Gå direkt till huvudinnehållet

Plantarfasciit

Senast uppdaterad: Senast reviderad:
Sakkunnig:


Definition:
Smärttillstånd med kronisk inflammation/degeneration vid fästet till fascia plantaris på tuber calcanei.
Förekomst:
Vanligast efter 40-årsåldern, eller hos yngre idrottsutövare.
Symtom:
Smärtor eller ömhet i eller framför hälen vid belastning mot fotsulan, gångsmärtor.
Kliniska fynd:
Palpationsömhet i främre kanten av calcaneus, mest uttalat på hälens mediala sida vid början av plantarfascian.
Diagnostik:
Klinisk diagnos. Belastad slätröntgen kan vara aktuellt vid tveksamhet om diagnosen.
Behandling:
Konservativ behandling med avlastande skor, eventuellt tejpning, sträckning av vadmuskulatur och plantarfascian samt undvikande av träning som förvärrar tillståndet. Viktnedgång vid övervikt. Eventuellt extrakorporeal stötvågsbehandling och/eller lokal injektion av botulinumtoxin, trombocytrik plasma eller kortison.
  1. Buchbinder R. Plantar fasciitis. N Engl J Med 2004; 350: 2159-66. PubMed  
  2. Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician 2011; 84: 676-82. PMID: 21916393 PubMed  
  3. Kjellson N, Horvath A, Samuelsson K, Karlsson J ABC om Vanliga sjukdomstillstånd i fot och fotled, del 2. Lakartidningen.se 2020-11-09 lakartidningen.se  
  4. Tu P. Heel Pain: Diagnosis and Management. Am Fam Physician. 2018 Jan 15;97(2):86-93. PMID: 29365222. PubMed  
  5. Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc 2003; 93: 234-7. PubMed  
  6. Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg Am 2003; 85: 872-7. PubMed  
  7. Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002 Apr;36(2):95-101. doi: 10.1136/bjsm.36.2.95. PMID: 11916889 PubMed  
  8. Rano JA, Fallat LM, Savoy-Moore RT. Correlation of heel pain with body mass index and other characteristics of heel pain. J Foot Ankle Surg 2001; 40: 351-6. PubMed  
  9. Young JR, Sternbach S, Willinger M et al. The etiology, evaluation, and management of plantar fibromatosis. Orthop Res Rev. 2019; 11: 1–7. PMID: 30774465 PubMed  
  10. Ahn JM, El-Khoury G. Radiologic evaluation of chronic foot pain. Am Fam Physician 2007; 76: 975-83. PubMed  
  11. Karabay N, Toros T, Hurel C. Ultrasonographic evaluation in plantar fasciitis. J Foot Ankle Surg 2007; 46: 442-6. PubMed  
  12. McMillan AM, Landorf KB, Barrett JT, Menz HB, Bird AR. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis. J Foot Ankle Res 2009; 2: 32. PubMed  
  13. Romulo RO, Sendin FA, et al. Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: a randomized controlled trial. JOSPT 2011;41. PMID: 21285525 PubMed  
  14. David JA, Sankarapandian V, Christopher PR, Chatterjee A, Macaden AS. Injected corticosteroids for treating plantar heel pain in adults. Cochrane Database Syst Rev. 2017 Jun 11;6(6):CD009348. doi: 10.1002/14651858.CD009348.pub2. PMID: 28602048 PubMed  
  15. McMillan AM, Landorf KB, Gilheany MF, Bird AR, Morrow AD, Menz HB. Ultrasound guided corticosteroid injection for plantar fasciitis: randomised controlled trial. BMJ. 2012 May 22;344:e3260. doi: 10.1136/bmj.e3260. PMID: 22619193 PubMed  
  16. Huang YC, Wei SH, Wang HK, Lieu FK. Ultrasonographic guided botulinum toxin type A treatment for plantar fasciitis: an outcome-based investigation for treating pain and gait changes. J Rehabil Med. 2010 Feb;42(2):136-40. doi: 10.2340/16501977-0491. PMID: 20140409 PubMed  
  17. Abbasian M, Baghbani S, Barangi S, et al. Outcomes of Ultrasound-Guided Gastrocnemius Injection With Botulinum Toxin for Chronic Plantar Fasciitis. Foot Ankle Int. 2019. pmid: 31587569 PubMed  
