RECENT ADVANCES IN THE MANAGEMENT OF PLANTAR FASCIITIS: A SYSTEMATIC REVIEW
Abstract
Introduction and Purpose: Plantar fasciitis (PF) is one of the most common causes of heel pain in adults, with a lifetime incidence of about 10%. Diagnosis is primarily clinical, based on patient history and physical examination. This study aims to present and compare treatment modalities for PF, including conservative and surgical options.
Brief Description of the State of Knowledge: The plantar fascia is a dense connective tissue crucial for supporting the medial longitudinal arch and enabling efficient gait. PF most often affects individuals aged 45–65 and is frequently associated with elevated body mass index. A characteristic symptom is sharp heel pain upon rising in the morning, which improves with walking. Physical examination may include the Silfverskiöld test to assess gastrocnemius contracture. Imaging, such as radiography, ultrasonography, or MRI, can support diagnosis. Although PF often recurs, 85–90% of patients respond to conservative treatment. Historically, management relied on night splints, orthoses, NSAIDs, and corticosteroid injections. Current strategies emphasize stretching and strengthening exercises. Surgical treatment is reserved for refractory cases.
Materials and methods: In this article, we utilized scientific literature describing various treatment approaches for patients with PF. Particular attention was given to diagnostic strategies and the appropriate use of imaging modalities. Treatment efficacies were compared, and potential adverse effects were also discussed.
Conclusions: Multiple therapies for PF show similar efficacy. Conservative management should remain first-line, with surgery considered when nonoperative measures fail. Successful outcomes depend on individualized treatment, patient education, and adherence. Collaboration between orthopedic surgeons and physiotherapists plays a key role in optimizing care.
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