Editing Plantar fasciitis (section)

{{short description|Connective tissue disorder of the heel}}
{{good article}}
{{Infobox medical condition (new)
| name          = Plantar fasciitis
| image         = PF-PainAreas.jpg
| caption       = Most common areas of pain in plantar fasciitis
| field         = [[Orthopedics]], [[sports medicine]], [[plastic surgery]], [[podiatry]]
| synonyms      = Plantar fasciosis, plantar fasciopathy, jogger's heel, heel spur syndrome<ref name="Toronto_2017"/>
| symptoms      = [[Pain]] in the [[heel]] and [[Sole (foot)|bottom of the foot]]<ref name="Bee_2014"/>
| complications = 
| onset         = Gradual<ref name="Rosenbaum_2014"/>
| duration      = 
| causes        = Unclear<ref name="Bee_2014"/>
| risks         = Overuse (long periods of standing), [[obesity]], [[Pronation of the foot|inward rolling of the foot]]<ref name="Bee_2014"/><ref name="Goff_2011"/>
| diagnosis     = Based on symptoms, [[ultrasound]]<ref name="Bee_2014"/>
| differential  = [[Osteoarthritis]], [[ankylosing spondylitis]], [[heel pad syndrome]], [[reactive arthritis]]<ref name="Cutts_2012"/><ref name="Tu_2011"/>
| prevention    = 
| treatment     = [[Conservative management]]<ref name="Goff_2011"/><ref name="Tahririan_2012"/>
| medication    = 
| prognosis     = 
| frequency     = ~4%<ref name="Bee_2014"/><ref name="Cutts_2012"/>
| deaths        = 
}}

<!-- Definition and symptoms -->
'''Plantar fasciitis''' or '''plantar heel pain''' is a disorder of the [[plantar fascia]], which is the [[connective tissue]] that supports the [[Arches of the foot|arch of the foot]].<ref name="Bee_2014"/> It results in pain in the [[heel]] and [[Sole (foot)|bottom of the foot]] that is usually most severe with the first steps of the day or following a period of rest.<ref name="Bee_2014"/><ref name="Goff_2011"/> Pain is also frequently brought on by [[dorsiflexion|bending the foot and toes up towards the shin]].<ref name="Rosenbaum_2014"/><ref name="Goff_2011">{{cite journal | vauthors = Goff JD, Crawford R | title = Diagnosis and treatment of plantar fasciitis | journal = American Family Physician | volume = 84 | issue = 6 | pages = 676–682 | date = September 2011 | pmid = 21916393 | url = https://www.aafp.org/afp/2011/0915/p676.html }}</ref> The pain typically comes on gradually, and it affects both feet in about one-third of cases.<ref name="Bee_2014"/><ref name="Rosenbaum_2014"/>

<!-- Risk factors, mechanism, and diagnosis -->
The cause of plantar fasciitis is not entirely clear.<ref name="Bee_2014"/> Risk factors include overuse, such as from long periods of standing, an increase in exercise, and [[obesity]].<ref name="Bee_2014"/><ref name="Goff_2011"/> It is also associated with [[pronation of the foot|inward rolling of the foot]], a tight [[Achilles tendon]], and a sedentary lifestyle.<ref name="Bee_2014"/><ref name="Goff_2011"/> It is unclear if [[calcaneal spur|heel spurs]] have a role in causing plantar fasciitis even though they are commonly present in people who have the condition.<ref name="Bee_2014"/> Plantar fasciitis is a disorder of the insertion site of the ligament on the bone characterized by micro tears, breakdown of collagen, and scarring.<ref name="Bee_2014"/> Since [[inflammation]] plays either a lesser or no role, a review proposed it be renamed '''plantar fasciosis'''.<ref name="Bee_2014">{{cite journal | vauthors = Beeson P | title = Plantar fasciopathy: revisiting the risk factors | journal = Foot and Ankle Surgery | volume = 20 | issue = 3 | pages = 160–165 | date = September 2014 | pmid = 25103701 | doi = 10.1016/j.fas.2014.03.003 | url = http://nectar.northampton.ac.uk/6575/1/Beeson20146575.pdf }}</ref><ref name="Lareau_2014">{{cite journal | vauthors = Lareau CR, Sawyer GA, Wang JH, DiGiovanni CW | title = Plantar and medial heel pain: diagnosis and management | journal = The Journal of the American Academy of Orthopaedic Surgeons | volume = 22 | issue = 6 | pages = 372–380 | date = June 2014 | pmid = 24860133 | doi = 10.5435/JAAOS-22-06-372 | s2cid = 43241954 }}</ref> The presentation of the symptoms is generally the basis for diagnosis; with [[ultrasound]] sometimes being useful if there is uncertainty.<ref name="Bee_2014"/> Other conditions with similar symptoms include [[osteoarthritis]], [[ankylosing spondylitis]], [[heel pad syndrome]], and [[reactive arthritis]].<ref name="Cutts_2012"/><ref name="Tu_2011">{{cite journal | vauthors = Tu P, Bytomski JR | title = Diagnosis of heel pain | journal = American Family Physician | volume = 84 | issue = 8 | pages = 909–916 | date = October 2011 | pmid = 22010770 | url = https://www.aafp.org/afp/2011/1015/p909.html }}</ref>

<!-- Prevention and treatment -->
Most cases of plantar fasciitis resolve with time and conservative methods of treatment.<ref name="Goff_2011"/><ref name="Tahririan_2012">{{cite journal | vauthors = Tahririan MA, Motififard M, Tahmasebi MN, Siavashi B | title = Plantar fasciitis | journal = Journal of Research in Medical Sciences | volume = 17 | issue = 8 | pages = 799–804 | date = August 2012 | pmid = 23798950 | pmc = 3687890 }}</ref> For the first few weeks, those affected are usually advised to rest, change their activities, take [[analgesics|pain medications]], and stretch.<ref name="Goff_2011"/> If this is not sufficient, [[physiotherapy]], [[orthotics]], [[Splint (medicine)|splinting]], or [[corticosteroid|steroid injections]] may be options.<ref name="Goff_2011"/> If these measures are not effective, additional measures may include [[extracorporeal shockwave therapy]] or surgery.<ref name="Goff_2011"/>

<!-- Epidemiology -->
Between 4% and 7% of the general population has heel pain at any given time: about 80% of these are due to plantar fasciitis.<ref name="Bee_2014"/><ref name="Cutts_2012">{{cite journal | vauthors = Cutts S, Obi N, Pasapula C, Chan W | title = Plantar fasciitis | journal = Annals of the Royal College of Surgeons of England | volume = 94 | issue = 8 | pages = 539–542 | date = November 2012 | pmid = 23131221 | pmc = 3954277 | doi = 10.1308/003588412X13171221592456 }}</ref> Approximately 10% of people have the disorder at some point during their life.<ref name="Zhiyun_2013">{{cite journal | vauthors = Zhiyun L, Tao J, Zengwu S | title = Meta-analysis of high-energy extracorporeal shock wave therapy in recalcitrant plantar fasciitis | journal = [[Swiss Medical Weekly]] | volume = 143 | pages = w13825 | date = July 2013 | pmid = 23832373 | doi = 10.4414/smw.2013.13825 | doi-access = free }}</ref> It becomes more common with age.<ref name="Bee_2014"/> It is unclear if one sex is more affected than the other.<ref name="Bee_2014"/>