Conservative Treatment of Plantar Heel Pain: Long-Term Follow-Up

TLDR

Plantar heel pain often follows an indolent course, yet patients with plantar fasciitis generally have a high likelihood of complete symptom resolution. This study aimed to assess the long‑term outcomes of patients who received conservative treatment for plantar heel pain through a telephone follow‑up survey. A telephone survey of 100 eligible patients—excluding those with worker’s compensation claims or inflammatory arthritides—was conducted after an average 47‑month follow‑up, with participants averaging 48 years of age. Among the respondents, 82 achieved complete resolution, 15 had persistent symptoms without functional limitation, and 3 experienced poor outcomes; risk factors for continued symptoms included overweight status, bilateral involvement, and prolonged symptom duration before seeking care, and 31 patients had considered surgery, of whom 22 ultimately resolved.

Abstract

In order to evaluate the long-term results of patients treated conservatively for plantar heel pain, a telephone follow-up survey was conducted. After eliminating those patients with worker's compensation-related complaints and those with documented inflammatory arthritides, data on 100 patients (58 females and 42 males) were available for review. The average patients was 48 years old (range 20-85 years). The average follow-up was 47 months (24-132 months). Clinical results were classified as good (resolution of symptoms) for 82 patients, fair (continued symptoms but no limitation of activity or work) for 15 patients, and poor (continued symptoms limiting activity or changing work status) in 3 patients. The average duration of symptoms before medical attention was sought was 6.1, 18.9, and 10 months for the three groups, respectively. The three patients with poor results all had bilateral complaints, but had no other obvious risk factors predictive of their poor result. Thirty-one patients stated that, even with the understanding that surgical treatment carries significant risk, they would have seriously considered it at the time medical attention was sought; twenty-two of these patients eventually had resolution of symptoms. Although the treatment of heel pain can be frustrating due to its indolent course, a given patient with plantar fasciitis has a very good chance of complete resolution of symptoms. There is a higher risk for continued symptoms in over-weight patients, patients with bilateral symptoms, and those who have symptoms for a prolonged period before seeking medical attention.