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Careful when treating plantar fasciitis

Mr Rohit Madhav's article on plantar fasciitis covers the subject very well. (The information: plantar fasciitis)

But as a rheumatologist, I was somewhat concerned by your photograph showing injection through the sole.

I advocate a lateral approach because it is far less painful and no less effective, although there are several variables in regard to steroid injections – such as length of needle, steroid dose and type plus post-injection advice. Also, I think it is good to use local anaesthetic before injecting, rather than the combined steroid/local injection. The more comfortable the first injection, the less likely a patient will refuse a repeat, which are sometimes needed.

One other point – plantar fasciitis is sometimes associated with raised urate levels, and it may be helpful to treat that for a time, if persistent, especially in bilateral fasciitis.

From Dr Geoff Clarke, Brentwood, Essex