[Plantar fascitis: evidence-based review of treatment]

Abstract

Objective: 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). Meta-analysis, 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 fascitis, 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.