Topuk dikenine bağlı kronik plantar topuk ağrısında konvansiyonel radyofrekans ablasyonunun etkinliği

Amaç: Bu çalışmanın amacı, topuk dikenine bağlı kronik plantar topuk ağrısında Konvansiyonel Radyofrekans Ablasyon (CRF) tedavisinin etkinliğini araştırmaktır. Gereç ve Yöntem: Çalışmaya, topuk dikenine bağlı topuk ağrısı olan konservatif tedavilere yanıt vermeyen toplam 20 hasta alındı. Ayağın longitudinal düzleminde topuk dikeninin tepe, üst ve altındaki üç noktaya floroskopi klavuzluğunda CRF uygulandı. Ağrı şiddeti; görsel analog skala (VAS), basınç ağrı eşiği (PPT); basınç algometre ve fonksiyonel durum; Ayak Fonksiyon İndeksi (FFI) kullanılarak değerlendirildi. Tüm ölçümler işlemden önce ve işlemden sonraki bir, üç ve altıncı aylarda yapıldı. Bulgular: CRF, 16 (%80) kadın ve 4 (%20) erkek olmak üzere toplam 20 hastaya uygulandı. Ortalama yaşları 51.40±8.10 yıl, ortalama VKİ 33.80±5.47 kg/m2, ortalama semptom süresi 18.30±9.02 aydı ve beş hastada (%25) pes planus mevcuttu. CRF’u takiben birinci, üçüncü ve altıncı ayda VAS skoru, PPT ve FFI ölçümlerinde, CRF öncesine göre istatistiksel olarak anlamlı azalma gözlendi (p

The effectiveness of conventional radiofrequency ablation for chronic plantar heel pain due to heel spur

Objectives: The purpose of this study was to investigate the effectiveness of conventional radiofrequency (CRF) ablation treatment on chronic plantar heel pain due to heel spur. Methods: A total of 20 patients with heel spur who did not respond to conservative treatments were recruited for the study. Under fluoroscopy guidance, CRF was performed to three points at the top, above, and below the heel spur in the longitudinal plane of the foot. Pain intensity, the pressure pain threshold (PPT), and functional status were assessed using a visual analog scale (VAS), pressure algometers, and the Foot Function Index (FFI). All measurements were taken before the procedure, as well as 1, 3, and 6 months following the procedure. Results: CRF was applied to 20 patients – 16 (80%) females and 4 (20%) males. Their mean age was 51.40±8.10 years, the mean body mass index was 33.80±5.47 kg/m2, the mean duration of symptoms was 18.30±9.02 months, and pes planus was present in 5 patients (25%). A statistically significant decrease was observed in VAS score and PPT and FFI measurements at the 1st, 3rd, and 6th month following CRF compared to before CRF (p

