Clinical Rheumatology

, Volume 34, Issue 5, pp 957–964 | Cite as

Psychological variables associated with foot function and foot pain in patients with plantar heel pain

  • Matthew P. CotchettEmail author
  • Glen Whittaker
  • Bircan Erbas
Original Article


It is widely accepted that psychological variables are associated with self-reported pain and self-reported physical function in patients with musculoskeletal pain. However, the relationship between psychological variables and foot pain and foot function has not been evaluated in people with plantar heel pain. Eighty-four participants with plantar heel pain completed the Depression, Anxiety and Stress Scale short version (DASS-21) and Foot Health Status Questionnaire. Using a hierarchical regression analysis, a baseline model with age, sex and BMI explained 10 % of the variability in foot function. The addition of depression and stress in separate models explained an additional 7.3 % and 8.1 % of foot function scores, respectively. In the respective models, depression was a significant predictor (β = −0.28; p = 0.009) as was stress (β = −0.29; p = 0.006). Females drove the effect between stress and foot function (β = −0.50; p = 0.001) and depression and foot function (β = −0.53; p < 0.001). In regression models for foot pain, depression, anxiety and stress did not contribute significantly to pain scores. When the data was stratified by sex, stress (β = −0.36; p = 0.024) and depression (β = −0.41; p = 0.013) were significantly associated with foot pain in females but not in males. For participants with plantar heel pain, stress and depression scores were significantly associated with foot function but not foot pain. When the data was stratified by sex, stress and depression were significant predictors of foot pain and function in females.


Depression Foot Pain Stress 



This study was funded by the Australian Podiatry Education and Research Foundation (APERF). The authors would like to acknowledge the assistance of Mr Andrew McMillan with recruitment of participants.

Conflict of interest

We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated and, if applicable, we certify that all financial and material support for this research (e.g. NIH or NHS grants) and work are clearly identified in the title page of the manuscript.

Supplementary material

10067_2014_2565_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 14 kb)


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Copyright information

© Clinical Rheumatology 2014

Authors and Affiliations

  • Matthew P. Cotchett
    • 1
    • 2
    Email author
  • Glen Whittaker
    • 3
  • Bircan Erbas
    • 4
  1. 1.Department of Allied HealthLa Trobe UniversityBendigoAustralia
  2. 2.Lower Extremity and Gait Studies ProgramLa Trobe UniversityMelbourneAustralia
  3. 3.Department of PodiatryLa Trobe UniversityMelbourneAustralia
  4. 4.Department of Public Health and Human BiosciencesLa Trobe UniversityMelbourneAustralia

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