Effect of Pain Neuroscience Education along with Conventional Physiotherapy in patients with Chronic Plantar Fasciitis
Description
The plantar fascia consists of three bands of fibrous connective tissue originating from the medial calcaneal tubercle and extending to the proximal phalanges. It plays a crucial role in foot biomechanics, particularly in the windlass mechanism, which enhances the medial longitudinal arch during gait. Plantar fasciitis (PF), also termed plantar fasciopathy, is a chronic degenerative condition of the plantar aponeurosis, primarily causing heel pain. It is commonly referred to as "jogger’s heel" or "policeman’s heel." PF affects approximately 1% of the general population, with higher prevalence among runners, military personnel, and individuals aged 45-64, especially women. Around 30% of cases present with bilateral symptoms. Several factors contribute to PF, including a tight gastrocnemius muscle due to prolonged sitting, high heels, or limited dorsiflexion. Flat feet, heel pronation, obesity, improper footwear, and nerve entrapment are also implicated. Structural foot abnormalities like pes planus, pes cavus, and leg length discrepancies increase susceptibility. Conservative treatments for PF include medications, splints, manual therapy, exercise, and orthotics. However, about 10% of patients experience persistent symptoms. Psychological factors like pain catastrophizing and fear of movement significantly impact recovery. A biopsychosocial approach integrating physical therapy with psychological interventions may improve outcomes. Pain Neuroscience Education (PNE) has emerged as a promising treatment for chronic pain conditions, aiming to alter pain perception and reduce fear and anxiety. While PNE has demonstrated benefits for conditions like fibromyalgia and low back pain, its efficacy in managing chronic plantar fasciitis remains underexplored. This study evaluates the effectiveness of PNE alongside conventional physiotherapy in patients