Curriculum · Musculoskeletal / Orthopedic / Rheumatology
Plantar fasciitis
What it is
Plantar fasciitis is the most common cause of heel pain, with a prevalence of 10% in the general population.
Causes and risk
Obesity, running and prolonged standing are the associations listed for it, and the classic exam clue is morning heel pain in a runner or an overweight individual.
How it presents
The pain is throbbing and is worst in the morning with the first step after rest. It eases during the day but returns after a long day on the feet, so the pattern is heel pain that is worse in the morning or after rest and improves with activity. On examination there is pain on palpation of the medial calcaneal tuberosity and along the plantar fascia, tenderness at the heel insertion, and pain on passive dorsiflexion of the foot. Tenderness may be diffuse and worse on the medial aspect of the heel, and the pain is worse on walking on the toes. The mnemonic offered for it is post-sleep pain.