Talk:Plantar fasciitis

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)

Metatarsalgia is completely unrelated to plantar fasciitis so its discussion in this article does not make sense. — Preceding unsigned comment added by 166.147.72.20 (talk) 04:22, 3 December 2013 (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)

This is the problem when there needs to be broad consensus among authors and changes are being approved "by committee." The bottom line is that traditional shoe design has emphasized the importance of the shank for hundreds of years. The shank of the shoe protects the arch and prevents torsional strain on the plantar fascia. Minimalist shoes are a recent fad, have no shanks and are largely a marketing gimmick. — Preceding unsigned comment added by 166.147.72.20 (talk) 04:26, 3 December 2013 (UTC)

Material in the article needs to reflect what reliable sources have to say about the subject. As this is a collaborative project, yes, consensus will determine the content in the long run. This is not a site for individuals to present their opinions of what is correct. There are sites for that kind of thing, ranging from medical journals to blogs. Wikipedia is not part of that continuum. - SummerPhD (talk) 14:40, 3 December 2013 (UTC)

Who is the arbiter of which sources are deemed reliable or not? — Preceding unsigned comment added by 166.147.72.29 (talk) 02:59, 27 December 2013 (UTC)

Guidelines for this can be found at WP:MEDRS. In case of a dispute as to whether or not a source is reliable, discuss the issue on the article's talk page. If no consensus is found, discuss the source at the Reliable sources/Noticeboard. - SummerPhD (talk) 03:20, 27 December 2013 (UTC)

Hi folks, please remember to sign your comments by clicking the button with the pencil or by typing four ~ marks in a row. I think the shoe debate is very important to this issue because it reflects two very different treatment approaches, both which have enough success to be worth further investigation. It is appropriate for articles to reflect controversy in treatment approaches. Ideally sources can be produced to support each of these. The minimalist approach is new enough that while there are some good studies for using it to treat various conditions, I'm not certain if there are any for the treatment of PF yet. The primier holistic podiatrist advocating minimal shoes for the treatment of various conditions is Dr. Ray McClanahan of Northwest Foot and Ankle, Portland, Oregon. --Karinpower (talk) 22:14, 12 May 2014 (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).

Invitation to edit? Really? I am a medical professional and would love to edit this weak article. I tried to do so about a year ago, only to be frustrated by the self appointed guardians of site rectitude here who feel the need to prevent changes, not to mention the arcane structural changes in the means to provide references for statements. Take a look at the MIT Technology Review article about this issue in the recent November/December issue which discussed the shrinking authorship here in Wikipedia. Better look fast though as my comments will not be here very long! — Preceding unsigned comment added by 166.147.72.20 (talk) 04:34, 3 December 2013 (UTC)

Actually, your comments on a talk page (other than outright vandalism, personal attacks or violations of our WP:BLP policy) aren't going anywhere.

As to what you encountered "about a year ago", I can only really speculate. Because you are editing under an IP address with no edits to this article, you must have been using a different IP address (or a registered account) at that time. I have no way to see what happened without a lot of guesses. If you can take a look at the article's history and tell us when this was, we cab certainly look at it. - SummerPhD (talk) 14:32, 3 December 2013 (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. — Preceding unsigned comment added by 173.173.99.116 (talk • contribs) 23:27, 11 February 2012‎

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. — Preceding unsigned comment added by 173.173.99.116 (talk • contribs) 23:27, 11 February 2012‎

Actually, yes, most alt med is WP:FRINGE by definition, but this is a digression. I am not here to label ESWT, but to neutrally describe it based on the best sources available. If you have other sources that meet our guidelines for reliable sourcing for medical claims, please bring them forward. ESWT, as far as I can tell from the best sources, has at best a mixed record for efficacy, which is what our current article says. To say otherwise, you will need to find other high quality secondary sources that say differently. Yobol (talk) 23:42, 11 February 2012 (UTC)

The ISMST website contains scores of "high quality secondary sources." It is a compendium of references. You obviously have an agenda if you refused to acknowledge the references on that site. You see no need to critique the reference to needling of the fascia, a technique with less than 5% of the level of proof and literature of ESWT. Your utilization of the term "fringe" is by your own definition. You are biased, have an unstated agenda and have little business editing this article, let alone being on Wikipedia. — Preceding unsigned comment added by 173.173.99.116 (talk) 00:57, 12 February 2012 (UTC)

Just "edit warring" information into an article doesn't work. It annoys and wastes the time of editors you need to collaborate with.

Editing is a collaboration.

You'll need to master WP:MEDRS. Claims of efficacy won't get into a medical article unless they're supported by the kind of source outlined in that guideline. One good source is enough for most medical claims.

Just saying "X is so," and pointing readers to a hundred or more references on a web site won't work. You'll need to find a source that conforms to WP:MEDRS that supports "X is so."

So read that guideline.

Some other points: sign your comments by following them with ~~~~ (When you don't do that other editors have to search the history and sign for you, which takes a minute or so and annoys them.) Get a user name so we know when we're talking to you and will know what we've already discussed.

