Talk:Plantar fasciitis

Comment

The following statement needs to be updated or have a qualifier added: Evidence is lacking to strongly support any type of treatment for plantar fasciitis.[5] See Journal of Bone and Joint Surgery, online: http://www.ejbjs.org/cgi/content/full/90/4/928#SEC10 The news of the effective stretching method is also presented in a short online CBS video segment at: http://www.cbsnews.com/stories/2007/04/19/earlyshow/health/main2703942.shtml

I also agree that showing the actual plantar fascia ligament would be helfpul to readers. It's okay to use my own image of the foot with plantar fascia (and Achilles tendon) shown, which is at http://plantarfasciitis-treatment.com/2009/08/18/stop-inflammation-and-trauma-in-plantar-fasciitis/ Article needs a picture or diagram to help. Sorry, I don't understand how to insert information properly here, or how to sign.(Ellen Graves) 03:29, 24 August 2009 (UTC)Jkg718 (talk)DyslexicEditor 09:41, 12 May 2006 (UTC)

,

The article on the foot already carries this picture, but this does not show the plantar facia itself (immediately under the skin and sub-dermal layer), nor where the pain is usually experienced along it (namely at its attachment over the front edge of the heal bone). So I'm not sure if this would help further this article or not - what do others think ? David Ruben ^Talk 12:22, 12 May 2006 (UTC)

Hmmm... I think it needs a diagram then. The foot article has many pictures of feet, but their best diagram Image:Foot.png is lacking. This picture of a skeleton Image:Foot-bones.jpg, if it was photoeditted to be labbelled might be good--I don't know if it is okay to edit a GFDL with labels and upload it, though. DyslexicEditor 12:40, 12 May 2006 (UTC)

ultrasound

The article currently says:

Therapeutic ultrasound, with or without iontophoresis, and more recently, extracorporeal shockwave therapy (ESWT) have been used with some success in patients with symptoms lasting more than 6 months.

However, the title of the article referenced seems to indicate that it's only about ESWT. I've added a reference to a controlled study that showed that ordinary therapeutic ultrasound was not effective, and changed the text appropriately.--75.83.140.254 21:05, 1 January 2007 (UTC)

I have found that certain heel seats and gel heel cushions really help with the pain. I also found out about night splints, what this does is keep the ligaments stretched while your sleeping. I have found heelthatpain.com splints, heel seats, the dorcel night splint work extremely well, especially with early morning heel pain. —Preceding unsigned comment added by 99.132.218.230 (talk) 18:53, 25 September 2008 (UTC)

Reebok DMX Shoes

While Reebok DMX shoes are not a cure, they provided me instant relief from the pain of plantar fasciitis.

I had plantar fasciitis a few years ago from too much standing on a ladder without using steel shanked boots while remodelling a home for 5 years. My podiatrist prescribed me anti-pronating inserts, stretches, Reebok DMX shoes and steel shanked boots for times when I would be on a ladder in the future. I went straight from her office to get the Reeboks and even without the inserts, the shoes allowed me to instantly walk normally again. I just found out a co-worker was suffering from this affliction and encouraged him to find some of these shoes. This also reminded me to share my experience here. What makes these shoes so soft is they contain two air bladders connected by a small straw. One bladder is at the front of the shoe and one is at the back. As you walk, air is forced through the resistance of the small straw, giving a very soft landing on each step. As far as I know, only the Reebok DMX shoes are constructed in this way.

See also The American Academy of Podiatric Sports Medicine http://www.aapsm.org/walkingshoes.html for a longer list of shoes approved by this organization.

Laughingskeptic 18:44, 14 January 2007 (UTC)

Here's my experience when I got it in 2004, posted on the uk.rec.walking newsgroup - [1]. Occasional minor reoccurences (and new occurence on other foot) since, easily controlled with stretching. -- John (Daytona2 · talk) 18:20, 30 December 2007 (UTC)

Weight on the heel

"Weight on the heel does not cause plantar fasciitis."

