The longitudinal course of conservative treatment for plantar fasciitis

Abstract

Introduction: Although previous studies have revealed the risk factors related to the development of plantar fasciitis, little is known about the predictive factors for early outcome and recurrence of conservatively treated plantar fasciitis. This study evaluated the predictive factors for early outcome and recurrence during a longitudinal course of conservatively treated plantar fasciitis.

Materials and Methods: In the retrospective analysis, 429 feet of 276 patients were included. The unfavorable early outcomes were defined as no improvement in the visual analog scale (VAS) at 1 month after treatment. Possible predictive factors were included in the analysis of the unfavorable early outcomes. To evaluate recurrence, 290 feet of the 184 patients who achieved complete remission (CR) of the symptoms after conservative treatment were analyzed using the possible predictive factors.

Results: By the last follow-up, CR was achieved in 377 feet (87.9%). The mean time to reach CR was 4.4 months after treatment. The rate of recurrence was 51.0%. An age-matched analysis showed that the body mass index (BMI), symptom duration before treatment, and daily total standing time (TST) were significant predictive factors for an unfavorable early outcome. With regard to recurrence, TST was the only covariate that was significant after the adjustment. TST ≥120 min/day was significant in the analyses of early outcome and recurrence with an odds ratio of 9.256 (95% confidence interval [CI], 4.801-17.844) and a hazards ratio of 2.760 (95% CI, 1.841-4.139).

Conclusions: To achieve favorable early outcomes and no recurrence, conservatively treated plantar fasciitis patients should be informed about modifiable factors (e.g., lowering their BMI, scheduling early clinic visits before the disorder becomes chronic, and shortening their daily TST).