O35. Population Prevalence and Associations of Plantar Heel Pain in Adults Aged 50 Years and Over: Cross-Sectional Findings from the Clinical Assessment Study of the Foot

Roddy, Edward; Case, Rebecca; Thomas, Martin J.; Menz, Hylton B.; Rathod, Trishna; Marshall, Michelle

Abstract

Background: Plantar heel pain is a very common presentation to primary care and yet among the most difficult to manage. There is a lack of epidemiological evidence on the rates of consultation for the condition and of the health status of affected individuals. Greater understanding of these aspects may help more appropriately target and successfully manage the condition. The objectives of this study were to estimate the population prevalence and distribution of plantar heel pain in mid-to-older age groups; examine associations with health status; and report frequency of healthcare use.

Methods: A general Health Survey was mailed to all adults aged ≥50 years registered with four general practices in North Staffordshire. Plantar heel pain in the last month was defined by self-reported shading on a foot manikin. Disabling plantar heel pain was defined as self-reported foot problems occurring on most/every day(s) on at least one of the 10 function items of the Manchester Foot Pain and Disability Index. Population prevalence was estimated using multiple imputation and weighted logistic regression. The following analyses were based on complete case data. Binary logistic regression estimated the association between plantar heel pain and demographic characteristics, health status measures [Short Form-12, Hospital Anxiety and Depression Scale) and lifestyle factors (BMI), Short-Form International Physical Activity Questionnaire, past use of high-heeled footwear]. Healthcare use was summarized as the 12-month period prevalence of foot-related consultation.

Results: The population prevalence of plantar heel pain was 9.1% (95% CI 8.3, 9.9) and 7.4% (95% CI 6.7, 8.1) for disabling plantar heel pain. Prevalence was higher in females, and in those with routine and manual occupations. Plantar heel pain was less prevalent but more frequently disabling in older age groups. After adjustment for age, sex and BMI, plantar heel pain was associated with poorer physical health [adjusted odds ratio (aOR) 3.9 (95% CI 2.9, 5.2)], poorer mental health [aOR 2.6 (95% CI 2.0, 3.3)], anxiety [aOR, mild 2.4 (95% CI 1.8, 3.1); moderate 3.0 (95% CI 2.2, 4.0); severe 3.2 (95% CI 2.2, 4.7)], depression [aOR, mild 2.2 (95% CI 1.7, 2.9); moderate 2.7 (95% CI 2.0, 3.6); severe 3.2 (95% CI 2.2, 4.7)], BMI [aOR, overweight 1.7 (95% CI 1.3, 2.2); obese 2.1 (95% CI 1.5, 2.9); severely obese 5.1 (95% CI 3.6, 7.2)] and low levels of physical activity [aOR, 2.9 (95% CI 2.3, 3.6)] but not high-heeled footwear [aOR, 0.8 (95% CI 0.6, 1.1)]. The 12-month period prevalence of foot-related consultation with a general practitioner or allied health professional was 43.6% (95% CI 38.6, 48.8) and 41.5% (95% CI 36.6, 46.5), respectively.

Conclusion: Plantar heel pain is a common, disabling symptom among adults aged 50 years and over. Observed patterns of association indicate that in addition to focused site-specific management, interventions should also target more general physical and psychological factors that could potentially act as barriers to treatment compliance and recovery.

Citation

Roddy, E., Case, R., Thomas, M. J., Menz, H. B., Rathod, T., & Marshall, M. O35. Population Prevalence and Associations of Plantar Heel Pain in Adults Aged 50 Years and Over: Cross-Sectional Findings from the Clinical Assessment Study of the Foot. Rheumatology, 54(S1), i39–i40. https://doi.org/10.1093/rheumatology/kev084.005

• Journal Article Type: Conference Paper
• Online Publication Date: Apr 20, 2015
• Deposit Date: Sep 5, 2023
• Journal: Rheumatology
• Print ISSN: 1462-0324
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 54
• Issue: S1
• Pages: i39–i40
• DOI: https://doi.org/10.1093/rheumatology/kev084.005