This is an odd claim! It might be technically correct, but it is hard to believe that heel weight would not at least aggravate the condition, since that is where it is usually felt. If this claim remains in the article, it should have a reference supporting it.-69.87.200.231 13:08, 13 July 2007 (UTC)

"Running long distances or putting repetitive pounding on the heel of the foot during exercise often are huge factors that can add excessive stress to the heel of the foot, therefore contributing to development of plantar fasciitis." "Additional and unnecessary strain on the heel will aggravate the area even more, and cause the pain to become even more severe." [2] -69.87.200.231 13:17, 13 July 2007 (UTC)

The claim does not strike me as odd, as it is traction on the attachment of the plantar fascia to the end of the heel bone, and not pressure on the bone itself, that produces the pain. Many cases, in fact, result from walking or running barefoot on the beach, where the bone itself is well-cushioned by the sand but the fascia of the arch is stressed by having to "pull" the heel up out of the sand with each stride that causes the problem. Sfahey 03:57, 28 August 2007 (UTC)

Spelling of Plantar Fasciitis

My podiatrist calls it "Planar Fascitiis" on the internet it is also spelled "Planar Fascitiis" and other numerous spellings.

Perhaps someone knows how to link up additional spellings to this entry as I have almost started a new entry on the subject.

Thanks Astrocloud 19:07, 26 August 2007 (UTC)

You need a new podiatrist. It is quite clearly "plantar", referring to the underside of the foot, as in "plantar warts". re: the internet: googling "nucular" yields 173,000 hits, but doesn't make it right. Sfahey 03:53, 28 August 2007 (UTC)

Acupuncture

The article used to say: "It should be noted that acupuncture has not been scientifically proven to be an effective treatment for any condition, and that pain is highly subjective and subject to placebo effects."

This is not true. A very quick search releaved, just in the last few weeks, at least three peer-review article on the effects of acupuncture:

Acupuncture in Polycystic Ovary Syndrome: Current Experimental and Clinical Evidence. Stener-Victorin E, Jedel E, Mannerås L., Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, Göteborg University, Sweden. (Journal of Neuroendocrinology, 2007 Nov 28)

Monitoring of neuromuscular blockade at the P6 acupuncture point reduces the incidence of postoperative nausea and vomiting.Arnberger M, Stadelmann K, Alischer P, Ponert R, Melber A, Greif R., Department of Anesthesiology, Inselspital, University Hospital Bern, Switzerland. (Anesthesiology. 2007 Dec;107(6):903-8)

Laser acupuncture in children with headache: A double-blind, randomized, bicenter, placebo-controlled trial.Gottschling S, Meyer S, Gribova I, Distler L, Berrang J, Gortner L, Graf N, Shamdeen MG., University Children’s Hospital, Department of Pediatric Hematology and Oncology, Saarland University. (Pain. 2007 Nov 15) —Preceding unsigned comment added by 216.16.236.150 (talk) 19:43, 4 December 2007 (UTC)

Stretch EZ

Another product recommended for treating plantar fasciitis is the Stretch EZ. It was developed for athletes to help stretch their legs, hips, and lower back. Also, it has been proven to increase flexibility and prevent injury. It is endorsed by Physical Therapists that have used Stretch EZ to treat sports related injuries and conditions such as plantar fasciitis with positive results. There are many product reviews such as the one on :http://www.killerlifestyle.com/wp02/2007/10/29/product-review-stretch-ez/ (MarkH45 (talk) 00:46, 31 May 2008 (UTC))

