From the Guidelines
Rare causes of plantar fasciitis include systemic inflammatory conditions, genetic disorders, neurological conditions, metabolic disorders, infectious causes, and anatomical variations, which can trigger inflammation in the plantar fascia or alter its biomechanics. These conditions can lead to plantar fasciitis through various mechanisms, such as inflammation, crystal deposition, neuropathic changes, or biomechanical stress. Some of the specific rare causes of plantar fasciitis include:
- Systemic inflammatory conditions such as rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis, as mentioned in the study by 1
- Genetic disorders like Marfan syndrome, which can affect connective tissue integrity
- Neurological conditions such as tarsal tunnel syndrome, which can mimic or contribute to plantar fascia pain
- Metabolic disorders including gout and diabetes mellitus, which can cause plantar fasciitis through crystal deposition in the fascia or through neuropathic changes, as discussed in the study by 1
- Infectious causes, such as bacterial infections, which can directly involve the fascia
- Anatomical variations like accessory muscles in the foot or tarsal coalition, which can alter biomechanics and stress the plantar fascia It is essential to consider these rare causes when plantar fasciitis presents atypically, is bilateral, occurs in younger patients without risk factors, or fails to respond to conventional treatments, as they may require specific treatments beyond standard plantar fasciitis management, as recommended by 1. Identifying the underlying cause of plantar fasciitis is crucial to provide effective treatment and improve patient outcomes, as emphasized in the study by 1. In some cases, surgical intervention may be necessary to treat underlying conditions, such as diabetic foot infections, as discussed in the study by 1. Overall, a comprehensive approach to diagnosing and treating plantar fasciitis should consider both common and rare causes, as well as individual patient factors, to optimize treatment outcomes.
From the Research
Rare Causes of Plantar Fasciitis
There are no specific mentions of rare causes of plantar fasciitis in the provided studies. However, some studies discuss the common causes and risk factors associated with plantar fasciitis, such as:
- Obesity 2, 3
- Excessive foot pronation 2
- Excessive running 2
- Prolonged standing 2, 3
- Limited ankle dorsiflexion 3
- Increased body mass index 3
Diagnosis and Treatment
The diagnosis of plantar fasciitis is generally made clinically, but diagnostic modalities such as ultrasonography and magnetic resonance imaging may be used to confirm the diagnosis 2, 3, 4. Treatment options for plantar fasciitis include:
- Conservative measures such as rest, activity modification, ice massage, oral analgesics, and stretching techniques 2, 3
- Physical therapy modalities, foot orthotics, night splinting, and corticosteroid injections 2
- Extracorporeal shock wave therapy or plantar fasciotomy for chronic recalcitrant cases 2, 3
Other Conditions
One study discusses the use of methotrexate for treating rheumatoid arthritis, which is a separate condition from plantar fasciitis 5. This study is not directly relevant to the topic of rare causes of plantar fasciitis.