A Holistic Review of the Etiology and Treatment of Plantar Fasciitis Based on Unani and Modern Perspectives

Background: Plantar fasciitis (PF) is a frequent cause of pain in the heel, which affects posture, mobility, and quality of life. It is now understood as a degenerative disorder and not an inflammatory one. In Unani medicine, pain in the heel falls under the category of Waja-ul-Mafasil and is related to humoral disturbance and morbid matter deposition. Objective: To present a comparative and integrative analysis of plantar fasciitis from the both modern biomedical and Unani perspectives with emphasis on its etiology, pathophysiology, diagnosis, and treatment. Methods: A descriptive and comparative review of literature from both the modern biomedical literature and classical Unani literature was carried out. This comprised epidemiological findings, risk factors, diagnostic criteria, and treatment protocols. Results: Current medicine recognizes mechanical overload, obesity, foot abnormality, and prolonged standing as main risk factors for PF. Diagnosis relies on clinical history and physical examination with the Windlass test facilitating confirmation. Treatment involves NSAIDs, orthotics, physiotherapy, and corticosteroid injections or surgery in certain cases. In Unani medicine, PF (Waja al-'Aqab) is considered a product of imbalanced temperament (Sue Mizaj), retention of morbid matter (Ehtebase Madda), and compromised innate heat (Zaeef Hararat). The diagnostic process is based on pulse diagnosis, examination of urine, and symptomology. Treatment comprises Ta'deel-e-Mizaj (correction of temperament), Tanqiya-e-Madda (evacuation of morbid matter), cupping, venesection, massage, herbal treatments, and modification of lifestyle based on temperament. Conclusion: Both Unani and contemporary systems recognize the multifactorial etiology of plantar fasciitis and the causative role of chronic stress in its development. An integrated treatment strategy combining evidence-based biomedical therapy with Unani principles has the potential to provide holistic and personalized ca