Explanation of Changes

I made several changes. Potentially controversial changes I'll justify here.
1) removed link to a web site selling products with only one minor sentence being used as justification for the link.
2) removed newspaper link that was redundant
3) changed the ESWT link to a more professional and faster website that isn't loaded with ads.
4) deleted odd comment not justified in the new ESWT link ("brain no longer receives signals")
5) removed link to the picture because the data for the statistics in it comes from a non-peer-reviewed web site selling products ([3])
6) removed newspaper link that referenced a small study on glucosamine. The bottom of the heel isn't a joint, so i don't know why someone was looking into that. Also, the reference didn't mention glucosamine. I imagine a mess if every small study with an odd claim was listed.
7) provided reference for the needle fasciotomy and shortened the comments since the prior sentence says surgery is a last resort and therefore the needle fasciotomy should not be given more space than "first resort" treatments.
8) moved "lessen pressure under the balls of the feet" to an appropriate area to fix bad text flow. Also improved explanation.
9) removed reference to acupuncture. If acupuncture is listed, more alternative treatments should be listed like: prolotherapy, cryosurgery, glucosamine, rolfing, epsom salts, iontopheresis with acetic acid, magnets, and light therapy, none of which have any significant study and do not deserve more than a sentence for each. —Preceding unsigned comment added by 24.214.120.227 (talk • contribs) 22:20, 8 March 2008

Personally I liked the image. OK site supports itself commercially, but it is a detailed site and general seems sensibly written (with caveats to particular views). OK a self-reported survey, but primary focus on calcaneum attachment and less extend further along the sole matches my clinical impression (but I certainly in mind have no fixed % values for the distribution). I've restored the image, shortening the caption, but added as footnote that a self-reported survey. Whilst I've provided the link to the web site, you'll note I left it as an inline link rather than give specific promotional value to the site's name - is this acceptable ? David Ruben ^Talk 23:26, 8 March 2008 (UTC)

Other names

Someone has removed the line that says it used to be called Policemans heel in the UK (which is true) and it now says that it used to be called Dog's heel... I found only 2 other references to dog's heel through google, but a lot for policeman's heel (which is what my doctor even calls it). Think it would be ok to turn it back? 79.68.78.142 (talk) 23:15, 12 July 2008 (UTC)

I say "go for it". Sfahey (talk) 04:50, 14 July 2008 (UTC)

One of my doctors has also called it Policeman's Foot —Preceding unsigned comment added by 82.7.42.183 (talk) 19:10, 30 July 2008 (UTC)

What is the plantar fascia?

Oh, by going to another article, I see that the plantar fascia is the thick connective tissue which supports the arch of the foot. Do we think the opening paragraph needs to be in more layman's terms? --Knulclunk (talk) 02:16, 18 August 2008 (UTC)

Agree/done. Those goofy nicknames didn't belong in the 1st sentence anyway. Sfahey (talk) 13:30, 18 August 2008 (UTC)

Recent edit by User:Dr.Joshie

The recent edit to this article by User:Dr.Joshie replaced most of the material in the article, much of which was sourced, with a mass of material which sounds at least reasonable, but none of which is sourced. (I'm not qualified to judge the quality of either version of the article beyond being able to see that the previous version had quite a few references.) It would be helpful for someone else to assess the recent edit and decide whether it should remain.

To Dr.Joshie: If the material is to remain, it needs to be sourced. --Tkynerd (talk) 03:32, 19 September 2008 (UTC)

I know, I know.....

This is not a forum, but I have been wearing New Balance sneakers (any type, they pretty much all have a stiff heel cup), and the Doc Martens' Saxon model. I feel better than I have in quite a while. —Preceding unsigned comment added by 72.226.77.1 (talk) 04:11, 25 September 2008 (UTC)

Differential diagnoses - what type of pain is it?

It's mentioned that there is pain but if someone can add what type of pain- e.g. burning, an ache, etc that would be useful for laypeople like me who hobble across this page in trying to find out what is wrong with their hooves. —Preceding unsigned comment added by 92.29.55.18 (talk) 14:34, 14 August 2009 (UTC)

For me, when I try to step on the affected foot, it feels like there's a a blunt piece of glass embedded in my foot. If I brush the sore point very ligthly with my finger, it burns. At night it throbs agonisingly, so much so that I wake up gritting my teeth. Also, for me it doesn't just occur on the heel - over the years I've had it occur in places all over the soles of either foot. Usually it goes away by itself, after a few days. —Preceding unsigned comment added by 212.182.184.113 (talk) 19:09, 11 October 2009 (UTC)

too much jargon -- DISAGREE

As of Oct 2009, this page has been flagged for having too much jargon. I totally disagree. I read the article carefully looking for instances of excessive jargon. What is here belongs here. This is a medical article and using anatomical terms to describe anatomy is required. Using drug names to describe drugs is required. Everything else is pretty much straight forward. Perhaps some auto-bot does the flagging, but it's wrong, and this should be taken down. —Preceding unsigned comment added by Lapabc (talk • contribs) 16:57, 8 October 2009 (UTC)

