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Effect of Surgical Weight Loss on Plantar Fasciitis and Health-Care Use

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  • 1 Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH.
  • | 2 Department of General Surgery, Carolinas Medical Center, Charlotte, NC.
  • | 3 Statistical Center for HIV/AIDS Research and Prevention, Seattle, WA.
  • | 4 Kent State University College of Podiatric Medicine, Independence, OH.
  • | 5 Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
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Background:

Plantar fasciitis (PF) is one of the most common causes of heel pain. Obesity is recognized as a major factor in PF development, possibly due to increased mechanical loading of the foot due to excess weight. The benefit of bariatric surgery is documented for other comorbidities but not for PF.

Methods:

A retrospective medical record review was performed for patients with PF identified from a prospectively maintained database of the Cleveland Clinic Bariatric and Metabolic Institute. Age, sex, surgery, excess weight loss, body mass index (BMI), and health-care use related to PF treatment were abstracted. Comparative analyses were stratified by surgery type.

Results:

Two hundred twenty-eight of 10,305 patients (2.2%) had a documented diagnosis of PF, of whom 163 underwent bariatric surgery and were included in the analysis. Eighty-five percent of patients were women, mean ± SD age was 52.2 ± 9.9 years, and mean ± SD preintervention BMI was 45 ± 7.7. Postoperatively, mean ± SD BMI and excess weight loss were 34.8 ± 7.8 and 51.0% ± 20.4%, respectively. One hundred forty-six patients (90%) achieved resolution of PF and related symptoms. The mean ± SD number of treatment modalities used for PF per patient preoperatively was 1.9 ± 1.0 (P = .25). After surgery, the mean ± SD number of treatment modalities used per patient was reduced to 0.3 ± 0.1 (P = .01).

Conclusions:

We present new evidence suggesting that reductions in BMI after bariatric surgery may be associated with decreasing the number of visits for PF and may contribute to symptomatic improvement.

Corresponding author: Mena Boules, Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Ave, A100, Cleveland, OH 44195. (E-mail: menaboules@hotmail.com)