Journal Information
Vol. 3. Issue 4.
Pages 159-165 (July - August 2007)
Share
Share
Download PDF
More article options
Vol. 3. Issue 4.
Pages 159-165 (July - August 2007)
Full text access
Plantar Fasciitis: Evidence-Based Review of Treatment
Fascitis plantar: revisión del tratamiento basado en la evidencia
Visits
10957
Ana Lafuente Guijosa
Corresponding author
analagui@yahoo.es

Correspondence: Baños de Montemayor, 5 portal 2–7.º A. 28005 Madrid. España.
, Isabel O’Mullony Muñoz, Maruxa Escribá de La Fuente, Paula Cura-Ituarte
Unidad de Rehabilitación, Fundación Hospital Alcorcón, Alcorcón, Madrid, Spain
This item has received
Article information
Abstract
Objetive

To analyze the effectiveness of the interventions in the management of plantar fasciitis.

Material and method

The main medical and biomedical databases have been used: MedLine, Evidence Based Medicine, Cochrane Database of Systematic Review, Cochrane Register of Controlled Trials, EMBASE, and PEDRO (Physiotherapy Evidence Database). Metaanalysis, systematic reviews, reviews, and controlled or randomized clinical trials of interventions for heel pain have been selected.

Results

After an updated review of the treatment of plantar fasciitis, we have found several therapy options to treat this problem, but their efficacy is variable, and none show strong evidence of benefit. The use of plantar insoles and stretching exercises focused on plantar fascia have demonstrated limited evidence of benefit. Corticosteroid injections and iontophoresis with steroids have also demonstrated evidence of benefit, although limited and during a short time. The rest of interventions have not demonstrated enough evidence of benefit.

Conclusions

An evidence-based review of treatments of plantar fasciitis suggests that we must first recommend the use of conservative measures, easy to perform and of low cost, such as plantar soft insoles, plus specific stretching plantar fascia exercises. Limited evidence suggest that steroid injection or iontophoresis may be useful, but of transient effect, when conservative options fail.

Key words:
Plantar fasciitis
Heel pain
Painful heel syndrome
Review
Treatment
Clinical trial
Resumen
Objetivos

Analizar la eficacia de los tratamientos utilizados en la fascitis plantar.

Material y método

Se ha consultado los principales buscadores y bases de datos biomédicas: MEDLINE, Evidence Based Medicine, Cochrane Database of Systematic Reviews, Cochrane Register of Controlled Trials, EMBASE y PEDRO (Physiotherapy Evidence Database). Se seleccionó los estudios de mayor calidad científica: metaanálisis, revisiones sistemáticas, revisiones y ensayos clínicos controlados y/o aleatorizados de una o varias intervenciones para tratar el dolor plantar del talón.

Resultados

Tras realizar una revisión bibliográfica actualizada sobre el tratamiento de las fascitis plantar, se encontró que existen múltiples opciones terapéuticas, pero su eficacia es variable y no hay evidencia fuerte del beneficio de ninguna modalidad de tratamiento. Únicamente se encontró limitada evidencia de beneficio con la utilización de taloneras blandas, junto con la realización de cinesiterapia, principalmente ejercicios específicos de estiramiento de la fascia plantar. Con las infiltraciones y la iontoforesis con corticoides también se ha demostrado beneficio, aunque limitado y a corto plazo. Con el resto de los tratamientos no se ha hallado suficiente evidencia de beneficio.

Conclusiones

Según el análisis de la evidencia científica, ante una fascitis plantar debemos recomendar primero la utilización de medidas conservadoras, sencillas y de bajo coste, como taloneras blandas y ejercicios específicos de estiramiento de la fascia plantar. Si lo anterior no es eficaz, se puede administrar corticoides locales mediante infiltraciones o iontoforesis, aunque su efecto es transitorio.

