Plantar Fasciitis in Diabetic Foot Patients: Risk Factors, Pathophysiology, Diagnosis, and Management

Abstract

Karim Gariani,1 Felix WA Waibel,2 Arnd F Viehöfer,2 Ilker Uçkay3 1Service of Endocrinology, Diabetes, Hypertension and Nutrition, Geneva University Hospitals, Geneva, Switzerland; 2Foot and Ankle Service, Department of Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland; 3Unit for Clinical and Applied Research, Balgrist University Hospital, Zurich, SwitzerlandCorrespondence: Karim GarianiEndocrinology, Diabetes, Hypertension and Nutrition, Geneva University Hospitals, Geneva, SwitzerlandEmail [email protected]: Plantar fasciitis (PF) is a common degenerative disorder and a frequent cause of heel pain, mostly affecting patients in their fourth and fifth decades. Diabetic patients are particularly at risk due to the presence of common risks and co-morbidities such as obesity or a sedentary lifestyle. The diagnosis of PF is mainly clinical. Imaging is not recommended for the initial approach. The initial management is conservative and should include physiotherapy, off-loading, stretching exercises, and nonsteroidal anti-inflammatory drugs. Glucocorticoid injections or surgery is an option at a later stage in recalcitrant cases. The overall management of PF does not differ between patients with diabetic foot problems and non-diabetic patients, although the details can differ. This narrative review summarizes the state of the art in terms of the risk factors, pathophysiology, diagnosis, assessment, and management of PF in diabetic patients.Keywords: plantar fasciitis, diabetic foot, management, epidemiology, diagnosis

Keywords

• plantar fasciitis
• diabetic foot
• management
• epidemiology
• diagnosis