The incidence, prevalence, and management of plantar heel pain in Dutch general practice

Nadine Rasenberg; Sita MA Bierma-Zeinstra; Patrick Bindels; Johan van der Lei; Marienke Van Middelkoop

doi:10.3399/bjgp19X703217

Abstract

Background Plantar heel pain (PHP) is a common cause of foot complaints, but information on the occurrence in primary care is scarce.

Aim The objective of this study was to determine the incidence and prevalence of PHP and to gain insight in types of treatments provided to patients with PHP in primary care.

Method A cohort study was conducted in a healthcare database containing the electronic general practice medical records of approximately 1.9 million patients throughout the Netherlands. A search algorithm was defined and used to identify cases of PHP in the years 2013–2016. Descriptive statistics were used to obtain the incidence and prevalence of PHP. Data on the management of PHP was extracted in a random sample of 1000 patients.

Results The overall incidence of PHP was 3.81 (95% confidence [CI] = 3.75 to 3.87) per 1000 patient years and the overall prevalence of PHP was 0.4374% (95% CI = 0.4369 to 0.4378). Incidence of PHP peaked in the last quarter of every calendar year. The GP applied a wait-and-see policy at the first consultation for PHP in 18.0% of patients. The most commonly applied interventions included prescription for NSAID (19.9%), referral to a paramedical podiatric specialist (19.7%), and advice to wear insoles (16.4%): 34.0% of patients received multiple interventions (range 2–11) and 30.9% had multiple consultations for PHP (range 2–8).

Conclusion PHP appears to be common in primary care. Despite a lack of evidence for most treatments, multiple interventions are applied. This urges the need for future research on effectiveness of treatments.

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