Association of Obesity and Plantar Fasciitis in Patients With Plantar Heel Spurs

Abstract

Background: Although its pathophysiology is not clear, the presence of a plantar heel spur has been considered a cause of heel pain in plantar fasciitis. This study investigated demographic and radiographic differences between a plantar fasciitis patient group with plantar heel spur and the age/sex-matched control group with plantar heel spur. Methods: Patients who visited the office under the diagnosis of plantar fasciitis and had a plantar heel spur were compared to an age/sex-matched control group who visited the office with other foot and ankle issues except for heel pain. All patients in both the control and case groups had radiographically proven presence of a plantar heel spur. Demographics and radiographic findings between the 2 groups were compared, and a multivariable logistic regression analysis was performed to identify independent risk factors that are associated with plantar fasciitis symptoms. Results: A total of 100 patients were included in the plantar fasciitis study group (PF+S) and age/sex-matched control group (C+S). BMI was higher in the study group than in the control group: 35.2 vs 30.9 ( P = .002). The size of the plantar heel spur was larger in the study group than in the control group: 5.9 vs 4.6 mm ( P = .017). A multivariable regression analysis identified that obesity (BMI > 30, odds ratio [OR] = 2.675) and the size of plantar heel spur >5.3 mm (OR = 2.642) were associated with PF+S. Conclusion: We found an association of both obesity and increased average plantar heel spur length on lateral radiographs in patients with painful plantar fasciitis compared to patients without plantar fasciitis but with plantar heel spurs. The presence of a plantar heel spur alone did not account for the symptoms of plantar fasciitis. Level of Evidence: Level III, comparative case study.