Is Higher BMI Associated with Plantar Fasciopathy/Fasciitis?

Research Paper Title

Higher body mass index is associated with plantar fasciopathy/‘plantar fasciitis’: systematic review and meta-analysis of various clinical and imaging risk factors.

Question

What (risk) factors are associated with plantar fasciopathy (PF)?

Design

Systematic review with meta-analyses.

Participants

Patients with PF.

Factors

All factors described in prospective, case–control or cross-sectional observational studies.

Results

51 included studies (1 prospective, 46 case–control and 4 cross-sectional studies) evaluated a total of 104 variables. Pooling was possible for 12 variables. Higher body mass index (BMI) (BMI>27, OR 3.7 (95% CI 2.93 to 5.62)) in patients with PF was the only significant clinical association, and its effect was the strongest in the non-athletic subgroup. In people with PF compared to controls, pooled imaging data demonstrated a significantly thicker, hypoechogenic plantar fascia with increased vascular signal and perifascial fluid collection. In addition, people with PF were more likely to have a thicker loaded and unloaded heel fat pat, and bone findings, including a subcalcaneal spur and increased Tc-99 uptake. No significant difference was found in the extension of the first metatarsophalangeal joint.

Conclusions

The researchers found a consistent clinical association between higher BMI and plantar fasciopathy. This association may differ between athletic and non-athletic subgroups. While consistent evidence supports a range of bone and soft tissue abnormalities, there is lack of evidence for the dogma of clinical and mechanical measures of foot and ankle function. Clinicians can use this information in shared decision-making.

Reference

van Leeuwen, K.D.B., Rogers, J,, Winzenberg, T, & van Middelkoop, M (2016) Higher Body Mass Index is Associated with Plantar Fasciopathy/‘Plantar Fasciitis’: Systematic Review and Meta-analysis of Various Clinical and Imaging Risk Factors. British Journal of Sports Medicine. 50(16), pp.972-981. doi:10.1136/bjsports-2015-094695.

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