Gill LH
Miller Orthopaedic Clinic, Charlotte, NC.
J Am Acad Orthop Surg. 1997 Mar;5(2):109-117. doi: 10.5435/00124635-199703000-00006.
Plantar fasciitis is a common cause of heel pain, which frustrates patients and practitioners alike because of its resistance to treatment. It has been associated with obesity, middle age, and biomechanical abnormalities in the foot, such as tight Achilles tendon, pes cavus, and pes planus. It is considered to be most often the result of a degenerative process at the origin of the plantar fascia at the calcaneus. However, neurogenic and other causes of subcalcaneal pain are frequently cited. A combination of causative factors may be present, or the true cause may remain obscure. Although normally managed with conservative treatment, plantar fasciitis is frequently resistant to the wide variety of treatments commonly used, such as nonsteroidal anti-inflammatory drugs, rest, pads, cups, splints, orthotics, corticosteroid injections, casts, physical therapy, ice, and heat. Although there is no consensus on the efficacy of any particular conservative treatment regimen, there is agreement that nonsurgical treatment is ultimately effective in approximately 90% of patients. Since the natural history of plantar fasciitis has not been established, it is unclear how much of symptom resolution is in fact due to the wide variety of commonly used treatments.
足底筋膜炎是足跟疼痛的常见原因，因其治疗困难，令患者和医生都感到困扰。它与肥胖、中年以及足部生物力学异常有关，如跟腱紧张、高弓足和扁平足。它通常被认为是跟骨处足底筋膜起点退变过程的结果。然而，神经源性和其他导致跟骨下疼痛的原因也经常被提及。可能存在多种致病因素，或者真正的病因可能仍不明确。尽管足底筋膜炎通常采用保守治疗，但它经常对常用的多种治疗方法有抵抗，如非甾体类抗炎药、休息、鞋垫、足杯、夹板、矫形器、皮质类固醇注射、石膏固定、物理治疗、冰敷和热敷。尽管对于任何特定保守治疗方案的疗效尚无共识，但人们一致认为非手术治疗最终对约90%的患者有效。由于足底筋膜炎的自然病程尚未确定，目前尚不清楚症状缓解实际上有多少是由于常用的多种治疗方法所致。
