Prevalence and Association of Risk Factors for Plantar Fasciitis Among Nurses in Government Tertiary Care Hospitals of Peshawar

Main Article Content

Dr. Muhammad Suleman Sikander
Naeem Ullah Shinwari
Dr. Jamal Shah
Dr. Muhammad Atif
Syed Issam Ullah Jan
Maria Naz


Background: Plantar fasciitis is a common cause of heel discomfort and pain, resulting from inflammation of the plantar fascia, a thickened fibrous aponeurosis extending from the medial calcaneal tuberosity to the metatarsal heads. It affects more than 1 million people worldwide annually, with a lifetime prevalence that may reach 10% of the general population. Despite its widespread impact, the exact incidence remains unknown.

Objective: This study aimed to determine the prevalence and associated risk factors of plantar fasciitis among nurses working in government tertiary care hospitals in Peshawar.

Methods: A cross-sectional survey was conducted over six months, utilizing a convenient sampling technique. A total of 332 female nurses aged 25 to 50 years with clinical duties exceeding five hours per day participated in the study. Data were collected using the Plantar Fasciitis Pain and Disability Scale and the Visual Analogue Scale (VAS) for pain intensity. Face-to-face interviews and physical assessments were conducted by trained healthcare professionals. Statistical analysis was performed using SPSS version 25.0, with descriptive statistics calculated for quantitative variables and Chi-Square tests used to examine associations between variables. Ethical approval was obtained from the Institutional Review Board, and informed consent was secured from all participants.

Results: The mean age of participants was 29.8042 ± 3.67743 years. The mean total score for plantar fasciitis was 31.4096, and the mean VAS score was 1.9458. Pain occurrence per week was reported as 1-2 days by 44.0% of participants, 3-4 days by 46.7%, and 5-7 days by 9.3%. Pain was most commonly worse in the afternoon (35.8%) and interfered with walking occasionally (52.7%). High heel standing was uncomfortable for 54.5% of participants. A significant relationship was found between age and VAS scores (p=0.001), as well as between high heel usage and increased pain levels (p=0.000).

Conclusion: The mean score of plantar fasciitis among the nurses was below the threshold indicating significant prevalence. However, a significant association was found between high heel usage and plantar fasciitis, suggesting that footwear choices play a critical role in the development of this condition. Ergonomic interventions promoting supportive footwear and regular breaks are recommended to mitigate the risk of plantar fasciitis among nurses.

Article Details

How to Cite
Dr. Muhammad Suleman Sikander, Naeem Ullah Shinwari, Dr. Jamal Shah, Dr. Muhammad Atif, Syed Issam Ullah Jan, & Maria Naz. (2024). Prevalence and Association of Risk Factors for Plantar Fasciitis Among Nurses in Government Tertiary Care Hospitals of Peshawar. Journal of Health and Rehabilitation Research, 4(2), 1623–1628.
Author Biographies

Dr. Muhammad Suleman Sikander, City's University of Science and Information Technology Peshawar

Lecturer City's University of Science and Information Technology Peshawar.

Consultant Physical Therapist Shifa Rehab and Research Canter Peshawar.

Naeem Ullah Shinwari, City University of Science and Information Technology

Student City University of Science and Information Technology

Dr. Jamal Shah, Lady Reading Hospital Peshawar

Lady Reading Hospital Peshawar

Dr. Muhammad Atif, School of Health Science Peshawar

Lecturer School of Health Science Peshawar

Syed Issam Ullah Jan, Sarhad University of Science and Information Technology Peshawar

Student Sarhad University of Science and Information Technology Peshawar

Maria Naz, Sarhad University of Science and Information Technology Peshawar

Student Sarhad University of Science and Information Technology Peshawar


Hashmi R, Naeem L, Arif S, Habiba U, Irfan R, Zafar M. Frequency of Plantar Fasciitis Among Females in Teaching Profession. J Aziz Fatimah Med Dent Coll. 2020;2(2):53-7.

Nahin RL. Prevalence and Pharmaceutical Treatment of Plantar Fasciitis in United States Adults. J Pain. 2018;19(8):885-96.