Yobol has included text that reflects the sources he/she has cited. If you wish to challenge that text, you must do that with a WP:MEDRS-compliant source that supports your objections. That's how it works here. --Anthonyhcole (talk) 08:53, 12 February 2012 (UTC)

This is an example of intellectual dishonesty. Any statement or comment in an article can be taken out of context and referenced presumably meeting your interpretation of WP:MEDRS. Consider what the authors, Rompe, et. al. were really stating in the referenced article in question, "Conclusions With current studies heterogenous in terms of the duration of the disorder; type, frequency and total dose of shock wave therapy (SWT); period of time between SWT; type of management and control group; timing of follow-up and outcomes assessed, a pooled meta-analysis of SWT for chronic plantar fasciopathy was considered inappropriate. Neverhteless, there was a preponderance of well-designed studies showing favourable results. It appears that one should only consider SWT for plantar fasciopathy after more common, accepted and proven non-invasive treatments have failed." So Rompe acknowledges the fact that a number of early studies were not well designed which generated controversial results but that there are a sufficient number of well designed studies which support the efficacy of ESWT for recalcitrant plantar fasciitis. Most clinicians such as myself now realize that ESWT has its primary effect for patients who specifically have plantar fasciosis which is discussed here.173.173.99.116 (talk) 15:06, 12 February 2012 (UTC) — Preceding unsigned comment added by 173.173.99.116 (talk) 15:01, 12 February 2012 (UTC)

Which is why our article says, "One review found that the preponderance of evidence supports the use of ESWT, but only after several months of treatment with more accepted and proven therapies have failed, as a possible alternative to surgical intervention." I fail to see the problem here. Yobol (talk) 18:36, 12 February 2012 (UTC)

I didn't realize this was the subject of discussion until now, but I added a citation from 2002, a metaanalysis. Results were favorable for SWT, and the authors suggested it be used as a treatment for cases refractory to other treatments. If anybody objects to this addition, let me know. Rytyho usa (talk) 10:01, 9 December 2012 (UTC)

Comment

Just commenting: it seems a very US oriented description for an article on a global Internet site. 87.115.43.103 (talk) 11:33, 22 July 2013 (UTC)

Policeman's Heel misnomer

Plantar fasciitis is NOT Policeman's Heel. That is a different condition completely. Policemen's Heel is plantar calcaneal bursitis, and the management of it is very different. FootmanJ (talk) 11:01, 26 July 2013 (UTC)

Wrong IT IS "Policeman's heel," ask a qualified Chiropodist preferably not based in the US. I suffer from it and believe you me it is painful, my arches collapsed in both feet as a result of injury and I now have to wear orthotics specially built for me. — Preceding unsigned comment added by 90.244.55.57 (talk) 12:15, 3 August 2013 (UTC)

Bring sources that meet wp:MEDRS, please. LeadSongDog come howl! 02:29, 16 October 2013 (UTC)

Pre-GA comments

I'm not going to do the full review but here are some quick comments:

• The lead in particular is much too dense with unexplained medical terminology, as so often. This will just put off the average reader.
• I'm getting dubious about what seems to be a common practice of just having DMOZ in External links. It seems a semi-moribund, and typically US-centric, resource to me. In this case 2 of the 6 links on the DMOZ page (# 2 & 3 I think) perpetuate what other links say is the "misnomer" that "heel spur" (which WP redirects to Calcaneal spur) is the same as Plantar fasciitis. One thing all the 6 sites do is mention both terms, those making the distinction all pointing out the "misnomer", not mentioned by WP as such, though heel spurs are covered in para 2 of diagnosis. I must say I'd never heard the term in the UK, but it seems to be common in the US. Probably the lead should have a sentence explaining.
• It's a pity there's no image of the foot labelling some of the medical terms for the parts that the article uses.
• maybe more later

Wiki CRUK John (talk) 10:30, 20 May 2014 (UTC)

Thanks for pointing out the external link. I hadn't even noticed that and I agree that it was not a good choice of link. It's replaced. Regarding the lead, it's more helpful if you tell me with specific examples how the lead is too dense (because it doesn't appear too dense to me). I know it's a pity that there's no image consistent with what you described, but that's beyond the scope of what I can do. You're saying there should be a sentence in the lead explaining heel spurs? That part doesn't make sense to me since that's linked in the body of the article and has a main page. The article is about plantar fasciitis, not heel spurs. The only reason heel spurs are mentioned at all in the article is because they're sometimes seen on imaging even though they don't actually relate to the symptoms. TylerDurden8823 (talk) 13:48, 20 May 2014 (UTC)

Additional comments:

• The lead contains a review of relevant anatomy that seems redundant with the wikilinks and doesn't seem to appear in other GA class articles about medical conditions.
• I've added several tags for sources and tone
• In the risk factors section, can odds ratios be reported?
• The paragraph on Extracorporeal shockwave therapy in the treatment section... I've never heard of Extracorporeal shockwave therapy. Is it a commonly used medical treatment?

All-in-all I think it would pass after adding some more citations and fixing a couple areas for tone. Good work ITasteLikePaint (talk) 14:03, 20 May 2014 (UTC)