Palabras clave:
Fascitis plantar
Dolor en la parte inferior del talón
Talalgia
Revisión
Tratamiento
Ensayo clínico
Full text is only aviable in PDF
References
[1.]
D. Singh, J. Angel, G. Bentley, S.G. Trevino.
Fortnightly review. Plantar fasciitis.
BMJ, 315 (1997), pp. 172-175
[2.]
M. Wolgin, C. Cook, C. Grahan, D. Mauldin.
Conservative treatment of plantar heel pain: long-term follow-up.
Foot Ankle Int, 15 (1994), pp. 97-102
[3.]
M.W. Cornwall, T.G. MCPoil.
Plantar fasciitis: Etiology and treatment.
J Orthop Sports Phys Ther, 29 (1999), pp. 756-760
[4.]
N. Sabir, S. Demirlenk, B. Yagci, N. Karabulut, S. Cubukcu.
Clinical utility of sonography in diagnosing plantar fasciitis.
J Ultrasound Med, 24 (2005), pp. 1041-1048
[5.]
J.F. Berkowitz, R. Kier, S. Rudicel.
Plantar fasciitis: MR imaging.
Radiology, 179 (1991), pp. 665-667
[6.]
D.L. Sackett, S.E. Straus, W.S. Richardson, W. Rosemberg, R.B. Haynes.
Evidence-Based-Medicine. How to practice an teach MBE.
2nd ed., Churchill Livingstone, (2000),
[7.]
M. van Tulder, A. Furlan, C. Bombardier, L. Bouter, Editorial Board of the Cochrane Collaboration Back Review Group.
Updated method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group.
[8.]
M. Powell, W.R. Post, J. Keener, S. Wearden.
Effective treatment of chronic plantar fasciitis with dorsiflexion night splints: a crossover prospective randomized outcome study.
Foot Ankle Int, 19 (1998), pp. 10-18
[9.]
J.E. Martin, J.C. Hosch, W.P. Goforth, R.T. Murff, D.M. Lynch, R.D. Odom.
Mechanical treatment of plantar fasciitis: a prospective study.
J Am Pod Med Assoc, 91 (2001), pp. 55-62
[10.]
R.A. Probe, M. Baca, R. Adams, C. Preece.
Nigth splint treatment for plantar fasciitis: a prospective randomized study.
Clin Orthop Relat Res, 368 (1999), pp. 190-195
[11.]
M.E. Batt, J.L. Tanji, N. Skattum.
Plantar fasciitis: a prospective randomized clinical trial of the tension night splint.
Clin J Sports Med, 6 (1996), pp. 158-162
[12.]
F. Crawford, C. Thomson.
Interventions for treating plantar heel pain.
Cochrane Database Syst Rev, 3 (2003), pp. CD000416
[13.]
A.J. Black.
A preliminary study of the comparative effectos of steroid injection versus orthosis (Viscoheel sofspot) on plantar fasciitis.
Quenn's University, (1996),
[14.]
G.B. Pfeffer, P. Bacchetti, J. Deland, A. Lewis, R. Anderson, W. Davis, et al.
Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis.
Foot Ankle Int, 20 (1999), pp. 214-221
[15.]
P.F. Davis, E. Severud, D.E. Baxter.
Painful heel syndrome: results of nonooperative treatment.
Foot Ankle Int, 15 (1994), pp. 531-535
[16.]
C.C. Young, D.S. Rutherford, M.W. Niedfeldt.
Treatment of plantar fasciitis.
Am Fam Phys, 63 (2001), pp. 467-474
[17.]
D. Porter, E. Barrill, K. Oneacr, B.D. May.
The effects of duration and frequency of Achilles tendon stretching on dorsiflexion and outcome in painful heel syndrome: a randomized, blinded, controlled study.
Foot Ankle Int, 23 (2002), pp. 619-624
[18.]
B.F. diGiovanni, D.A. Nawoczenski, M.C. Lintal, E.A. Moore, J.C. Murray, G.E. Wilding, et al.
Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain.
J Bone Joint Surg (Am), 85 (2003), pp. 1270-1277
[19.]
B.F. diGiovanni, D.A. Nawoczenski, D.P. Malay, P.A. Graci, T.T. Williams, G.E. Wilding, et al.
Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis.
J Bone Joint Surg (Am), 88 (2006), pp. 1775-1781
[20.]
F. Crawford, D. Atkins, P. Young, J. Edwards.
Steroid injection for heel pain: evidence of short-term effectiveness. A randomized controlled trial.
Rheumatology (Oxford), 38 (1999), pp. 974-977
[21.]
S. Kriss.
Heel pain: an investigation into its etiology and management [tesis].
University of Westminster, (1990),
[22.]
D.M. Lynch, W.P. Gogorth, J.E. Martin, R.D. Odom, C.K. Preece, M.W. Kotter.
Conservative treatment of plantar fasciitis. A prospective study.
J Am Pod Med Assoc, 88 (1998), pp. 375-380
[23.]
A.F. Tallia, D.A. Cardone.
Diagnostic and therapeutic injection of the ankle and foot.
Am Fam Phys, 68 (2003), pp. 1356-1362
[24.]
J.I. Acevedo, J.L. Baskin.
Complications of plantar fascia rupture associated with corticosteroid injection.
Foot Ankle Int, 19 (1998), pp. 91-97
[25.]
S.D. Gudeman, S.A. Eisele, R.S. Heidt, A.J. Colosimo, A.L. Stroupe.
Treatment of plantar fasciitis by iontophoresis at 0.4% dexamethasone. A randomized, double-blind, placebo-controlled study.
Am J Sports Med, 25 (1997), pp. 312-326
[26.]
F. Crawford, M. Snaith.
How effective is ultrasound in the treatment of heel pain?.
Ann Rheum Dis, 55 (1996), pp. 265-267
[27.]
J.R. Basford, G.A. Malanga, D.A. Krause, P.T. William, M.S. Harmsen.
A randomised controlled evaluation of low-intensity laser therapy: Plantar fasciitis.
Arch Phys Med Rehabil, 79 (1998), pp. 249-254
[28.]
M.A. Caselli, N. Clark, S. Lazarus, Z. Velez, L. Venegas.
Evaluation of magnetic foil and PPT Insoles in the treatment of heel pain.
J Am Podiatr Med Assoc, 87 (1997), pp. 11-16
[29.]
C.E. Thomson, F. Crawford, G.D. Murray.
The effectiveness of extra corporeal shock wave therapy for plantar heel pain: a systematic review and metaanalysis.
BMC Musculoskelet Disord, 22 (2005), pp. 19
[30.]
R.E. Leach, M.S. Seavey, D.K. Salter.
Results of surgery in athletes with plantar fasciitis.
Foot Ankle, 7 (1986), pp. 156-161
[31.]
P.J. Daly, H.B. Kitaoka, Y.S. Chao.
Plantar fasciotomy for intractable plantar fasciitis: clinical results and biomechanical evaluation.
Foot Ankle, 13 (1992), pp. 188-195
[32.]
W. Benton-Weil, A.H. Borreelli, L.S. Weil, L.S. Weil.
Percutaneous plantar fasciotomy: a minimally invasive procedure for recalcitrant plantar fasciitis.
J Foot Ankle Surg, 37 (1998), pp. 269-272
Copyright © 2007. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
Download PDF
Idiomas
Reumatología Clínica (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?