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Preferred plantar fasciitis treatment changes with duration of symptoms

Foot and ankle surgeons favor stretching for a patient with four months of plantar fasciitis symptoms but turn to less conservative treatments if the pain continues for four months, according to survey results presented in February at the AAOS meeting.

Researchers from Bowling Green University surveyed 83 foot and ankle surgeons about their preferred response to a hypothetical case of plantar fasciitis. Presented with four months of symptoms, respondents were asked to pick one of six non-operative treatments; 43% picked plantar fascia-specific stretching, followed by physical therapy (24%) and night splinting (21%).

Presented with 10 months of symptoms, the surgeons had to pick two choices from a longer list that included surgical procedures. Only 25% selected non-operative treatment, 33% selected extracorporeal shock wave therapy, and 72% went with surgery.

The extent to which respondents said their decisions would be evidence-based also changed over time, from 75.9% at four months to 48.2% at 10 months. Nearly 40% of respondents said treatment at 10 months would be based on their personal clinical experience.

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