PLANTAR FASİİTİS SENDROMUNUN NÖRALTERAPİ İLE TEDAVİSİ

Plantar topuk ağrısı ayağın en sık görülen kas-iskelet patolojilerinden biridir. Toplumun yaklaşık 10%’un hayatının belirli bir zamanında plantar fasiitten etkilediği tahmin edilmektedir. Plantar fasiit tanısı çoğunlukla anemnez ile konulur. Hastalar sabah kalkınca veya uzun süre oturma sonrası ilk adımda aşırı ağrı tarif ederler.Plantar fasiit tedavisinde klasik tedavi öncelikle fizik tedavi modaliteleri olmak üzere non invazif yöntemlerdir. Nadir dirençli olgularda cerrahi tedavi endikedir. Nöralterapi, bozulmuş olan beden fonksiyonlarının, lokal anestezik maddeler kullanılarak nörovejetatif sistemin uyarılmasıyla organizmanın yeniden regülasyonu sonucu beden fonksiyonlarının normale dönüştürülmesi esasına dayanan bir bütüncül tedavi metodudur. Nöralterapinin bütüncül bakış açısı ile myofasiyal, vasküler ve sinirsel yapıların birlikte değerlendirerek tedaviye alınmakta, böylece geçici bir iyileşme değil tam şifa ile tedavi mümkün olmaktadır

TREATMENT OF PLANTAR FASCIITIS BY NEURAL THERAPY

Plantar heel pain is one of the most common musculoskeletal pathologies of the foot. It is estimated to affect 10% of the population at some time in their life. Plantar fasciitis is diagnosed often from the patients history. Patients describe extreme pain in their heels at their first step in the morning or after sitting for long periods. First step treatment of plantar fasciitis is physical therapy modalities. In rare resistant cases, surgery is indicated for treatment. Neural therapy, is a holistic treatment method, based on the transformation of the impaired function of the body to normal by stimulating and regulating the autonomic nervous system function using local anesthetics. With a holistic view of Neural therapy, myofascial, vascular and neural structures are taken into consideration for evaluation of the treatment, so the patient achieve full cure instead of a temporary improvement

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  • Cleland JA, Abbo JH, Kidd MO, et al: Manual physical therapy and exer- cise versus electrophysical agents and exercise in the management of plantar heel pain: a mul center randomized clinical trial. J Orthop Sports Phys Ther 39:573, 2009
  • Hyland MR, Webber-Gaff ney A, Cohen L, et al: Randomized controlled trial of calcaneal taping, sham taping, and plantar fascia stretching for the short-term management of plantar heel pain. J Orthop Sports Phys Ther 36:364, 2006
  • Renan-Ordine R, Alburquerque-Sendin F, de Souza DP, et al: Eff ec ve- ness of myofascial trigger point manual therapy combined with a self- stretching protocol for the management of plantar heel pain: a randomi- zed controlled trial. J Orthop Sports Phys Ther 41:43, 2011
  • Mitchell IR, Meyer C, Krueger WA. Deep fascia of the foot. Anatomical and clinical considera ons. J Am Podiatr MedAssoc 1991;81:373-8.
  • Hicks JH. The mechanics of the foot: the plantar aponeurosis and the arch. J Anat 1954;88:25-31.
  • Gur S Plantar fascii s in athletes Acta Orthop Traumatol Turc 2002;36 Suppl 1:73-81
  • Goff JD, Crawford R. Diagnosis and treatment of plantar fascii s. Am Fam Physician. 2011 Sep 15;84(6):676-82.
  • DiGiovanni BF, Nawoczenski DA, Malay DP et al. Plantar fascia-specifi c stretching exercise improves outcomes in pa ents with chronic plantar fascii s. A prospec ve clinical trial with two-year follow-up. J Bone Joint Surg Am 2006;88: 1,775–1,778
  • Wolgin M, Cook C, Graham C, Mauldin D. Conserva ve treatment of plantar heel pain: long-term follow-up. Foot Ankle Int 1994; 15: 97–102.
  • Crawford F, Atkins D, Young P, Edwards J. Steroid injec on for heel pain: evidence of short-term eff ec veness. A randomized controlled trial.
  • Rheumatology 1999; 38: 974–977.
  • Acevedo JI, Beskin JL. Complica ons of plantar fascia rupture associated with cor costeroid injec on. Foot Ankle Int 1998; 19: 91–97.
  • Leach R, Jones R, Silva T. Rupture of the plantar fascia in athletes. Bone Joint Surg Am 1978; 60: 537–539.
  • Babcock MS, Foster L, Pasquina P, Jabbari B. Treatment of pain a ribu- ted to plantar fascii s with botulinum toxin a: a short-term, randomized, placebocontrolled, double-blind study. Am J Phys Med Rehabil 2005; 84: 649–654.
  • Sampson S, Gerhardt M, Mandelbaum B. Platelet rich plasma injec on gra s for musculoskeletal inju ries: a review. Curr Rev Musculoskelet Med. 2008;1(3-4):165-174.
  • Kim E, Lee JH. Autologous platelet-rich plasma versus dextrose prolothe- rapy for the treatment of chronic recalcitrant plantarfascii s. PM R. 2014 Feb;6(2):152-8.
  • Gerdesmeyer L, Frey C, Vester J et al. Radial extracorporeal shock wave therapy is safe and eff ec ve in the treatment of chronic recalcitrant plantar fascii s:results of a confi rmatory randomized placebo-controlled mul center study. Am J Sports Med 2008; 36: 2,100–2,109.
  • Sorensen MD, Hyer CF, Philbin TM. Percutaneous bipolar radiofrequency microdebridement for recalcitrant proximal plantar fasciosis. J Foot Ank- le Surg 2011;50:165-70.
  • Othman AM, Ragab EM. Endoscopic plantar fasciotomy versus extra- corporeal shock wave therapy for treatment of chronic plantar fascii s. Arch Orthop Trauma Surg. 2010;130(11):1343-1347.
  • Barop, H.; Lehrbuch und Atlas der Neuraltherapie nach Huneke, 1996, Hippokrates
  • Fischer, L., Neuraltherapie nach Huneke, 2001, Hippokrates
  • Nazlıkul. H.: Nöralterapi Ders Kitabı, Nobel Kitabevi, İstanbul, 2010
  • Weinschenk, S: Neuraltherapi – Urban Fischer München 2009
  • Stri ma er, B; Taschenatlas Ohrakupunktur nach Nogier/Bahr, Hippok- rates; 2005
  • Angermeier,M; Lei aden Akupunktur, URBAN&FISCHER Munchen; 2000