Management of planter heel pain in general practice in Australia

Background: Studies have described general practitioner (GP) management of plantar heel pain from some countries; however, there is limited information from Australian general practice. Objectives: To describe patient and GP characteristics, and management actions for plantar heel pain in Australian general practice. Design: Secondary analysis of data from the Bettering the Evaluation and Care of Health (BEACH) dataset. Methods: Data were summarised using descriptive analysis and robust 95% confidence intervals (CIs) were calculated around point estimates. Multivariate logistic regression identified predictors of plantar heel pain management. Results: From 1,568,100 encounters between April 2000 and March 2016, plantar heel pain was managed at 3007 encounters. GPs manage plantar heel pain approximately once every 500 encounters, which extrapolates to 271,100 encounters in 2015-2016. Patient factors independently associated with plantar heel pain encounters included female sex (OR 1.27, 95% CI 1.17-1.34 cf. males), being aged 45-64 (OR 3.44, 95% CI 2.94-4.01 cf. aged 75+) and patients from a non-English speaking background (OR 1.22, 95% CI 1.07-1.39). Plantar heel pain was frequently managed using medication (45.1 per 100), with non-steroidal anti-inflammatory drugs the most common (22.8 per 100). GPs also commonly provided counselling/advice/education (32.4 per 100), and referrals for diagnostic imaging (19.1 per 100) and to podiatrists (12.0 per 100). Conclusions: Plantar heel pain is a frequently managed foot condition in Australian general practice. GPs use medication, counselling and education, diagnostic imaging and referral to podiatrists for management. Further research is required to understand the drivers of these management actions and whether they are effective.