The association of demographic, psychological, social and activity factors with foot health in people with plantar heel pain

Background Plantar Heel Pain (PHP) can be a debilitating musculoskeletal condition from which only 50% recover within a year due to poor understanding of the mechanisms explaining severity and predicting outcomes specific to PHP. Objective To explore associations between biopsychosocial variables and the severity of people with PHP. Secondly, to determine what combination of self-reported factors distinguishes people with PHP from other foot pain (OFP). Methods We collected data from 235 participants, including 135 (%57) PHP (age 44 ± 12 years, 66% female) and 99 OFP (%43) (age 38 ± 11 years, 57% female) using 5 demographic, 13 biomedical, 8 psychological, 3 social and 8 activity-related factors. These were tested in linear and logistic regression models. Results Quality of life (QoL) (β = 0.35; p < 0.001), education (β = −0.22; p = 0.003), gender (β = −0.20; p = 0.007), morning pain duration (β = −0.18; p = 0.01) and disease duration (β = −0.15; p = 0.040) were significantly associated with severity of PHP. The second model, without QoL, showed that having sensitisation (β = −0.18; p = 0.002) and a higher level of morning pain (β = −0.20; p = 0.01) are associated with severity. The logistic regression results revealed that people with PHP tend to have a systemic disease (OR = 3.34; 1.53–7.76), express more kinesiophobia (OR = 1.02; 1.01–1.14), are less likely to have previous injuries (OR = 0.40; 0.19–0.81), worse morning pain (OR = 1.02; 1.01–1.03) and standing pain (OR = 2.60; 1.39–4.87) compared to people with OFP. Conclusions People with PHP have higher associated levels of a range of psychological, social and activity related factors than people with OFP. The findings highlight the importance of considering psychosocial assessments alongside physical examination.