Plantar heel pain

Med Clin North Am. 2014 Mar;98(2):339-52. doi: 10.1016/j.mcna.2013.10.009. Epub 2013 Dec 10.


Plantar heel pain is a common complaint encountered by orthopedic surgeons, internists, and family practitioners. Although it is most often caused by plantar fasciitis, this is a diagnosis of exclusion. Other mechanical, rheumatologic, and neurologic causes must be considered first. The history and physical examination are typically all that is needed to make the proper diagnosis, but diagnostic adjuncts are available to assist the clinician. When plantar fasciitis is diagnosed, conservative modalities must be tried first. Corticosteroid injections and extracorporeal shock-wave therapy may also be used. After 6 months of failed conservative treatments, surgical intervention should be considered.

Keywords: Baxter nerve; Extracorporeal shock-wave therapy; First branch lateral plantar nerve; Heel spur; Plantar fascia; Plantar fasciitis; Plantar heel pain; Windlass mechanism.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Combined Modality Therapy / methods
  • Disease Management
  • Fasciitis, Plantar* / diagnosis
  • Fasciitis, Plantar* / physiopathology
  • Fasciitis, Plantar* / therapy
  • Heel Spur* / diagnosis
  • Heel Spur* / physiopathology
  • Heel Spur* / therapy
  • Heel* / innervation
  • Heel* / physiopathology
  • Humans
  • Neurologic Examination / methods
  • Orthopedic Procedures / methods*
  • Pain / etiology
  • Pain / physiopathology
  • Phonophoresis
  • Physical Examination / methods
  • Physical Therapy Modalities*
  • Tibial Nerve / physiopathology
  • Treatment Outcome


  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents, Non-Steroidal