NLM CIT. ID: 99278906
TITLE: Management of heel pain syndrome with acetic acid iontophoresis. AUTHORS: Japour CJ; Vohra R; Vohra PK; Garfunkel L; Chin N AUTHOR AFFILIATION: Department of Surgery, Veterans Affairs Medical Center, Brooklyn, NY 11209, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 64-19-7 (Acetic Acid)
ABSTRACT: This study was undertaken to determine the effectiveness of acetic acid iontophoresis in the treatment of heel pain. Thirty-five patients with chronic heel pain were treated with acetic acid iontophoresis over a 4- year period. Ninety-four percent of patients had complete or substantial relief of heel pain after an average of 5.7 sessions of acetic acid iontophoresis over an average period of 2.8 weeks. Heel pain levels were rated from 0 to 10, with 10 representing the most severe pain. Heel pain prior to iontophoresis treatment received an average rating of 7.5; by the end of therapy, the average rating had decreased to 1.8. At an average follow-up time of 27 months, heel pain levels averaged 0.64, indicating continued reduction in heel pain. Ninety-four percent of participants said that they would recommend acetic acid iontophoresis to someone with similar heel pain. NLM PUBMED CIT. ID: 10349289 SOURCE: J Am Podiatr Med Assoc 1999 May;89(5):251-7 2

NLM CIT. ID: 99244282
TITLE: Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis. AUTHORS: Pfeffer G; Bacchetti P; Deland J; Lewis A Anderson R; Davis W; Alvarez R; Brodsky J; Cooper P; Frey C Herrick R; Myerson M; Sammarco J; Janecki C; Ross S; Bowman M Smith R AUTHOR AFFILIATION: San Francisco Orthopaedic Foot and Ankle Center, Department of Orthopaedics, University of California, USA. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng
ABSTRACT: Fifteen centers for orthopaedic treatment of the foot and ankle participated in a prospective randomized trial to compare several nonoperative treatments for proximal plantar fasciitis (heel pain syndrome). Included were 236 patients (160 women and 76 men) who were 16 years of age or older. Most reported duration of symptoms of 6 months or less. Patients with systemic disease, significant musculoskeletal complaints, sciatica, or local nerve entrapment were excluded. We randomized patients prospectively into five different treatment groups. All groups performed Achilles tendon- and plantar fascia-stretching in a similar manner. One group was treated with stretching only. The other four groups stretched and used one of four different shoe inserts, including a silicone heel pad, a felt pad, a rubber heel cup, or a custom-made polypropylene orthotic device. Patients were reevaluated after 8 weeks of treatment. The percentages improved in each group were: (1) silicone insert, 95%; (2) rubber insert, 88%; (3) felt insert, 81%; (4)stretching only, 72%; and (5) custom orthosis, 68%. Combining all the patients who used a prefabricated insert, we found that their improvement rates were higher than those assigned to stretching only (P = 0.022) and those who stretched and used a custom orthosis (P = 0.0074). We conclude that, when used in conjunction with a stretching program, a prefabricated shoe insert is more likely to produce improvement in symptoms as part of the initial treatment of proximal plantar fasciitis than a custom polypropylene orthotic device. NLM PUBMED CIT. ID: 10229276 SOURCE: Foot Ankle Int 1999 Apr;20(4):214-21 3

NLM CIT. ID: 99236494
TITLE: Plantar fasciitis and other causes of heel pain. AUTHORS: Barrett SJ; O'Malley R AUTHOR AFFILIATION: Advanced Foot Care, Spring, TX 77380, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: The most common cause of heel pain is plantar fasciitis. It is usually caused by a biomechanical imbalance resulting in tension along the plantar fascia. The diagnosis is typically based on the history and the finding of localized tenderness. Treatment consists of medial arch support, anti-inflammatory medications, ice massage and stretching. Corticosteroid injections and casting may also be tried. Surgical fasciotomy should be reserved for use in patients in whom conservative measures have failed despite correction of biomechanical abnormalities. Heel pain may also have a neurologic, traumatic or systemic origin. NLM PUBMED CIT. ID: 10221305 SOURCE: Am Fam Physician 1999 Apr 15;59(8):2200-6 4

NLM CIT. ID: 99219420
TITLE: Heel lancing in term new-born infants: an evaluation of pain by frequency domain analysis of heart rate variability. AUTHORS: Lindh V; Wiklund U; Hakansson S AUTHOR AFFILIATION: Department of Pediatrics, University Hospital, Umea, Sweden. vialih96@student.umu.se PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng
ABSTRACT: The aim of the investigation was to assess pain by frequency domain analysis of heart rate variability (HRV) during a routine heel lancing procedure in term new-born infants. Beat-to-beat heart rate (HR) was recorded in 23 healthy new-born infants on the maternity ward during blood sampling for neonatal screening. A sham heel prick prior to the sharp lancing procedure was performed randomly in half of the infants. Spectral analysis of HRV was assessed for each of the following sequences: (1) baseline (2) sham heel prick (3) sharp heel prick and (4) squeezing the heel for blood sampling. The response to the sham prick did not differ significantly from the sharp prick. Compared with the baseline, sharp lancing gave rise to minor increases in HR and variability in the low frequency band of the spectral analysis. A clear stress response was provoked when the heel was squeezed for blood sampling, indicated by an increased HR and a decreased spectral power in the high frequency band (i.e. lower vagal tone). The different stress responses during the lancing and the squeezing of the heel were clearly illustrated when principal component analysis was applied and the vectors for the changes in HR and spectral pattern were indicated. In conclusion, the squeezing of the heel is the most stressful event during the heel prick procedure. NLM PUBMED CIT. ID: 10204726 SOURCE: Pain 1999 Mar;80(1-2):143-8 5

NLM CIT. ID: 99215272
TITLE: Diagnosing and treating plantar fasciitis: a conservative approach to plantar heel pain. AUTHORS: Tisdel CL; Donley BG; Sferra JJ AUTHOR AFFILIATION: Department of Orthopaedic Surgery, Cleveland Clinic, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Plantar fasciitis is the most common cause of pain at the weight- bearing surface of the heel, and may coexist with other sources of heel pain. This has led to a confusing array of treatment strategies, including surgery. We offer a simple, effective diagnostic and treatment algorithm that emphasizes nonsurgical treatment options for this often frustrating condition. NLM PUBMED CIT. ID: 10199059 SOURCE: Cleve Clin J Med 1999 Apr;66(4):231-5 6

NLM CIT. ID: 99210898
TITLE: Randomised controlled trial of paracetamol for heel prick pain in neonates. AUTHORS: Shah V; Taddio A; Ohlsson A AUTHOR AFFILIATION: Women's College Hospital, Department of Newborn and Developmental Paediatrics, Faculty of Medicine, University of Toronto, Ontario, Canada. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng REGISTRY NUMBERS: 0 (Analgesics, Non-Narcotic) 103-90-2 (Acetaminophen)
ABSTRACT: AIM: To evaluate the effectiveness of paracetamol in decreasing the pain from heel prick. METHODS: A prospective randomised double blind placebo controlled trial was conducted of 75 term neonates undergoing heel prick. Sixty to 90 minutes before the procedure neonates received paracetamol orally in a dose of 20 mg/kg (group 1) or an equal volume of placebo (group 2). Heel prick was performed in a standardised manner. Pain assessments were made using per cent facial action (brow bulge, eye squeeze, and nasolabial fold (range 0-300%) and per cent of time spent crying (range 0-100%). RESULTS: Thirty eight neonates were enrolled in group 1 and 37 neonates in group 2. There were no significant differences in the demographic characteristics between groups. Mean gestational age was 39 (SD 1.4) vs 39.4 (SD 1.2) weeks, p = 0.86, mean birthweight 3.45 (SD 0.45) vs 3.44 (SD 0.42) kg; p = 0.31 for groups 1 and 2, respectively. Facial action pain scores did not differ between groups (143.5 (SD 54.2)% vs 131.1 (SD 59.6)%; p = 0.38). Cry scores also did not differ (29.4 (SD 19.9)% vs 26.8 (SD 20.2)%; p = 0.60). No adverse effects were observed. CONCLUSION: Paracetamol is ineffective for decreasing the pain from heel prick in term neonates. NLM PUBMED CIT. ID: 10194994 SOURCE: Arch Dis Child Fetal Neonatal Ed 1998 Nov;79(3):F209-11 7

NLM CIT. ID: 99201541
TITLE: The relationship of heel pad elasticity and plantar heel pain. AUTHORS: Turgut A; Gokturk E; Kose N; Seber S; Hazer B Gunal I AUTHOR AFFILIATION: Department of Orthopedics, Osmangazi University Hospital, Meselik, Eskisehir, Turkey. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Loss of heel pad elasticity has been suggested as one of the possible explanations of plantar heel pain. This hypothesis is evaluated by this blinded observer prospective study, using an age and weight matched control population. Hindfoot lateral radiographs of 73 patients with plantar heel pain, 29 of whom had bilateral involvement (102 feet), and who ranged in age from 20 to 60 years, were studied and compared with 120 healthy subjects (240 feet). Heel pad thickness and heel pad compressibility index were not significantly different in patients with plantar heel pain than in healthy subjects matched for age and weight. In patients with unilateral heel pain, heel pad thickness and heel pad compressibility index on the painful side were not significantly different from the opposite painless side. The contribution of the heel pad elasticity measured as a visual compressibility index for plantar heel pain is a matter of debate. NLM PUBMED CIT. ID: 10101325 SOURCE: Clin Orthop 1999 Mar;(360):191-6 8

NLM CIT. ID: 99196722
TITLE: Pain-relieving effect of sucrose in newborns during heel prick. AUTHORS: Overgaard C; Knudsen A AUTHOR AFFILIATION: Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng REGISTRY NUMBERS: 0 (Placebos) 0 (Solutions) 57-50-1 (Sucrose)
ABSTRACT: We assessed the effect of sucrose as a pain reliever in a population of newborns when cuddled and comforted during heel prick for diagnosis of phenylketonuria. In addition, the influences of gender, gestational age, postnatal age, ponderal index and behavioural state of the infant before the heel prick were studied, as judged by the neonatal infant pain scale (NIPS) score, on crying time (CT) and subsequent NIPS score. 100 healthy full-term infants were enrolled in this double-blind, randomized controlled trial. Before the heel prick, the newborns, when cuddled by the parent(s), were either given 2 ml 50% sucrose solution or 2 ml sterile water. The sessions were videotaped and analyzed for determination of CT and NIPS scores. The frequency distribution of CT showed a bimodal pattern in both the sucrose and the placebo groups. Sucrose significantly reduced CT and NIPS scores after the heel prick. No influence of gender, gestational age, postnatal age or ponderal index on CT was found. NIPS scores before the heel prick correlated significantly and positively with CT and subsequent NIPS scores in both the sucrose and the placebo groups. Intra-orally administered sucrose given before heel prick can be recommended as a useful pain reliever. Furthermore, the findings indicate that factors calming the newborn and creating low NIPS scores before the procedure can reduce the pain reaction equivalently and additively to sucrose administration. NLM PUBMED CIT. ID: 10095141 SOURCE: Biol Neonate 1999 May;75(5):279-84 9

