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Is 'plantar heel pain' a more appropriate term than 'plantar fasciitis'? Time to move on

PainSci » bibliography » Riel et al 2017
Tags: plantar fasciitis, etiology, foot, leg, limbs, pain problems, overuse injury, injury, tendinosis, pro

Two articles on PainSci cite Riel 2017: 1. Complete Guide to Plantar Fasciitis2. Baxter’s Neuritis versus Plantar Fasciitis

PainSci commentary on Riel 2017: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This is a short, articulate paper arguing that plantar heel pain is too poorly understood to be named after any specific cause. “Plantar fasciitis” implies only one of several possible explanations for the condition. The authors “propose the term ‘plantar heel pain’ to describe the condition of pain under the heel when no differential diagnoses are indicated and until further research is undertaken to arrive at a clear understanding of the appropriate terminology and associated diagnostic criteria.”

The authors’ deserve credit for their unusually enlightened acknowledgement of an important principle: “although it should be noted that there is an unpredictable association that exists between pain and tissue integrity, as pain is an output of the brain and is not just simply caused by a noxious stimulus at a local level.”

There’s a good one-minute video summary of the paper too! (Bit of a novelty, that.)

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

During the last 300 years, a range of terms have been used to describe pain under the plantar aspect of the heel including gonorrhoeal heel, Policeman’s heel, heel spur syndrome, subcalcaneal pain, jogger’s heel, plantar fasciitis, plantar fasciopathy, plantar fasciosis and plantar heel pain. To facilitate effective communication between clinicians, improve patients’ understanding of their condition and allow for shared decision making, consistent and unambiguous terminology is required. Similar challenges with terminology have been recognised for other conditions, including groin pain experienced by athletes.1 The aim of this article is to provide a stimulus for discussion about the terminology used to describe pain under the heel and propose an appropriate term based on current knowledge. By doing so, we hope that we will set the scene for a future consensus on appropriate nomenclature for the condition of pain under the heel and its associated diagnostic criteria. Pain under the heel is typically characterised by pain located at the anteromedial aspect of the plantar heel during weight-bearing. It is usually exacerbated by …

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