>>I forgot to add, does anyone know who to contact to remove / take down the flagging? —Preceding unsigned comment added by Lapabc (talk • contribs) 17:00, 8 October 2009 (UTC)

Hello, any user can add or remove a jargon tag and you should feel free to remove tags you disagree with. The worst that can happen is that someone will put them back. I added this particular tag in August. The article has been cleaned up significantly since then so I would not object to its removal. To remove the tag, delete the text reading "{{Cleanup-jargon}}" at the top of the article. Gruntler (talk) 18:46, 8 October 2009 (UTC)

I removed it. Glad to have this one resolved! —Preceding unsigned comment added by 24.152.174.76 (talk) 04:26, 10 October 2009 (UTC)

Metatarsalgia, a.k.a. capsulitis

There's a related diagnosis / condition that ought to be mentioned in this article, as it is NOT PF. There's another kind of foot pain, more like dull "sore feet," often in the balls of the feet, that is unconnected to the heel and with PF. It's metatarsalgia or capsulitis. I raise this because in most cases, "sore feet" is immediately assumed in health or athletic forums to be PF. I've had PF myself and can tell the difference -- no sharp pain in this case, not associated with the heel, etc. Please add a section that links to this other condition, and flesh out the article on metatarsalgia. Much obliged! A.k.a. (talk) 17:07, 4 February 2010 (UTC)

Shoe Type Contradiction

In the therapies section, it says minimalist/no shoes and motion control shoes may be employed to fix the problem. This is a contradiction as these are the two extremes of types of a running shoe.

Since there is conflicting evidence for both arguments and the issue is laregly personal, I propose that the section be amended to "PF may be fixed by... a change in footwear" —Preceding unsigned comment added by 130.15.38.200 (talk) 19:50, 25 May 2010 (UTC)

Percentages in image add up to more than 100%

The percentages in the image of the areas of pain add up to more than 100%. I don't understand what that means. Could someone explain it to me? —Preceding unsigned comment added by 67.98.222.16 (talk) 00:46, 24 September 2010 (UTC)

I interpret it to mean that some people have symptoms in more than one area at the same time. And since there are eight areas on the chart, any given case of PF could be counted up to eight times, creating an upper limit of 800%. Langrel (talk) 04:58, 1 October 2010 (UTC)

Invitation to edit

It is proposed that Plantar fasciitis be part of the trial of a new template; see the green strip at the top of Pain where it has been in place for a couple of months. The purpose of this project is to encourage readers to edit, while equipping them with the basic tools. If you perceive a problem with this, or have any suggestions for improvement, please discuss at the project talk page --Anthonyhcole (talk) 09:47, 10 January 2011 (UTC).

Extracorporeal shockwave therapy

ESWT now has an extensive track record in the treatment of so-called "intractable plantar fasciitis." The term "plantar fasciosis" is better description of a degenerative process of the fascia which is resistant to treatment with anti-inflammatory medications. The ESWT industry originated in Germany and it's website, http://www.ismst.com/ obtains an extensive listing of research in this area. ESWT is in a somewhat unique category of medicine as it is non-pharmaceutical and non-surgical. It is a "disruptive" technology that can lessen the need for surgical treatment. ESWT has been met with resistance in the surgical community and has had an uphill struggle in the realm of medical politics. Unfortunately, the Wikipedia site on "plantar fasciitis" reflects the political landscape in that information about ESWT has been repeatedly edited out. I am very dissapointed at this type of censorship. — Preceding unsigned comment added by 70.132.206.22 (talk) 17:36, 11 February 2012 (UTC)

Hi. Thank you for bringing this up. It looks important. You're not being censored. We're constrained in what we can add to medical articles by this policy: Wikipedia:Identifying reliable sources (medicine). Essentially, medical claims need to be supported by authoritative systematic reviews or similar secondary sources. I went to the site and under Literature found a long list of papers on medical shockwave therapy. Rather than spend 20 minutes scanning those, I searched PubMed for reviews using "shockwave treatment plantar fasciitis" and turned up 5.

