Clinical reference

Plantar fasciitis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

AAOS Clinical Practice Guideline on Plantar Fasciitis 2014 · Diclofenac sodium 50 mg delayed-release (gastro-resistant) tablets US prescribing information, DOSAGE AND ADMINISTRATION (DailyMed SetID a57b897e-0cbe-4ac3-969f-b00357a0cfa8) · Diclofenac topical gel SmPC section 4.2 (eMC) · Plantar Fasciitis - disease-level clinical article (plantar-fasciitis-full.txt)

Verified against2 documents

Diclofenac sodium 50 mg delayed-release (gastro-resistant) tablets US prescribing information, DOSAGE AND ADMINISTRATION (DailyMed SetID a57b897e-0cbe-4ac3-969f-b00357a0cfa8)
Diclofenac topical gel SmPC section 4.2 (eMC)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

Pain is sharp and worst with the first steps out of bed in the morning. [foot pain]
Pain eases with the start of activity but then worsens again as the day's activity continues.
Despite the name ending in -itis, there are no inflammatory cells in it - the process is degenerative
The irritation sits where the fascia takes off from the inner side of the heel bone, and in the tissues around it
Most cases come from overuse, though the causes are several

Signs — what you find (4)

A positive windlass (Jack) test reproduces the pain on passive dorsiflexion of the big toe joint.
Associated findings can include a tight Achilles tendon, flat feet, or high-arched feet. [foot deformity]
The fascia holds up the arch and absorbs the shock of each step [shock]
A heel spur is sometimes found on the film

Tests (4)

The diagnosis is made clinically, and imaging is not routinely required.
Ultrasound characteristically shows thickening and swelling of the plantar fascia.
MRI, reserved for non-responders, shows fascial thickening with increased signal on STIR sequences.
Warn the patient early: this is hard to treat, most cases are managed without surgery, and the pain coming back is the usual frustration

If not this — what else fits (2)

Tarsal tunnel syndrome (a nerve entrapment), fat pad contusion or atrophy, and stress fracture belong on the differential too.
Other diagnoses to exclude are calcaneal injury, infection, sickle cell bone pain, contusion, neuropathic pain, tendinitis, osteoporosis, and malignancy.

SourceStatPearls "Plantar Fasciitis" - disease-level clinical article

Presentation findings are traced to the source above.

TOPICAL

DICLOFENAC

Topical

1st line

Formtopical

Adult dose and duration

Apply 1% gel to heel/sole 3-4 times daily gently rubbing in (max 16 g daily) - Up to 7 days

Paediatric dose

(Children 14 years and over: rub gently into skin 3-4 times daily)

Dose by age
14 years and over:	Rub the gel gently into the skin 3 to 4 times daily

Dose source

Diclofenac topical gel SmPC section 4.2 (eMC)

Why

Topical diclofenac gel delivers the same anti-inflammatory NSAID action directly to the heel and sole with much lower systemic absorption, making it an option for patients who cannot tolerate oral NSAIDs because of GI risk.

Cautions

Diclofenac is a topical alternative for patients with NSAID GI risk or intolerance.
Wash hands after application.
Avoid contact with open wounds or eyes.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
RHEUMAFEN ACTI-GEL 1% GEL 15 GM	GLAXO SMITHKLINE	5.00 EGP
OLFEN 1% TOPICAL GEL 15 GM	MUP > ACINO	9.00 EGP
DECLOFENAC 1% GEL 20 GM	EL NASR	13.00 EGP
DECLOPHEN GEL 1% 30 GM	PHARCO	29.00 EGP
ANTIFLAM 1% EMULGEL 20 GM	UP PHARMA	7.50 EGP
DOLPHIN 3% TOPICAL GEL 30 GM	DELTA PHARMA	34.00 EGP
DOLPHIN 3% TOPICAL GEL 60 GM	DELTA PHARMA	58.00 EGP
DICLAC-N 4% GEL 50 GM	MINA PHARM > NOVARTIS	72.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.