Early clinical results of the use of radiofrequency lesioning in the treatment of plantar fasciitis

Sollitto, Ronald J.; Plotkin, Elliot L.; Klein, Paul; Mullin, Patricia

doi:10.1016/s1067-2516(97)80118-4

Cited by 41 publications

(43 citation statements)

References 32 publications

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“…Although plantar fasciitis may resolve after a few weeks, in some patients symptoms may become chronic. The best management of chronic plantar fasciitis is not entirely agreed upon and a variety of conservative approaches as well as more invasive treatments has been suggested (13)(14)(15)(16)(17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

Sonographic Evaluation of the Plantar Fascia in Asymptomatic Subjects

Gadalla

Kichouh²,

Boulet³

et al. 2014

Journal of the Belgian Society of Radiology

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Plantar fasciitis is a low-grade inflammation of the plantar fascia and perifascial tissues. It is a common cause of heel pain and usually affects middle-aged women, as well as younger, predominantly male, runners (1). The condition is likely related to repeated strain, leading to microtears and inflammation. Imaging is commonly used to confirm the diagnosis, and exclude other causes of posterior heel pain (2).Although MR imaging may be used to diagnose plantar fasciitis, many authors suggest ultrasound is an accurate, simple, and noninvasive technique to diagnose the condition. Previous investigators have reported that the most important diagnostic findings in plantar fasciitis are thickening and hypoechogenicity, and occasionally fluid collections adjacent to the fascia. Wall et al. (3) suggest that a plantar fascia thickness greater than 4 mm is consistent with plantar fasciitis. This value has been used as a reference value in several studies (4-6).To our knowledge, there are no data about the ultrasound appearance of the plantar fascia in asymptomatic subjects. Hence, it is not known if certain commonly used ultrasound criteria of plantar fasciitis might be seen in such a population. If so, this may entail the risk of attributing the patients' symptoms to a reference point where the plantar fascia crossed the anterior aspect of the inferior border of the calcaneus. The measurement points are indicated in the figures by calipers (Figs. 1-3). The plantar fascia was evaluated for echogenicity. It was only considered hypoechoic if its echogenicity was markedly decreased with respect to the subcutaneous heel fat. The plantar fascia was also assessed for presence of calcification defined as markedly hyperechoic foci, with or without acoustic shadowing, vascularity with Doppler, tear, and fluid adjacent to the fascia. The saved images were reviewed by 2 investigators. Statistical analysis was performed using a t-test (independent samples) (IBM SPSS Statistics 20, Armonk, NY). The significance threshold was set at p = 0.05. ResultsA total of 62 plantar fascias in 31 subjects (14 men, 17 women), aged from 17 to 79 years (mean age, 45 years) were evaluated ( Fig. 1-3). The results are shown in Tables I and II. The mean thickness of the plantar fascia in men was 3.7 mm (range, 2.5-7 mm), and in women 3.5 mm (range, 1.7-5.1 mm). There was no statistically significant difference between the thickness of the fascia in men and women (p = 0.21). There was no significant difference between the right and the left foot (p = 0.64).The thickness of the plantar fascia was greater than 4 mm in 4 men plantar fasciitis while other abnormalities may be overlooked and not further investigated. Therefore we decided to evaluate the plantar fascia in asymptomatic subjects with high resolution ultrasound. Materials and methodsInstitutional Review Board approval for our study was obtained and consent from the asymptomatic subjects. They were interviewed to confirm they had not been symptomatic at the sole of the foot. Other exclusion cr...

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Section: Discussionmentioning

confidence: 99%

Sonographic Evaluation of the Plantar Fascia in Asymptomatic Subjects

Gadalla

Kichouh²,

Boulet³

et al. 2014

Journal of the Belgian Society of Radiology

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“…Cozzarelli et al 6 reported the use of fluoroscopy for placement of the probe. It has been suggested that ultrasound may also be useful for directing the RFNA probe to the site as well.…”

Section: Concerns and The Future Of This Techniquementioning

confidence: 99%

Radiofrequency Nerve Ablation for the Treatment of Heel Pain

Landsman

2011

Techniques in Foot &Amp; Ankle Surgery

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Radiofrequency nerve ablation is a safe and effective treatment for plantar fasciosis and other types of heel pain. It can be used as a primary treatment, or after other methods have failed. It is easily performed in the office, or in the operating room, and the basic technique has been used to manage chronic pain for over a decade. In this study, we review the mechanism of action, examine the treatment technique, and examine the outcomes from some recent studies.

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“…1 Its etiology can be multifactorial, and much debate has been attributed to the underlying cause. [2][3][4][5][6][7][8][9][10][11][12][13][14] The most common etiology is a biomechanical disturbance that causes excessive tension and inflammation of the plantar fascia and nerve entrapment. 7,9,15,16 This chronic inflammation caused by biomechanical imbalances can secondarily cause an irritation of the medial calcaneal nerve in this area.…”

Section: Levels Of Evidence: Therapeutic Level IVmentioning

confidence: 99%

A 12-Year Long-Term Retrospective Analysis of the Use of Radiofrequency Nerve Ablation for the Treatment of Neurogenic Heel Pain

Cozzarelli

Sollitto²,

Thapar³

et al. 2010

Foot & Ankle Specialist

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The authors discuss their rationale for the use of radiofrequency nerve ablation (RFNA) in the treatment of chronic neurogenic heel pain. Patients treated for plantar fasciitis who fail to improve after conservative and/ or surgical treatment should be reevaluated for a coexistent nerve entrapment. The results of a retrospective study of 82 patients who have undergone RFNA are presented. The patients were followed at 5, 10, and 12 years after the procedure. An evaluation of medical records was performed as a means of inclusion in this study. A standardized telephone interview was then done, and subjectively scored responses of the patients were recorded and analyzed. Of the patients, 89% reported no recurrence of pain after 5, 10, and 12 years postoperatively. The procedure is relatively easy to perform and involves inserting a 22-gauge cannula with an electrode into the areas of pain. This is done under general anesthesia. It takes approximately 15 to 20 minutes per heel to perform, depending on how many sites of tenderness have been identified. The patient is discharged with a minimal bandage and returns to shoe gear immediately following the procedure. The success rate with RFNA appears to be quite high with fewer associated risks and less post-operative morbidity.

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Early clinical results of the use of radiofrequency lesioning in the treatment of plantar fasciitis

Cited by 41 publications

References 32 publications

Sonographic Evaluation of the Plantar Fascia in Asymptomatic Subjects

Sonographic Evaluation of the Plantar Fascia in Asymptomatic Subjects

Radiofrequency Nerve Ablation for the Treatment of Heel Pain

A 12-Year Long-Term Retrospective Analysis of the Use of Radiofrequency Nerve Ablation for the Treatment of Neurogenic Heel Pain

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