b) Plantar Fasciitis

Plantar fasciitis is a common condition for which aetiology is not completely clear; it is usually related to repetitive stressors to the foot (eg. running, exercise). Most patients complain of pain when walking. Examination demonstrates point tenderness within the plantar fascia.

Treatment is usually conservative, with initial rest, anti-inflammatories and increased shoe wearing (or shoe supports). Steroid injection is reserved for difficult cases.

Radiotherapy is used for refractory plantar fasciitis in Germany but few other centres perform this treatment. Doses and fractionation schedules vary widely. An example might be 6 Gy in 6 fractions, 3 fractions per week. Radiotherapy is an effective treatment but is not routinely used due to concerns about second malignancies and unnecessary radiation exposure.