 (4.30%)) presentations; recurrent episodes showed a shift toward longer subacute courses without chronicity. Management remained predominantly conservative across episodes, with rest or activity modification and non-steroidal anti-inflammatory drugs used in every reported episode; during the first episode, stretching exercises (68 (73.10%)), avoidance of non-supportive footwear (63 (67.70%)), and external support (58 (62.40%)) were commonly reported. Pain severity improved after treatment across episodes, with median pain scores decreasing from 5.00 to 2.00 in the first episode, 5.00 to 1.00 in the second episode, 5.00 to 1.00 in the third episode, and 4.00 to 3.00 in the fourth episode. Satisfaction was high, with 52 (55.91%) very satisfied and 25 (26.88%) satisfied. Recurrence was significantly associated with obesity, with a Chi-squared value of 4.25 and a probability value of 0.039; recurrence was more frequent among obese than non-obese participants, 28.57% versus 9.80%.

In our cohort from King Saud Medical City, plantar fasciitis was managed mainly with conservative measures and was associated with meaningful patient-reported pain improvement and high satisfaction; however, recurrence was not uncommon and was significantly associated with obesity, supporting the importance of addressing weight-related risk alongside conservative management to reduce recurrence.