Treatment of Chronic Plantar Heel Pain With Radiofrequency Neural Ablation of the First Branch of the Lateral Plantar Nerve and Medial Calcaneal Nerve Branches
| Autor: | Ali Utkan, Ibrahim Akel, Tuba Tülay Koca, Resit Sevimli, Aydın Arslan |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Ablation Techniques
Male medicine.medical_specialty Heel Visual Analog Scale Visual analogue scale medicine.medical_treatment Pain 03 medical and health sciences 0302 clinical medicine Humans Medicine Orthopedics and Sports Medicine Fasciitis 030222 orthopedics business.industry 030229 sport sciences Middle Aged medicine.disease Lateral plantar nerve Ablation Sensory Nerve Endings Surgery medicine.anatomical_structure Patient Satisfaction Extracorporeal shockwave therapy Chronic Disease Female Tibial Nerve business Plantar heel pain |
| Zdroj: | The Journal of Foot and Ankle Surgery. 55:767-771 |
| ISSN: | 1067-2516 |
| DOI: | 10.1053/j.jfas.2016.03.009 |
| Popis: | From March 2012 to February 2013, 37 patients experiencing plantar heel pain for ≥6 months despite treatment with physical therapy and other conservative treatment modalities were followed up. If neurogenic heel pain originating from the first branch of the lateral plantar nerve was present, with or without the medial calcaneal nerve, diagnostic nerve blocks to these nerves were performed for confirmation. If the pain was determined to be of neurogenic origin, radiofrequency neural ablation (RFNA) was applied to the corresponding sensory nerve endings. Pain was evaluated using the visual analog scale, and patients were followed for at least one year. A total of 41 feet from 37 patients (30 [81.1%] females, 7 [18.9%] males; mean age, 50.7 ± 1.6 years; mean body mass index, 30.6 ± 0.7 kg/m 2 ) were included. The mean visual analog scale scores improved significantly from 1 to 6 to 12 months after the procedure relative to before the procedure, with 88% of all patients rating the treatment as either very successful or successful at 12 months postoperatively. RFNA applied to both the first branch of the lateral plantar nerve and the medial calcaneal nerve sensory branches (16 [39%] feet) and only the first branch of the lateral plantar nerve sensory branches (25 [61%] feet) showed similarly high levels of success. Of the 41 feet, 28 [68.3%] had received extracorporeal shockwave therapy, 35 [85.4%] had received steroid injections, and 22 [53.7%] had received both extracorporeal shockwave therapy and steroid injections before RFNA as an index procedure. All were unresponsive to these previous treatments. In contrast, almost all (88%) were treated successfully with RFNA. Despite a high incidence of neurologic variations, with a precise diagnosis and good application of the technique using the painful points, chronic plantar heel pain can be treated successfully with RFNA. |
| Databáze: | OpenAIRE |
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