The overlooked menace of plantar fasciitis in the Nigerian setting, with a contextualized treatment protocol

Abstract

Context: Plantar fasciitis is the commonest painful condition of the heel. It has a worldwide prevalence of 10%, a major economic impact and a key negative impact on quality of life. While publications on this condition from the developed world are fairly common, the publications from Nigeria on this condition are scanty and none by a Physiotherapist was found. These findings suggest gross underdiagnosis and thus many people suffering from this condition in this environment may be in misery despite available remedies.
Objective: The aim of the study is to draw attention to Plantar fasciitis in this environment, highlight details of Physiotherapy care and provide a contextualized treatment protocol.
Study design, setting and subjects: This study applied a retrospective observational study design. A case report was included for depth of discourse. The participants were patients with this condition who presented to the outpatient clinic of the index Physiotherapy department.
Results: There were 10 patients with Plantar fasciitis over the 5-year period of the study. Seven of the  patients were in the 40 – 60 year age group; nine out of the 10 patients were female; one patient was self-referred and the median duration of symptoms before presentation was seven months. The main features upon which diagnosis was based were inferior heel pain, first step pain and heel tenderness. All but one patient stopped attending clinic prematurely – probably due to frustration with delay in symptom resolution and fund constraints. A trace of the patients provided data on eight (80%) of them, which showed that six (60%) of the patients had full resolution of the posterior heel pain.
Conclusion: Plantar fasciitis is likely to be more common in this environment than published work in this setting indicates. Stretching of the Triceps surae / plantar fascia is the mainstay of treatment. A treatment protocol scaled to our resource constrained setting provides for the major components of diagnosis and treatment in the literature and from our experience. It is hoped that awareness of this condition will increase, and the suffering of patients be mitigated.