Pain catastrophizing beliefs and neuropathic symptoms are associated with a poorer long-term recovery in chronic plantar heel pain: a cohort study

Key Points

1. Individuals with chronic plantar heel pain that display worsening pain catastrophizing beliefs or neuropathic symptoms demonstrated poorer foot pain recovery over 12 months, but no association was found with foot function or quality of life.

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BACKGROUND & OBJECTIVE

Pain catastrophizing is characterized by heightened threat, negative expectations, feeling helpless and worrying about pain (1). Entrapment of terminal branches of posterior tibial nerve relates to neuropathic symptoms in individuals with chronic plantar heel pain (CPHP) (2).

Physical risk factors like ankle dorsiflexor and toe flexor muscle weakness, multisite pain, limited 1st metatarsophalangeal joint mobility and other factors that increase stress of plantar fascia are known causes for CPHP (3).

This study aimed to understand the association of how changes in an individual’s physical factors, psychological factors and activity levels affect their foot pain, function and quality of life recovery over 12 months.

Entrapment of terminal branches of posterior tibial nerve relates to neuropathic symptoms in individuals with chronic plantar heel pain.

Clinicians may incorporate the use of screening tools such as the Pain Catastrophizing Scale (PCS) and PainDETECT questionnaire to identify catastrophizing pain beliefs and neuropathic symptoms, respectively.

METHODS

The study enrolled 220 participants between November 2014 and May 2016 through clinics, workplaces, sporting clubs, community organizations, newspaper advertisements and social media. Eligible participants were aged 18 years or older and had a clinical diagnosis of plantar heel pain

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