Plantar fasciitis: How best to treat?

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Abstract

In addition to stretching exercises and orthotics, consider steroid injections as part of your first-line treatment options. For recalcitrant pain, a newer injectable reparative treatment is showing promise.

PRACTICE RECOMMENDATIONS

> Use plantar fascia— specific stretching to decrease ?? in patients with plantar fasciitis.Symbol

PRACTICE RECOMMENDATIONS

> Consider recommending prefabricated orthoses, including night splints, to decrease pain.Symbol

PRACTICE RECOMMENDATIONS

> Consider using extracorporeal shock wave therapy for plantar fascial pain.Symbol

PRACTICE RECOMMENDATIONS

Strength of recommendation (SOR)

PRACTICE RECOMMENDATIONS

Symbol Good-quality patient-oriented evidence

PRACTICE RECOMMENDATIONS

Symbol Inconsistent or limited-quality patient-oriented evidence

PRACTICE RECOMMENDATIONS

Symbol Consensus, usual practice, opinion, disease-oriented evidence, case series

CASE

▸ A 43-year-old obese woman seeks advice for left heel pain she has had for 2 months. Before the onset of pain, her activity level had increased as part of a weight loss program. Her pain is at its worst in the morning, with her first few steps; it decreases with continued walking and intensifies again after being on her feet all day. There is no history of trauma, and she reports no paresthesias or radiation of the pain. Her medical history is otherwise unremarkable. She has used ibuprofen sparingly, with limited relief.

CASE

If you were this patient's physician, how would you proceed with her care?

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