Plantar fasciopathy: Revisiting the risk factors

doi:10.1016/j.fas.2014.03.003

Foot and Ankle Surgery

Volume 20, Issue 3, September 2014, Pages 160-165

https://doi.org/10.1016/j.fas.2014.03.003 Get rights and content

Abstract

Background

Plantar fasciopathy is the most common cause of acquired sub-calcaneal heel pain in adults. To-date, research of this condition has mainly focused on management rather than causal mechanisms. The aetiology of plantar fasciopathy is likely to be multifactorial, as both intrinsic and extrinsic risk factors have been reported. The purpose of this review is to critically reevaluate risk factors for plantar fasciopathy.

Methods

A detailed literature review was undertaken using English language medical databases.

Results

No clear consensus exists as to the relative strength of the risk factors reported.

Conclusions

To-date numerous studies have examined various intrinsic and extrinsic risk factors implicated in the aetiology of plantar fasciopathy. How these factors interact may provide useful data to establish an individuals’ risk profile for plantar fasciopathy and their potential for response to treatment. Further research is indicated to rank the relative significance of these risk factors.

Introduction

Similar to other conditions where pathological origin is unclear, chronic plantar heel pain has become a generalized term that includes several pathological conditions that affect the heel [1]. Heel pain may be the result of arthritic, neurological, traumatic, or other systemic conditions, although the overwhelming cause is mechanical in origin [2], [3].

Plantar fasciitis is a commonly reported cause of plantar heel pain [4], [5], [6], [7]. Terminology for this condition is confusing, as a degenerative process of micro tears (fasciosis) similar to tendinosis, a degeneration of collagen in tendons [8], and fascial thickening predominates over inflammatory changes. Similar histopathological changes have been reported in tendon and ligament disorders elsewhere [8] hence redefinition of the condition from plantar fasciitis to plantar fasciopathy (PF) may better reflect the underlying pathology within the fascia, which rarely includes inflammatory cells.

The purpose of this paper is to critically reevaluate risk factors for PF.

Section snippets

Background

Relevant clinical aspects of PF are included to help support the discussion of risk factors.

Methods

The following criteria were used to search the literature:

1.
English language human studies.
2.
Published after 1988.
3.
Electronic databases: Cochrane library, BioMed Central, EMBASE, CINAHL, AMED, Ovid, Swetswise, PubMed, Highwire, SportDiscus, ISI web of knowledge, Science direct, Science citation index, The Lancet.com, BMJ clinical evidence, MEDLINE, Scirus.com, Index to thesis, Controlledtrials.com UK national research register for on-going/recently completed trials.
4.
MeSH terms used alone or in

Discussion

Although PF is the most common soft-tissue cause of heel pain [5], [19] its aetiology is not fully understood [22], [38], [39], [40], [41]. The condition is considered to be multifactorial [6], [17], [20] and numerous risk factors are implicated in its development (Table 1). The evidence supporting these factors is limited and their relative importance is unclear. Several causes have been hypothesized, with the most common being overuse due to prolonged weight-bearing, obesity, unaccustomed

Conclusion

Plantar fasciopathy is a common cause of sub calcaneal heel pain. The condition represents an important economic burden to health services due its potential to become chronic in nature. Studies supporting both intrinsic and extrinsic risk factors suggest complex multifactorial soft tissue pathology. Research to examine a possible genetic basis for developing this condition may advance our knowledge of the intrinsic risk profile, provide a novel and alternative approach to understanding this

Conflict of interest

None declared.

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CLO surgery significantly improved patients' quality of life of patients with symptomatic FFF. Also, kinetic results showed improvement in some parameters of gait results after CLO surgery. Thus, our study suggested CLO surgery as an excellent surgical option for symptomatic FFF.
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ReviewPlantar fasciopathy: Revisiting the risk factors

Abstract

Background

Methods

Results

Conclusions

Introduction

Section snippets

Background

Methods

Discussion

Conclusion

Conflict of interest

J Foot Ankle Surg

J Foot Ankle Surg

J Foot Ankle Surg

Eur J Radiol

J Foot Ankle Surg

J Foot Ankle Surg

J Sci Med Sport

Phys Med Rehabil

Foot

Foot

J Foot Ankle Surg

Foot

Foot

J Foot Ankle Surg

Foot Ankle Int

Clin Biomech

Biochem Biophys Res Commun

Eur Radiol

Painful heel: MR imaging findings

Radiographics

Plantar fasciitis – a clinical review

Br Med J

Plantar fasciitis

N Engl J Med

Injected corticosteroids for treating plantar heel pain in adults

Cochrane Database Syst Rev

Overuse tendon conditions: time to change a confusing terminology

Arthroscopy

Plantar fascia: imaging diagnosis and guided treatment

Semin Musculoskelet Radiol

Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis

J Foot Ankle Res

Ultrasound scanning for recalcitrant plantar faciopathy: basis of a new classification

Skelet Radiol

Plantar fasciitis – clinical review

Br Med J

Clinical presentation and self-reported patterns of pain and function in patients with plantar heel pain

Foot Ankle Int

Obesity and pronated foot type may increase the risk of chronic heel pain: a matched case–control study

BMC Musculoskelet Disord

The epidemiology of plantar fasciitis

Low Extrem Rev

Painful heel syndrome: results of nonoperative treatment

Foot Ankle Int

Risk factors for plantar fasciitis: a match controlled study

J Bone Joint Surg

Ultrasound guided corticosteroid injection for plantar fasciitis: randomized controlled trial

Br Med J

Prevalence and correlates of foot pain in population-based study: the North West Adelaide health study

J Foot Ankle Res

Review
Plantar fasciopathy: Revisiting the risk factors