PFPS-Defined Plantar Heel Pain Among Women Aged 40–60 Years Engaged in Prolonged Standing in Kerala, India: A Descriptive Cross-Sectional Online Survey

Background. Plantar heel pain is a common foot complaint and may be especially relevant where work involves prolonged standing. The Plantar Fasciitis Pain/Disability Scale (PFPS) was developed to quantify pain and disability associated with plantar fasciitis and, in its original validation, to discriminate it from other heel pain in already-diagnosed patients; it is not a stand-alone diagnostic test. Objective. To estimate the proportion of women aged 40–60 years engaged in prolonged standing who met a pre-specified PFPS criterion (> 35) for PFPS-defined plantar heel pain, and to describe the distribution of pain and disability. Methods. Descriptive cross-sectional online survey of women aged 40–60 years in prolonged-standing roles in Kerala, India (mainly Kannur and Kozhikode), during a one-month period in 2023. Participants were recruited by non-probability voluntary/convenience sampling through a Google Form circulated by WhatsApp and email; 142 women were reached and 100 completed the questionnaire (completion proportion 70.4%). Pain and disability were measured with the PFPS, which incorporates a 0–100 visual analogue scale (VAS). The proportion scoring > 35 was calculated with a Wilson 95% confidence interval (CI); scores were summarised as mean (SD) and median (IQR). Results. Of 100 participants, 69 scored > 35 on the PFPS — 69.0% (95% CI 59.4–77.2%); four scored exactly 35 and 27 scored below 35. PFPS totals had a mean of 40.8 (SD 13.2) and median of 40.5 (IQR 33.0–51.3; range 15–67). VAS pain had a mean of 51.2 (SD 16.5) and median of 50 (IQR 40–60); categories were no pain 1%, mild 25%, moderate 65% and severe 9%. Conclusion. About seven in ten women in prolonged-standing roles met the pre-specified PFPS criterion for plantar heel pain, with predominantly moderate pain. Because the criterion is not a validated diagnostic threshold and no clinical examination or imaging was performed, the finding represents the symptom burden of PFPS-defined plantar heel pain in a self-selected sample, not the population prevalence of clinically confirmed plantar fasciitis.