Plantar fasciitis: epidemiology, pathophysiology, diagnosis, and evidence-based treatment

Gabriela González Pernas, Eirina Pernas Cano, Dashiell González Abreu, Laura Beatriz Fernández Feitó, Mariam Alejandra González González, Andy Alonso Pazos and Lauren Beatriz González Claro

SAP Podiatry, 2026

Abstract: Introduction: Plantar fasciitis, the most common cause of heel pain in adults, is increasingly understood as a degenerative, load-related fasciopathy rather than a purely inflammatory condition, with a substantial impact on quality of life. Objective: To comprehensively describe the current state of knowledge on plantar fasciitis, covering its epidemiology and risk factors, pathophysiological mechanisms, diagnostic strategies, and conservative, injection-based, and surgical treatment. Methods: A narrative literature review was conducted through searches in PubMed/MEDLINE and SciELO, using the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) “fasciitis, plantar,” “heel,” “risk factors,” “ultrasonography,” “extracorporeal shockwave therapy,” and “platelet-rich plasma.” Development: Heel pain affected 11.1% of adults in a U.S. national survey, and higher body mass index and a greater range of ankle plantarflexion are associated with the condition. Diagnosis is clinical, with ultrasonography as a reliable complement. Custom foot orthoses and taping relieve pain in the short term; in a meta-analysis of 236 studies, extracorporeal shockwave therapy was the only intervention that maintained its effect at medium and long term; the evidence on injections is heterogeneous, and surgery is reserved for recalcitrant cases. Conclusions: Plantar fasciitis should be managed as a multifactorial overload condition through a stepwise, individualized approach. Standardizing therapeutic protocols and generating regional data are necessary to reduce variability in clinical practice.

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:cwf:podart:pod2026157

DOI: 10.62486/pod2026157

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