Plantar fasciitis, a self-limiting condition, is a common cause of heel pain in 
adults. It affects more than 1 million persons per year, and two-thirds of 
patients with plantar fasciitis will seek care from their family physician. 
Plantar fasciitis affects sedentary and athletic populations. Obesity, excessive 
foot pronation, excessive running, and prolonged standing are risk factors for 
developing plantar fasciitis. Diagnosis is primarily based on history and 
physical examination. Patients may present with heel pain with their first steps 
in the morning or after prolonged sitting, and sharp pain with palpation of the 
medial plantar calcaneal region. Discomfort in the proximal plantar fascia can 
be elicited by passive ankle/first toe dorsiflexion. Diagnostic imaging is 
rarely needed for the initial diagnosis of plantar fasciitis. Use of 
ultrasonography and magnetic resonance imaging is reserved for recalcitrant 
cases or to rule out other heel pathology; findings of increased plantar fascia 
thickness and abnormal tissue signal the diagnosis of plantar fasciitis. 
Conservative treatments help with the disabling pain. Initially, 
patient-directed treatments consisting of rest, activity modification, ice 
massage, oral analgesics, and stretching techniques can be tried for several 
weeks. If heel pain persists, then physician-prescribed treatments such as 
physical therapy modalities, foot orthotics, night splinting, and corticosteroid 
injections should be considered. Ninety percent of patients will improve with 
these conservative techniques. Patients with chronic recalcitrant plantar 
fasciitis lasting six months or longer can consider extracorporeal shock wave 
therapy or plantar fasciotomy.