What’s on the web for family physicians – plantar fasciitis treatment

Alfred KY Tang 鄧權恩，Wilbert WB Wong 王維斌

Diagnosis and treatment of plantar fasciitis
http://www.aafp.org/afp/2011/0915/p676.html

The plantar fascia is frequently a site of chronic pain. This article published in the website of American Family Physician gives an update on diagnosis and treatment of plantar fasciitis for family physicians. It covers differential diagnoses of heel pain, findings on different diagnostic imaging techniques and the various treatment options for plantar fasciitis. Besides conservative treatment such as rest and analgesics, stretching exercises and physical therapy were covered. Arch taping may be more cost effective for acute onset of plantar fasciitis, while the use of night splints are better received by many patients. Other studies found that night splints were especially useful in individuals who had symptoms of plantar fasciitis for more than 12 months.

Diagnostic and therapeutic injection of the ankle and foot
http://www.aafp.org/afp/2003/1001/p1356.html

The focus of this article is on the diagnostic and therapeutic injections of the ankle and foot. Apart from information on establishing diagnosis and indications for injections, there are illustrations on the approach of needle entry of ankle and foot injections. The dosage of anaesthetic and steroid are tabulated for reference. The best timing of injection and the risks involved with ankle and foot injection are also outlined.

Plantar fasciitis: exercises to relieve pain
http://www.webmd.com/a-to-z-guides/exercises-to-reduce-plantarfasciitis

Exercises for plantar fasciitis are very useful in relieving heel pain. Apart from traditional treatment modalities, self-stretching and strengthening exercises for plantar fasciitis are also very helpful in reducing heel pain. In the website, there are a number of wellillustrated daily exercises designed for patients, especially when one first get out of bed, to help reducing the symptoms of plantar fasciitis. These exercises include rolling tennis ball, toe stretch, towel stretch, plantar fascia and calf stretch, towel curls and marble pickups for strengthening. In addition, information on choices of shoe inserts for plantar fasciitis can be found at the website at http://www.webmd.com/pain-management/tc/shoe-inserts-forplantar-fasciitis-topic-overview

Extracorporeal shockwave therapy (ESWT) for refractory plantar fasciitis
https://www.nice.org.uk/guidance/ipg311/resources/extracorporeal-shockwave-therapy-for-refractory-plantarfasciitis-1899867386790853

ESWT for refractory plantar fasciitis has not raised major safety concerns, however, current evidence on its efficacy is inconsistent. This article from NICE guideline in United Kingdom based on review of clinical evidence of extracorporeal shockwave therapy for plantar fasciitis. It constitutes a useful reference for family physicians who might be thinking of referring patients for ESWT. Indications of ESWT, outline of the procedure, efficacy and safety considerations are discussed in the article.

Mayo clinic health information: plantar fasciitis
http://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/home/ovc-20268392

Apart from patient information on causes and symptoms, diagnosis and treatment of plantar fasciitis, the website has a section of self-management, which outlines different ways patients can help themselves with the symptoms through appropriate lifestyle and home remedies. These include weight control, choosing supportive shoes and low impact sports, regular ice massage, and stretching exercises for pain relief. Patient exercises to help prevent plantar fasciitis are also included in the webpage, well explained with good illustrations.

Plantar fasciitis: treatment pearls http://www.aapsm.org/plantar_fasciitis.html

This article from American academy of podiatric sports medicine outlines the treatment strategies for plantar fasciitis from the perspective of podiatrists. Treatment programmes can be different depending on whether it is in the acute phase, rehabilitation phase and functional phase. Treatment strategies include modulation of footwear, home therapy, custom foot orthoses and physical therapy. Custom foot orthoses has been proven to be well accepted by patients with plantar fasciitis. For the athletes, sports podiatrists may employ arch taping procedures as a precursor to or an adjunct to orthotic therapy.

Shoe inserts and prescription custom orthotics
http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=988

This article outlines different types of shoe inserts available over the counter, e.g. insoles, arch supports, heel liners and foot cushions, and also tips on how to choose the right shoe insert for a patient. Some basic principles on prescription of custom orthotics by podiatrists are also available. Benefits of prescription orthotics over those available over-the-counter are also outlined.