Neufeld Steven K, Cerrato Rebecca
Orthopaedic Foot and Ankle Center, Arlington, VA 22206-8316, USA.
J Am Acad Orthop Surg. 2008 Jun;16(6):338-46. doi: 10.5435/00124635-200806000-00006.
Plantar fasciitis is the most common cause of plantar heel pain. Its characteristic features are pain and tenderness, predominately on the medial aspect of the calcaneus near the sole of the heel. Considering a complete differential diagnosis of plantar heel pain is important; a comprehensive history and physical examination guide accurate diagnosis. Many nonsurgical treatment modalities have been used in managing the disorder, including rest, massage, nonsteroidal anti-inflammatory drugs, night splints, heel cups/pads, custom and off-the-shelf orthoses, injections, casts, and physical therapy measures such as shock wave therapy. Most reported treatment outcomes rely on anecdotal experience or combinations of multiple modalities. Nevertheless, nonsurgical management of plantar fasciitis is successful in approximately 90% of patients. Surgical treatment is considered in only a small subset of patients with persistent, severe symptoms refractory to nonsurgical intervention for at least 6 to 12 months.
足底筋膜炎是足跟底部疼痛最常见的原因。其特征性表现为疼痛和压痛，主要位于足跟底部靠近足跟内侧的跟骨处。考虑到足跟底部疼痛的完整鉴别诊断很重要；全面的病史和体格检查有助于准确诊断。许多非手术治疗方法已被用于管理该疾病，包括休息、按摩、非甾体类抗炎药、夜间夹板、足跟杯/垫、定制和现成的矫形器、注射、石膏固定以及物理治疗措施，如冲击波疗法。大多数报道的治疗结果依赖于轶事经验或多种方法的组合。然而，足底筋膜炎的非手术治疗在大约90%的患者中是成功的。仅在一小部分经至少6至12个月非手术干预仍有持续、严重症状且难治的患者中考虑手术治疗。