Thomas MJ, Whittaker JL, Whatman C. Plantar Fasciitis: Are Pain and Function Linked? Lower Extremity Review. 2019;11:20-5.

McNally EG, Shetty S. Plantar Fascia: Imaging Diagnosis and Guided Treatment. Semin Musculoskelet Radiol. 2010;14(3):334-43.

Hedrick MR. The Plantar Aponeurosis. Foot Ankle Int. 1996;17(10):646-9.

Aquino A, Payne C. Function of the Plantar Fascia. Foot. 1999;9(2):73-8.

Taş S, Çetin C. Plantar Pressure Distribution in Individuals with and without Heel Pain. Turk J Med Sci. 2019;49(1):159-65.

Werner RA, Gell N, Hartigan A, Wiggerman N, Keyserling WM. Risk Factors for Plantar Fasciitis Among Assembly Plant Workers. PM R. 2010;2(2):110-6.

Waclawski ER, Beach TA, Milne A, Yacyshyn EA, Dryden PJ. The Etiology of Plantar Fasciitis. Phys Ther Rev. 2015;20(4):261-5.

Cheung JT, Zhang M, An KN. Effect of Achilles Tendon Loading on Plantar Fascia Tension in the Standing Foot. Clin Biomech (Bristol, Avon). 2006;21(2):194-203.

Bernardes RA, Parreira P, Sousa LB, Stolt M, Apóstolo J, Cruz A. Foot Disorders in Nursing Standing Environments: A Scoping Review Protocol. Nurs Rep. 2022;11(3):584-9.

Goff JD, Crawford R. Diagnosis and Treatment of Plantar Fasciitis. Am Fam Physician. 2011;84(6):676-82.

Cutts S, Obi N, Pasapula C, Chan W. Plantar Fasciitis. Ann R Coll Surg Engl. 2012;94(8):539-42.

Choudhary R, Kunal K. Modifiable Risk Factors of Plantar Fasciitis in Non-Athletic Patients and Proposal of a New Objective Assessment System-RKISP. Rev Bras Ortop. 2021;56:368-71.

Attar SM. Plantar Fasciitis: A Review Article. Saudi J Intern Med. 2012;2(1):13-7.

Labovitz JM, Yu J, Kim C. The Role of Hamstring Tightness in Plantar Fasciitis. Foot Ankle Spec. 2011;4(3):141-4.

Ahmady A, Soodmand E, Soodmand I, Milani TL. The Effect of Various Heights of High-Heeled Shoes on Foot Arch Deformation: Finite Element Analysis. J Foot Ankle Res. 2014;7(Suppl 1).

García-Pérez JA, Pérez-Soriano P, Llana S, Martínez-Nova A, Sánchez-Zuriaga D. Effect of Overground vs Treadmill Running on Plantar Pressure: Influence of Fatigue. Gait Posture. 2013;38(4):929-33.

Hills AP, Hennig EM, McDonald M, Bar-Or O. Plantar Pressure Differences Between Obese and Non-Obese Adults: A Biomechanical Analysis. Int J Obes Relat Metab Disord. 2001;25(11):1674-9.

Monteiro MA, Gabriel RE, e Castro MN, Sousa MF, Abrantes JM, Moreira MH. Exercise Effects in Plantar Pressure of Postmenopausal Women. Menopause. 2010;17(5):1017-25.

Yin CM, Pan LL, Sun YX, Chen X. The Effects of Long-Term Wearing of High Heels on the Plantar Pressure Distribution and Foot Morphology. J Biomech. 2016;49(12):2872-80.

Suzan MA. Frequency and Risk Factors of Musculoskeletal Pain in Nurses at a Tertiary Centre in Jeddah, Saudi Arabia: A Cross-Sectional Study. BMC Res Notes. 2014;7:61.

Owens JM. Diagnosis and Management of Plantar Fasciitis in Primary Care. J Nurse Pract. 2017;13(5):354-9.

Abidin SZU, Haneef K, Malik NR, Mashal M, Zeb A, Rahman MU. Prevalence and Associated Risk Factors for Plantar Fasciitis Among Security Forces Personnel in Peshawar. Ann Allied Health Sci. 2019;5(2):20-3.