The diagnosis and management of plantar fasciitis

Plantar fasciitis is the most common diagnosis for pain in the inferior aspect of the heel and accounts for 10% of running injuries seen. It primarily afflicts the middle-aged and elderly populations and athletes. The diagnosis is relatively easy for the primary care provider to establish because of the typical presentation. Diagnostic studies usually are not warranted, but a careful history and physical examination are essential in identifying various predisposing anatomical, biomechanical, and environmental factors. This article addresses a wide array of conservative measures available in developing an individualized management approach based on the contributing factors identified. Because 90% or more respond to conservative measures, the primary care provider can manage the care of the majority of clients who present with plantar fasciitis. To avoid painful recurrence, measures effective in relieving symptoms need to be included in an ongoing plan of prevention.