Managing Chronic Plantar Fasciitis: When Conservative Strategies Fail

Plantar fasciitis is a common condition that causes heel pain in many adults. It occurs when the plantar fascia, a fibrous band of connective tissue running from the calcaneus along the sole of the foot, becomes inflamed or fibrotic or when it breaks down (Figure 1).1 Plantar fasciitis occurs most commonly in adults between the ages of 40 and 60 years2 and accounts for approximately 1 million office visits per year.3 The condition may occur earlier in people who run, are obese, have high arches, demonstrate excessive pronation of the foot, or stand for long periods on hard surfaces. Many patients with plantar fasciitis experience improvement with conservative measures, such as NSAID use, stretching, and change in footwear; however, an estimated 20% of patients do not find relief.2 The pain of chronic plantar fasciitis can be debilitating, resulting in a loss of function, so it is important for providers to be aware of other treatment options available to these patients.