  18. Acosta-Olivo C, Simental-Mendía LE, Vilchez-Cavazos F, Peña-Martínez VM, Elizondo-Rodíguez J, Simental-Mendía M. Clinical Efficacy of Botulinum Toxin in the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil. 2021 Oct 22:S0003-9993(21)01498-2. doi: 10.1016/j.apmr.2021.10.003. Epub ahead of print. PMID: 34688605 PubMed  
  19. Fei X, Lang L, Lingjiao H, Wei C, Zhou X. Platelet-rich plasma has better mid-term clinical results than traditional steroid injection for plantar fasciitis: A systematic review and meta-analysis. Orthop Traumatol Surg Res. 2021 Oct;107(6):103007. doi: 10.1016/j.otsr.2021.103007. Epub 2021 Jul 1. PMID: 34217867 PubMed  
  20. Engkananuwat P, Kanlayanaphotporn R, Purepong N. Effectiveness of the Simultaneous Stretching of the Achilles Tendon and Plantar Fascia in Individuals With Plantar Fasciitis. Foot Ankle Int. 2018; 39: 75-82. PMID: 28985685 PubMed  
  21. Martin JE, Hosch JC, Goforth WP, Murff RT, Lunch DM, Odom RD. Mechanical treatment of plantar fasciitis: A prospective study. J Am Podiatr Med Assoc 2001; 91: 55-62. PubMed  
  22. Lee SY, McKeon P, Hertel J. Does the use of orthoses improve self-reported pain and function measures in patients with plantar fasciitis? A meta-analysis. Phys Ther Sport 2009; 10: 12-8. PubMed  
  23. Roos E, Engström M, Söderberg B. Foot orthoses for the treatment of plantar fasciitis. Foot Ankle Int 2006; 27: 606-11. PubMed  
  24. Hawke F, Burns J, Radford JA, du Toit V. Custom-made foot orthoses for the treatment of foot pain. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006801. doi: 10.1002/14651858.CD006801.pub2. PMID: 18646168 PubMed  
  25. Rasenberg N, Riel H, Rathleff MS, et al . Efficacy of foot orthoses for the treatment of plantar heel pain: A systematic review and meta-analysis. Br J Sports Med 2018. pmid:29555795 PubMed  
  26. Effekt av stötvågsbehandling vid hälsenetendinopati och hälsporre HTA-rapport 2021:58 Metodrådet. Region Stockholm 2021. vardgivarguiden.se  
  27. Tengku Yusof TNB, Seow D, Vig KS. The Musculoskeletal Applications of Extracorporeal Shockwave Therapy for Foot and Ankle Disorders: A Systematic Review and Meta-Analysis. J Am Podiatr Med Assoc. 2021 Dec 8:18-191. doi: 10.7547/18-191. Epub ahead of print. PMID: 34878537 PubMed  
  28. Othman AM, Ragab EM. Endoscopic plantar fasciotomy versus extracorporeal shock wave therapy for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg 2010; 130: 1343-7. PubMed  
  29. Arshad Z, Aslam A, Razzaq MA, Bhatia M. Gastrocnemius Release in the Management of Chronic Plantar Fasciitis: A Systematic Review. Foot Ankle Int. 2021 Nov 12:10711007211052290. doi: 10.1177/10711007211052290. Epub ahead of print. PMID: 34766860 PubMed  
  30. Pickin CC, Elmajee M, Aljawadi A, Fathalla I, Pillai A. Gastrocnemius Recession in Recalcitrant Plantar Fasciitis: A Systematic Review. J Foot Ankle Surg. 2021 Nov 1:S1067-2516(21)00441-5. doi: 10.1053/j.jfas.2021.10.029. Epub ahead of print. PMID: 34838458 PubMed  
  31. Fernández-Rodríguez T, Fernández-Rolle Á, Truyols-Domínguez S, et al. Prospective Randomized Trial of Electrolysis for Chronic Plantar Heel Pain. Foot Ankle Int 2018. pmid:29771148 www.ncbi.nlm.nih.gov  
  32. Wolgin M, Cook C, Graham C, et al. Conservative treatment of plantar heel pain: long term follow up. Foot Ankle Int 1994; 15: 97-102. PubMed  
  • Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet