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Conservative treatment of painful heel and its relationship with longitudinal arch of the foot

Authors
Publisher
Turkish Association of Orthopaedics and Traumatology
Publication Date
Keywords
  • Heel/Radiography
  • Besity/Complications
  • Pain/Etiology/Therapy/Rehabilitation
Disciplines
  • Medicine

Abstract

Objectives: To evaluate the outcome of conservative treatment of heel pain and assess the relationship between heel pain and the longitudinal arch of the foot. Methods: A total of 101 symptomatic heels of 80 patients (62 females and 18 males, mean age 48 years) were treated according to a standard conservative protocol. Of the patient group, 59 patients had unilateral and 21 patients had bilateral involvement. Diagnoses of symptomatic feet included subcalcaneal pain syndrome (n=55), plantar fasciitis (n=21), painful heel pad (n=10) and entrapment of the first branch of the lateral nerve (n=2). Treatment consisted of losing weight in over-weight patients, nonsteroidal anti-inflammatory medications, soft type viscoelastic foot inserts or UCBL type orthosis, soft-soled shoe with a firm heel counter, and, when necessary, local injections. Response to treatment was evaluated using visual analogue scale. Patients were followed-up for a mean duration of 13.6 months (range 6-30 months). Results: Heel pain completely resolved in 61 patients (76.25%), 13 patients had mild discomfort, and six patients (7.5%) had no change in their symptoms. There were calcaneal spurs in 50 symptomatic heels (49.5%); this being 23% in the control group. Radiographic measurements of the medial longitudinal arch showed no significant difference between the patients and controls; however, thickening of the heel pad in the former group was greater. Conclusion: Wearing soft-soled shoes and/or foot inserts or orthosis proved useful in obtaining rapid pain relief. Obesity, painful heel pad and entrapment of the first branch of the lateral plantar nerve had adverse influence on the outcome of the treatment.

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