• 1

    Martin JE, Hosch JC, Goforth WP, et al: Mechanical treatment of plantar fasciitis: a prospective study. .JAPMA 91::55. ,2001. .

  • 2

    Leach R, Jones R, Silva T: Rupture of the plantar fascia in athletes. .J Bone Joint Surg Am 60::537. ,1978. .

  • 3

    Gross MT, Byers JM, Krafft JL, et al: The impact of custom semirigid foot orthotics on pain and disability for individuals with plantar fasciitis. .J Orthop Sports Phys Ther 32::149. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Lynch DM, Goforth WP, Martin JE, et al: Conservative treatment of plantar fasciitis: a prospective study. .JAPMA 88::375. ,1998. .

  • 5

    DiGiovanni BF, Nawoczenski DA, Lintal ME, et al: Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain: a prospective, randomized study. .J Bone Joint Surg Am 85::1270. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Bolgla LA, Malone TR: Plantar fasciitis and the windlass mechanism: a biomedical link to clinical practice. .J Athl Train 39::77. ,2004. .

  • 7

    Pfeffer G, Bacchetti P, Deland J, et al: Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis. .Foot Ankle Int 20::214. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Kwong PK, Kay D, Voner RT, et al: Plantar fasciitis: mechanics and pathomechanics of treatment. .Clin Sports Med 7::119. ,1988. .

  • 9

    Noerdlinger MA, Fadale PD: The role of injectable corticosteroids in orthopedics. .Orthopedics 24::400. ,2001. .

  • 10

    A How to Reference Guide: Periarticular and Intra-articular Injections, Pharmacia, Kalamazoo, MI. ,2002. .

  • 11

    Genovese MC: Joint and soft-tissue injection: a useful adjuvant to systemic and local treatment. .Postgrad Med 103::125. ,1998. .

  • 12

    Quaschnick MS: The diagnosis and management of plantar fasciitis. .Nurse Pract 21::50. ,1996. .

  • 13

    Clinical Practice Guideline Heel Pain Panel: The diagnosis and treatment of heel pain. .J Foot Ankle Surg 40::329. ,2001. .

  • 14

    Sellman JR: Plantar fascia rupture associated with corticosteroid injection. .Foot Ankle Int 15::376. ,1994. .

  • 15

    Ahstrom JP Jr: Spontaneous rupture of the plantar fascia. .Am J Sports Med 16::306. ,1988. .

  • 16

    Saxena A, Fullem B: Plantar fascia ruptures in athletes. .Am J Sports Med 32::662. ,2004. .

  • 17

    Buchbinder R: Clinical practice: plantar fasciitis. .N Engl J Med 350::2159. ,2004. .

  • 18

    Lemont H, Ammirati KM, Usen N: Plantar fasciitis: a degenerative process (fasciosis) without inflammation. .JAPMA 93::234. ,2003. .

  • 19

    Riddle DL, Pulisic M, Pidcoe P, et al: Risk factors for plantar fasciitis: a matched case-control study. .J Bone Joint Surg Am 85::872. ,2003. .

  • 20

    Kibler WB, Goldberg C, Chandler TJ: Functional biomechanical deficits in running athletes with plantar fasciitis. .Am J Sports Med 19::66. ,1991. .

  • 21

    Furey JG: Plantar fasciitis: the painful heel syndrome. .J Bone Joint Surg Am 57::672. ,1975. .

  • 22

    Fornaciari G, Salvarani C, Beltrami M, et al: Musculoskeletal manifestations in inflammatory bowel disease. .Can J Gastroenterol 15::399. ,2001. .

  • 23

    Lehman TJ: Enthesitis, arthritis, and heel pain. .JAPMA 89::18. ,1999. .

  • 24

    Kosinski M, Lilja E: Infectious causes of heel pain. .JAPMA 89::20. ,1999. .

Current Approaches to the Management of Plantar Heel Pain Syndrome, Including the Role of Injectable Corticosteroids

Stephen M. Pribut Private practice, 2141 K St NW, Ste 702, Washington, DC 20037.

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Plantar heel pain syndrome, which has a multifactorial and widely disputed etiology, affects more than 2 million people annually. A survey was conducted of members of the American Academy of Podiatric Sports Medicine about their strategies for managing plantar heel pain syndrome, especially the role of injectable corticosteroids. The respondents tended to be experienced (10–24 years in practice) podiatric physicians with a concentration in sports medicine. They reported that for early-stage plantar heel pain syndrome they generally recommend avoidance of wearing flat shoes and walking barefoot (92%), use of over-the-counter arch supports and heel cushions (90%), regular stretching of the calf muscles (88%), strapping of the foot (75%), cryotherapy applied directly to the affected part of the foot (67%), and nonsteroidal anti-inflammatory drug therapy (60%). When these measures fail to relieve heel pain, most of the responding podiatric physicians recommend using custom orthotic devices (60%) and corticosteroid injections (60%) as intermediate therapy. Surgical plantar fasciotomy (88%), cast immobilization (77%), and extracorporeal shockwave therapy (69%) are generally recommended as late-stage therapy for resistant cases. A staged approach seems to yield the best results in treatment of this common condition. (J Am Podiatr Med Assoc 97(1): 68–74, 2007)