Degenerative condition of the plantar fascia that causes sharp pain on the bottom of the foot pain
Aetiology
- Repetitive stress/overload or degenerative condition
Risk factors
- Physical overload - excessive exercise, excessive weight (obesity)
- Age - the cushioning heel fat pad atrophies with age
- Abnormal foot shape - splanovalgus or cavovarus
- Frequent walking on hard floors with poor cushioning in shoes
Clinical presentation
Symptoms
- Start up pain after rest on the instep of the foot (at the origin of the plantar aponeurosis on the distal plantar aspect of the calcaneal tuberosity)
- Pain can be worse after exercise
Signs
- Fullness or swelling on plantarmedial aspect of heel
- Localised tenderness on palpation of the plantar aspect of heel and/or plantarmedial aspect of heel
- Tinel's test positive for Baxter's nerve
Investigations
Management
- Night splints, taping, heel cups or medial arch supports
- Physiotherapy - achilles and plantar fascia stretching exercises
- Corticosteroid injection may alleviate symptoms
- Symptoms can take up to two years to resolve
- Surgical release of the plantar fascia risks injury to the plantar nerves and it is unclear whether there is an actual benefit
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