Hyperuricemia in Plantar Fasciitis- Attributable Cause or Associated Factor?

Pain at the heel affects millions of people globally. The burden of this entity can be virtually visualised by the fact that around 7% of people over 65 years of age report heel pain and tenderness, the main differential diagnosis being plantar fasciitis, amongst others. Plantar fasciitis is one of the most common causes of pain around the heel and plantar aspect of the foot. 80% of patients with heel pain are suffering from plantar fasciitis. Plantar fasciitis has been linked to many mechanical abnormalities and biochemical derangements. The most common biochemical derangement in patients with plantar fasciitis is increased serum uric acid levels. There is increasing evidence that presence of asymptomatic hyperuricemia is a potential risk factor for development of plantar fasciitis. The mean serum uric acid levels in the patients with plantar fasciitis was 7.02 mg/dl, which is in close proximity to the upper limit of normal uric acid levels. Also, the same was true for males and females independently. Even though majority of patients with plantar fasciitis accounting to 52% had serum uric acid levels between 6-8 mg/dl, close to the upper limit of normal value, it cannot be categorised as hyperuricemia. By virtue of this study, we can infer that hyperuricemia per se, cannot be an attributable cause of plantar fasciitis, even though it is known to play an important role in pathogenesis of calcaneal plantar spur formation, which might lead to or augment the pre existing plantar fasciitis.