• PMID 19440137
• PMID 15989378
• PMID 15246149
• PMID 12471854
• PMID 11642513

It's late here, so I'll start looking at them tomorrow. This may take a day or two. Would you consider creating an account for yourself? That way I'll be able to recognise you if we need to talk again.

I notice you are continuing to insert your text. Please don't. Please be patient. I will attend to this but, until one specific reliable source has been cited (rather than that list of several hundred on the web site), we can't include those claims. --Anthonyhcole (talk) 18:26, 11 February 2012 (UTC)

           ??? All of the references cited in the ISMST website are papers published in reputable journals.  There are items in the article on plantar fasciitis such needling of the plantar fascia which is supported by one reference and is a far more obscure treatment than ESWT.  The paragraph on ESWT in the article shows bias against ESWT.  Why not simply look at the prior discussions on the subject that had some reasonable balance that were present early in 2011?  There is discussion of having issues with reversions but how about those that seem determined not to have a discussion about ESWT in the article? ESWT had been deleted for a number of months. EWST should not require a different burden of proof than any of the other treatments listed in the article, deserves to be mentioned in a balanced fashion.

Please remember 3RR. Xavexgoem (talk) 20:41, 11 February 2012 (UTC)

I added some studies, with the highest quality reviews I could find (either to high impact journals or reviews that did a good job with evidence assessment, or to medical society recommendations). I did not review the reviews cited above by Anthonyhcole, though some may be a bit old (multiple RCTs came out in the 2002-2003 years). Yobol (talk) 21:32, 11 February 2012 (UTC)

The ISMST is the largest organization in the ESWT industry. Its' members include respected scientists and clinicians. Its' website, http://www.ismst.com/ provides one of the largest lists of literature on ESWT. ESWT is somewhat outside the mainstream of allopathic medical practice in the US so it is not reasonable to expect numerous articles and endorsements in the "big name" medical journals. Plantar fasciitis is often treated by podiatrists so domestic literature may be found in the Journal of the American Podiatric Medical Association or the Journal of the American College of Foot and Ankle Surgeons: http://www.jfas.org/search/quick The current paragraph in the Wkipedia article on plantar fasciitis cites the long discredited Buchbinder study in which faulty patient selection occurred and the patients in the study were provided a subtherapeutic dose of ESWT. The technique for application of ESWT is well established by the industry and physicians who utilize the modality. Buchbinder did not follow conventional technique. It would be like giving with a headache, one half of a Tylenol, not seeing results, then concluding that Tylenol has no effect on headaches. I have listed references in the conventional format in Wikipedia articles in prior years but I do not understand how references are to be listed as the instructions appear cryptic using some code which generates the listed reference. That is another reason I need refer to the ISMST website. A more complete explanation of how to use the system is lacking. — Preceding unsigned comment added by 173.173.99.116 (talk) 23:05, 11 February 2012 (UTC)

The sources we use for our articles is determined by the guideline on reliable sources for medical claims. If you have some you would like to add that meet that guideline, please suggest it, but Wikipedia presents the mainstream as mainstream and fringe as fringe. We do not give additional WP:WEIGHT to views beyond what is mainstream as that would go against our policy on having a neutral point of view. BTW, the Buchbinder article that is cited is a review, not a primary research article, so I'm not sure what you are referring to. Yobol (talk) 23:11, 11 February 2012 (UTC)

Yobol. You are now resorting to name calling and insults. Your statement that "mainstream is mainstream" and "fringe is fringe" is outrageous. Do you consider alternative medicine to be "fringe?" Many therapies possibly labelled as "alternative" in the US are mainstream in other advanced nations. Germany publishes the Commission E monographs which document the efficacy of herbal and natural therapies. ESWT is mainstream in many nations and is not even labeled as alternative medicine in the US.