# Plantar fasciitis - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - 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) ## Treatment metadata - Diclofenac — topical ## Complete treatment card ```text PLANTAR FASCIITIS 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) Review status: REVIEWED against 2 sources listed above (2026-08) 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. Source StatPearls "Plantar Fasciitis" - disease-level clinical article Status traced to the source above TOPICAL 1. DICLOFENAC [1st line] Adult Apply 1% gel to heel/sole 3-4 times daily gently rubbing in (max 16 g daily) - Up to 7 days Peds 14 years and over: Rub the gel gently into the skin 3 to 4 times daily (Children 14 years and over: rub gently into skin 3-4 times daily) 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. Caution Diclofenac is a topical alternative for patients with NSAID GI risk or intolerance. Wash hands after application. Avoid contact with open wounds or eyes. Egypt 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 > ... 72.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)