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1. Kumai T, Benjamin M. Heel spur formation and the subcalcaneal enthesis of the plantar fascia. J Rheumatol 2002;29(9):1957–64.
2. Williams PL, Smibert JG, Cox R, Mitchell R, Klenerman L. Imaging study of the painful heel syndrome. Foot Ankle 1987;7(6):345–9. [CrossRef ]
3. Forman WM, Green MA. The role of intrinsic musculature in formation of inferior calcaneal exostoses. Clin Podiatr Med Surg 1990;7(2):217–23.
4. Mücke R, Schönekaes K, Micke O, Seegenschmiedt MH, Berning D, Heyder R. Low-dose radiotherapy for painful heel spur. Strahlenther Onkol 2003;179(11):774–8. [CrossRef ]
5. Riel H, Cotchett M, Delahunt E, Rathleff MS, Vicenzino B, Weir A, et al. Is “plantar heel pain” a more appropriate term than “plantar fasciitis”? Time to move on. Br J Sports Med 2017;51(22):1576–7. [CrossRef ]
6. Agyekum EK, Ma K. Heel pain: A systematic review. Chin J Traumatol 2015;18(3):164–9. [CrossRef ]
7. Othman AM, Ragab EM. Endoscopic plantar fasciotomy versus extracorporeal shock wave therapy for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg 2010;130(11):1343–7. [CrossRef ]
8. Lee JS, Yoon KB, Kim IK, Yoon DM. Pulsed radiofrequency treatment of pain relieving point in a soft tissue. Korean J Pain 2011;24(1):57–60. [CrossRef ]
9. Misra S, Ward S, Coker C. Pulsed radiofrequency for chronic testicular pain-a preliminary report. Pain Med 2009;10(4):673–8. [CrossRef ]
10. Agel J, Beskin JL, Brage M, Guyton GP, Kadel NJ, Saltzman CL, et al. Reliability of the foot function ındex: A report of the AOFAS outcomes committee. Foot Ankle Int 2005;26(11):962–7. [CrossRef ]
11. Prichasuk S, Subhadrabandhu T. The relationship of pes planus and calcaneal spur to plantar heel pain. Clin Orthop 1994;306:192–6.
12. Johal KS, Milner SA. Plantar fasciitis and the calcaneal spur: Fact or fiction? Foot Ankle Surg 2012;18(1):39–41. [CrossRef ]
13. Köse N, Göktürk E, Turgut A, Seber S, Hazer B. The relationship between pes planus and calcaneal spur to plantar heel pain. Acta Ortop Traumatol Turc 1998;32:322–4.
14. Kane D, Geaney T, Shanaha M, Duffy G, Bresnihan B, Gibney R, et al. The role of ultrasonography in the diagnosis and management of idiopathic plantar fasciitis. Rheumatology 2001;40(9):1002–8. [CrossRef ]
15. David JA, Sankarapandian V, Christopher PR, Chatterjee A, Macaden AS. Injected corticosteroids for treating plantar heel pain in adults. Cochrane Database Syst Rev 2017;6(6):CD009348. [CrossRef ]
16. Uğurlar M, Sönmez M, Uğurlar Ö, Adıyeke L,Yıldırım H, Eren OT. Effectiveness of four different treatment modalities in the treatment of chronic plantar fasciitis during a 36-month follow-up period: A randomized controlled trial. J Foot Ankle Surg 2018;57(5):913–8. [CrossRef ]
17. Sluijter M, Racz G. Technical aspects of radiofrequency lesioning. Pain Pract 2002;2(3):195–200. [CrossRef ]
18. Porter MD, Shadbolt B. Intralesional corticosteroid injection versus extracorporeal shock wave therapy for plantar fasciopathy. Clin J Sport Med 2005;15(3):119–24. [CrossRef ]
19. Zundert J, Patijn J, Kessels A, Lamé I, Suijlekom H, Kleef M. Pulsed radiofrequency adjacent to the cervical dorsal root ganglion in chronic cervical radicular pain: A double blind sham controlled randomized clinical trial. Pain 2007;127(1- 2):173–82. [CrossRef ]
20. Huang JH, Galvagno SM, Hameed M, Wilkinson I, Erdek MA, Patel A. Occipital nerve pulsed radiofrequency treatment: A multi-center study evaluating predictors of outcome. Pain Med 2012;13(4):489–97. [CrossRef ]
21. Kroll HR, Kim D, Danic MJ, Sankey SS, Gariwala M, Brown M. A randomized, double-blind, prospective study comparing the efficacy of continuous versus pulsed radiofrequency in the treatment of lumbar facet syndrome. J Clin Anesth 2008;20(7):534–7. [CrossRef ]
22. Gabrhelik T, Michalek P, Adamus M, Mikova M, Dolecek L. Effect of pulsed radiofrequency therapy on the suprascapular nerve in shoulder pain of various aetiology. Ir J Med Sci 2010;179(3):369–73. [CrossRef ]
23. Fukui S, Nitta K, Iwashita N, Tomie H, Nosaka S, Rohof O. Results of intradiscal pulsed radiofrequency for lumbar discogenic pain: Comparison with intradiscal electrothermal therapy. Korean J Pain 2012;25(3):155–60. [CrossRef ]
24. Karaman H, Tüfek A, Kavak GÖ, Yildirim ZB, Uysal E, Celik F, et al. Intra-articularly applied pulsed radiofrequency can Chin Med Assoc 2011;74(8):336–40. [CrossRef ]
25. Ozyuvaci E, Akyol O, Acikgoz A, Leblebici H. Intraarticular pulsed mode radiofrequency lesioning of glenohumeral joint in chronic shoulder pain: 3 cases. Korean J Pain 2011;24(4):239–41. [CrossRef ]
26. Govindarajan R, Bakalova T, Doss N, Splain S, Michael R, Abadir A. Posterior tibial nerve block in the therapeutic management of painful calcaneal spur (plantar fasciitis): A preliminary experience. Can J Anaesth 2003;50(8):862–3.