Two-footed plantar fasciitis is the worst (literally)
Plantar fasciitis — foot-arch tendinitis — is known for being stubborn. Norwegian researchers, Røe et al, tracked how it goes over a full year, making it the biggest study so far of the “natural history” of plantar fasciitis. Who were the winners and losers? Their data was extracted from a separate trial, which I’ve written about before: “Shocking shockwave defeat.” For most patients…
- Pain during activity eased from 6.3 to 2.8, and pain at rest from 3.7 to 1.9 … good progress, and with no treatment, mind you, and this despite the fact that almost half of them had already been in pain for more than a year.
- Foot function scores also improved dramatically, and physical quality of life nudged upward toward normal population levels.
- The biggest gains came in the first three months, but then plateaued. Despite those improvements almost no one was entirely better after a year.
And then there were the un-lucky ones:
- People with pain in both feet, about 40% of the subjects, had a distinctly different “trajectory,” worse in every way.
- Slow recovery was also more prevalent with lower education and unemployment — which is basically standard across all conditions.
- The people who didn’t do as well had also done fewer heel raises in the year. Interesting.
For most people, the healing trajectory looks like a long downhill walk: almost steep for a while, then slowly flattening for quite a long time. For those at the greatest risk, healing stalls entirely, and can even become an uphill battle again.
My plantar fasciitis book has been updated with this citation. I’ve used it to support three points, and have a couple more in mind. See the bibliography page for more detail.