Biologics in the Treatment of Plantar Fasciitis

Plantar fasciitis is a one of the most common musculoskeletal (MSK) disorders encountered in a foot and ankle specialist?s office, afflicting up to 15% of adults1 and accounting for up to 1 million patient visits per year.2 The diagnosis of plantar fasciitis is mostly based on clinical symptoms and specific physical examination findings. Patients usually present with sharp pain isolated to the medial plantar tubercle, plantar calcaneus, or along the medial or central band of the fascia itself. Subjective complaints of post-static dyskinesia and worsening symptoms with barefoot walking are common. Most cases are believed to be secondary to altered biomechanics, which must be addressed. Heel pain of neurologic, arthritic, or traumatic origin should be ruled out as appropriate. Other, more obscure, causes should be explored in chronic cases unresponsive to standard treatment. Most cases of symptomatic plantar fasciitis are resolved with conservative therapies. However, approximately 10% remain recalcitrant. Plantar fasciitis has historically been considered an acute inflammatory disorder; however, it is now understood that the local histologic findings represent a more ? The role of regenerative medicine in the treatment of musculoskeletal disorders is continually expanding. Biologic therapies are being explored for their regenerative potential in a wide array of musculoskeletal disorders. ? Biologic therapies are categorized based on their derivation into three broad categories: cellular, blood, and noncellular. ? Biologic therapies can provide a multitude of different cellular components, growth factors, and proteins in an attempt to restore normal tissue biology and may be useful as an adjunct in the treatment of recalcitrant plantar fasciitis.