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- Issue 95
- Frequency of central sensitization and nociplastic…
Frequency of central sensitization and nociplastic pain in patients with plantar fasciitis
Key Points
- Nociplastic pain and central sensitization are common in people with chronic plantar heel pain.
BACKGROUND AND OBJECTIVE
Plantar heel pain (PHP) is a common condition that significantly impacts individuals through persistent symptoms, reduced physical activity, and diminished quality of life. Longitudinal research reports that 46% of individuals continue to experience symptoms an average 10 years after onset, even after trying an average of four different treatments (including corticosteroid injection, insoles, rehabilitation, NSAIDs, shockwave therapy, acupuncture) (1). Treatment approaches typically focus on mechanical drivers of symptoms and target local structures/impairments at the foot and ankle.
However, if symptoms are perpetuated by altered central pain processing, targeting local structures/impairments alone may prove insufficient for optimal outcomes. Identifying patients with altered central pain processing may be important to guide treatment decisions, potentially allowing clinicians to implement a more holistic pain management approach alongside locally focused physical treatments.
The aim of this study was to investigate the frequency of central sensitivity and nociplastic pain in people with plantar heel pain for at least six months, compared to people of similar age and sex with chronic musculoskeletal pain (without foot pain).
26-53% of patients had comorbidities such as fibromyalgia, chronic fatigue syndrome, anxiety, and depression, highlighting the complex, multifaceted nature of chronic plantar heel pain.
METHODS
- People aged 18-65 years who attended an outpatient clinic with heel pain for six months or longer and were diagnosed with plantar fasciitis by a Physical medicine and Rehabilitation specialist participated in the study.