Foot exercise plus education versus wait and see for the treatment of plantar heel pain (FEET trial): a protocol for a feasibility study

BackgroundPlantar heel pain (PHP) is a common cause of foot complaints, but information on the occurrence in primary care is scarce.AimThe objective of this study was to determine the incidence and prevalence of PHP and to gain insight in types of treatments provided to patients with PHP in primary care.MethodA cohort study was conducted in a healthcare database containing the electronic general practice medical records of approximately 1.9 million patients throughout the Netherlands. A search algorithm was defined and used to identify cases of PHP in the years 2013–2016. Descriptive statistics were used to obtain the incidence and prevalence of PHP. Data on the management of PHP was extracted in a random sample of 1000 patients.ResultsThe overall incidence of PHP was 3.81 (95% confidence [CI] = 3.75 to 3.87) per 1000 patient years and the overall prevalence of PHP was 0.4374% (95% CI = 0.4369 to 0.4378). Incidence of PHP peaked in the last quarter of every calendar year. The GP applied a wait-and-see policy at the first consultation for PHP in 18.0% of patients. The most commonly applied interventions included prescription for NSAID (19.9%), referral to a paramedical podiatric specialist (19.7%), and advice to wear insoles (16.4%): 34.0% of patients received multiple interventions (range 2–11) and 30.9% had multiple consultations for PHP (range 2–8).ConclusionPHP appears to be common in primary care. Despite a lack of evidence for most treatments, multiple interventions are applied. This urges the need for future research on effectiveness of treatments.

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Feasibility study to evaluate the clinical and cost effectiveness of foot orthoses in the management of plantar heel pain

http://isrctn.org/> ◽

10.1186/isrctn73264439 ◽

2012 ◽

Author(s):

Keith Rome

Keyword(s):

Cost Effectiveness ◽

Feasibility Study ◽

Heel Pain ◽

Foot Orthoses ◽

Plantar Heel Pain

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Incidence, prevalence, and management of plantar heel pain: a retrospective cohort study in Dutch primary care

British Journal of General Practice ◽

10.3399/bjgp19x706061 ◽

2019 ◽

Vol 69 (688) ◽

pp. e801-e808 ◽

Cited By ~ 2

Author(s):

Nadine Rasenberg ◽

Sita MA Bierma-Zeinstra ◽

Patrick J Bindels ◽

Johan van der Lei ◽

Marienke van Middelkoop

Keyword(s):

Primary Care ◽

General Practice ◽

Cohort Study ◽

Search Algorithm ◽

Treatment Strategies ◽

Heel Pain ◽

Healthcare Database ◽

Plantar Heel Pain ◽

Conflicting Evidence ◽

Wait And See

BackgroundPlantar heel pain (PHP) is a common cause of foot complaints in general practice. However, information on the occurrence and practical management is scarce.AimThe aim of this study was to determine the incidence and prevalence of PHP in Dutch primary care and to gain insight into the types of treatments provided to patients with PHP in primary care.Design and settingA cohort study was conducted using a healthcare database containing the electronic general practice medical records of approximately 1.9 million patients throughout the Netherlands.MethodA search algorithm was defined and used to identify cases of PHP from January 2013 to December 2016. Descriptive statistics were used to obtain the incidence and prevalence. Data on the management of PHP were manually validated in a random sample of 1000 patients.ResultsThe overall incidence of PHP was 3.83 cases (95% confidence interval [CI] = 3.77 to 3.89) per 1000 patient-years, the incidence in females was 4.64 (95% CI = 4.55 to 4.72), and 2.98 (95% CI = 2.91 to 3.05) in males. The overall prevalence of PHP was 0.4374% (95% CI = 0.4369 to 0.4378%). Incidence of PHP peaked in September and October of each calendar year. The most commonly applied strategies were a wait-and-see policy (18.0%, n = 168), use of non-steroidal anti-inflammatory drugs (NSAIDs) (19.9%, n = 186), referral to a paramedical podiatric specialist (19.7%, n = 184), and advice to wear insoles (16.4%, n = 153). Treatment strategies varied greatly among GPs.ConclusionThere was large variation in treatment strategies of GPs for patients with PHP. GPs should be aware of conflicting evidence for interventions, such as insoles, and focus more on exercises for which there is evidence for effectiveness.

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Chronic Plantar Heel Pain: Treatment with a Short Leg Walking Cast

Foot & Ankle International ◽

10.1177/107110079601700109 ◽

1996 ◽

Vol 17 (1) ◽

pp. 41-42 ◽

Cited By ~ 24

Author(s):

Christopher L. Tisdel ◽

Marion C. Harper

Keyword(s):

Complete Resolution ◽

Surgical Intervention ◽

Pain Treatment ◽

Heel Pain ◽

Treatment Modalities ◽

Plantar Heel Pain ◽

Long Term Follow Up

The efficacy of a short leg walking cast in the treatment of chronic plantar heel pain was assessed for 32 patients with 37 involved extremities treated over a 2-year period. All patients had failed numerous other treatment modalities and had been symptomatic for an average of 1 year. Long-term follow-up for 24 patients with 28 involved extremities revealed complete resolution of pain for 7 extremities (25%), improvement for 17 (61%), and no improvement for 4 (14%). Ten (42%) patients were completely satisfied with cast treatment, 3 (12%) were satisfied with reservations, and 11 (46%) were dissatisfied. Casting appears to be a reasonable option for patients with recalcitrant heel pain and should be offered before surgical intervention.

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