Novel Procedure for Heel Pain

At the 94th Scientific Assembly and Annual Meeting of the Radiological Society of North America in December, Italian radiologists presented results from their study of a novel treatment for plantar fasciitis. Dr. Luca M. Sconfienza and his research team evaluated 44 patients with plantar fasciitis who were unresponsive to therapy. Each patient had a local anesthetic at the heel area and then application of a technique called dry needling. Dry needling is a technique involving ultrasound guided, repeated needle punctures to an area without the injection of any medication. The goal is to cause injury to a localized area to stimulate the healing response. An ultrasound guided steroid injection was given after the treatment and patients were given orthotics and followed for six months. After 3 weeks, 95% of the patients had complete resolution of their symptoms. These patients remained pain-free after 6 months.

Plantar fasciitis is the microscopic tearing and resultant inflammation of the plantar fascia, a long ligament type structure in the bottom of the foot which helps support the arch. Common treatments include rest, anti-inflammatory medications, stretching exercises, physical therapy, taping, supportive shoes, orthotics/inserts, night splints, shockwave therapy and surgery if conservative therapies have failed. Most individuals will respond to conservative therapies, but treatment periods can last for 6 to 12 months.

Dry needling is not a new procedure and steroid injections are a common treatment for heel pain, but the combination is a novel treatment and has encouraging initial results. Dry needling will cause additional trauma to the already injured plantar fascia. The plantar fascia has very low vascularity and causing localized inflammation at the point of injury will increase blood flow to the area. This may actually increase the healing process. By contrast, steroids decrease inflammation and work when inflammation becomes overwhelming and inhibits healing. Using both needling and a steroid injection is not necessarily an intuitive combination for the treatment of plantar fasciitis. Further studies will be needed to fully evaluate it’s effectiveness.

RSNA 2008: 94th Scientific Assembly and Annual Meeting of the Radiological Society of North America: Scientific Session A10-07. Presented November 30, 2008.

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2 Responses to “Novel Procedure for Heel Pain”

  1. on 13 Mar 2013 at 11:54 am Tory Brockman

    Heel pain usually builds up gradually and gets worse over time. The pain is often severe and occurs when you place weight on the heel. In most cases, only one heel is affected, although estimates suggest around a third of peopl’

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    <.http://www.foodsupplementcenter.com/ubiquinol-side-effects/e have pain in both heels.

  2. on 23 Mar 2013 at 7:25 pm chris from cardiff

    ‘Dry Needling’ was administered to me on 20th March 2013, at a NHS hospital. The procedure was accompanied by a small steroid being injected. I am very hopeful of the outcome.

    Four days later it’s too early to say. I was given no special boot for after-care, so I adapted a shop-bought sponge insole by cutting out an oval space corresponding to the area where the plantar fasciitis was worst – I’ve been suffering for 6 months from the problem which was variable but made walking difficult on many occasions.

    So far, after 24 hours when walking was very painful, the pain has receded somewhat, though walking is iniformly uncomfortable. I am experiencing calf-muscle stiffness and soreness in the right leg – the same leg as the plantar dry needling. I am a little concerned whether this stiffness and soreness is temporary or not, and what it might indicate. But, as I say, my outlook is that positive things are taking place. Not very scientific, but there you are.

    Will give a further update when appropriate. Any after-care advice gratefully received. Thanks

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