Clinical characteristics of the causes of plantar heel pain

Tae Im Yi, Ga Eun Lee, In Seok Seo, Won Seok Huh, Tae Hee Yoon, Bo Ra Kim, Tae Im Yi, Ga Eun Lee, In Seok Seo, Won Seok Huh, Tae Hee Yoon, Bo Ra Kim

Abstract

Objective: The objectives of this study were to investigate the causes of plantar heel pain and find differences in the clinical features of plantar fasciitis (PF) and fat pad atrophy (FPA), which are common causes of plantar heel pain, for use in differential diagnosis.

Method: This retrospective study analyzed the medical records of 250 patients with plantar heel pain at the Foot Clinic of Rehabilitation Medicine at Bundang Jesaeng General Hospital from January to September, 2008.

Results: The subjects used in this study were 114 men and 136 women patients with a mean age of 43.8 years and mean heel pain duration of 13.3 months. Causes of plantar heel pain were PF (53.2%), FPA (14.8%), pes cavus (10.4%), PF with FPA (9.2%), pes planus (4.8%), plantar fibromatosis (4.4%), plantar fascia rupture (1.6%), neuropathy (0.8%), and small shoe syndrome (0.8%). PF and FPA were most frequently diagnosed. First-step pain in the morning, and tenderness on medial calcaneal tuberosity correlated with PF. FPA mainly involved bilateral pain, pain at night, and pain that was aggravated by standing. Heel cord tightness was the most common biomechanical abnormality of the foot. Heel spur was frequently seen in X-rays of patients with PF.

Conclusion: Plantar heel pain can be provoked by PF, FPA, and other causes. Patients with PF or FPA typically show different characteristics in clinical features. Plantar heel pain requires differential diagnosis for appropriate treatment.

Keywords: Fat pad atrophy; Plantar fasciitis; Plantar heel pain.

References

    1. Buchbinder R. Clinical practice. Plantar fasciitis. N Engl J Med. 2004;350:2159–2166.
    1. Bordelon RL. Subcalcaneal pain. A method of evaluation and plan for treatment. Clin Orthop. 1983;177:49–53.
    1. Neufeld SK, Cerrato R. Plantar fasciitis: evaluation and treatment. J Am Acad Orthop Surg. 2008;16:338–346.
    1. Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003;93:234–237.
    1. Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg Am. 2003;85-A:872–877.
    1. Baxter DE, Pfeffer GB. Treatment of chronic heel pain by surgical release of the first branch of the lateral plantar nerve. Clin Orthop Relat Res. 1992;279:229–236.
    1. Karabay N, Toros T, Hurel C. Ultrasonographic evaluation in plantar fasciitis. J Foot Ankle Surg. 2007;46:442–446.
    1. Rhee WI, Kim JM. Ultrasonographic findings of thickness and compressibility of heel pads in outpatient. J Korean Soc Med Ultrasound. 2004;23:213–218.
    1. Gould N. Graphing the adult foot and ankle. Foot Ankle. 1982;2:213–219.
    1. McCarthy DJ, Gorecki GE. The anatomical basis of inferior calcaneal lesions. A cryomicrotomy study. J Am Podiatry Assoc. 1979;69:527–536.
    1. Pfeffer G, Bacchetti P, Deland J, Lewis A, Anderson R, Davis W, Alvarez R, Brosdsky J, Cooper P, Frey C, et al. Comparison of custom and refabricated orthoses in the initial treatment of proximal plantar fasciitis. Foot Ankle Int. 1999;20:214–221.
    1. Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int. 2004;25:303–310.
    1. Forman WM, Green MA. The role of intrinsic musculature in the formation of inferior calcaneal exostoses. Clin Podiatr Med Surg. 1990;7:217–223.
    1. Inman VT, Ralston HJ, Todd F. Human walking. 2nd ed. Baltimore: Williams & Wilkins; 1994. pp. 45–72.
    1. Digiovanni BF, Nawoczenski DA, Malay DP, Graci PA, Williams TT, Wilding GE, Baumhauer JF. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up. J Bone Joint Surg. 2006;88:1775–1781.
    1. Davies MS, Weiss GA, Saxby TS. Plantar Fasciitis: how successful is surgical intervention? Foot Ankle Int. 1999;20:803–807.
    1. Williams PL, Smibert JG, Cox R, Mitchell R, Klenerman L. Imaging study of the painful heel syndrome. Foot Ankle. 1987;7:345–349.
    1. Dimarcangelo MT, Yu TC. Diagnostic imaging of heel pain and plantar fasciitis. Clin Podiatr Med Surg. 1997;14:281–301.

Source: PubMed

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