NLM CIT. ID: 99171037
TITLE: [MRI of plantar fasciitis] VERNACULAR
TITLE: MR-Tomographie der Plantarfasciitis. AUTHORS: Steinborn M; Heuck A; Maier M; Schnarkowski P Scheidler J; Reiser M AUTHOR AFFILIATION: Institut fur Radiologische Diagnostik, Ludwig-Maximilians-Universitat Munchen. Marc.Steinborn@ikra.med.uni-muenchen.de PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Ger REGISTRY NUMBERS: 0 (Contrast Media)
ABSTRACT: PURPOSE: The purpose of this study was to determine the type and frequency of characteristic bone and soft tissue changes on MRI of patients with a clinical diagnosis of plantar fasciitis. MATERIALS AND METHODS: 28 patients with a clinical diagnosis of plantar fasciitis underwent MR imaging. Besides T1- and T2-weighted sequences, short-tau- inversion-recovery sequences were used routinely. In 27 patients T1- weighted images after intravenous contrast injection were acquired additionally. As a control group the images of 15 patients without clinical signs for plantar fasciitis were evaluated. RESULTS: In 25 of 28 cases (89%) the clinical diagnosis of plantar fasciitis was established by MR imaging. The most common finding was a peritendinous edema at the calcaneal insertion site which was found in all 25 patients. In 19 of 25 cases (76%) a bone marrow edema of the calcaneus was present. In 14 of 25 cases (56%) an intratendinous signal intensity increase of the plantar fascia could be observed which showed contrast enhancement in 12 cases. Compared to the control group (mean thickness 3.3 mm) the plantar fascia showed significant thickening in the 25 MR positive patients (mean thickness 6.72 mm). DISCUSSION: Besides thickening of the plantar fascia and intratendinous signal intensity increase with contrast enhancement to some extent, bone marrow edema of the calcaneus and peritendinous edema close to the plantar fascia are characteristic signs of plantar fasciitis on MRI. Both signs can reliably be seen on STIR sequences only. NLM PUBMED CIT. ID: 10071643 SOURCE: Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 1999 Jan;170(1):41-6 10

NLM CIT. ID: 99169432
TITLE: Ultrasound guided injection of plantar fasciitis [letter; comment] AUTHORS: Quinn M; Gough A COMMENTS: Comment on: Ann Rheum Dis 1998 Jun;57(6):383-4 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng REGISTRY NUMBERS: 0 (Glucocorticoids, Synthetic) NLM PUBMED CIT. ID: 10070279 SOURCE: Ann Rheum Dis 1998 Dec;57(12):749-50 11

NLM CIT. ID: 99163265
TITLE: Long-term follow-up of heel spur surgery. A 10-year retrospective study. AUTHORS: Vohra PK; Giorgini RJ; Sobel E; Japour CJ Villalba MA; Rostkowski T AUTHOR AFFILIATION: Division of Surgery, New York College of Podiatric Medicine, New York, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: A comparative retrospective study of 48 open heel spur surgeries and 20 endoscopic plantar fasciotomies was conducted involving 59 patients over a 10-year period. There was a significant reduction in heel pain at the time of follow-up (average, 3 years) for both groups. Overall, 85% of procedures were associated with patient satisfaction with the results, and patients said that they would recommend heel spur surgery for relief of severe heel pain in 94% of cases. Factors influencing the postoperative outcome, such as duration of preoperative symptoms, extent of conservative care, and obesity, are discussed. NLM PUBMED CIT. ID: 10063778 SOURCE: J Am Podiatr Med Assoc 1999 Feb;89(2):81-8 12

NLM CIT. ID: 99163263
TITLE: Heel pain in children. Diagnosis and treatment. AUTHORS: Kim CW; Shea K; Chambers HG AUTHOR AFFILIATION: Department of Orthopaedic Surgery, University of California, San Diego, Medical Center 92103-8894, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Heel pain in children is common, and its evaluation is challenging. Medical history and physical examination may be unrevealing owing to children's limited communication skills. Often, advanced laboratory and imaging studies are required to make an accurate diagnosis. The most common causes of heel pain in children are apophysitis, enthesopathy, and overuse syndromes such as tendinitis. Juvenile rheumatoid arthritis is relatively uncommon. In very active children, occult fractures must also be evaluated. Pain unrelated to activity may indicate tumors, infection, or congenital problems. In general, heel pain in children is treated nonoperatively. For fractures in particular, children are less likely than adults to receive surgical treatment. NLM PUBMED CIT. ID: 10063776 SOURCE: J Am Podiatr Med Assoc 1999 Feb;89(2):67-74 13

NLM CIT. ID: 99162762
TITLE: Ultrasonographic assessment of posterior heel pain. AUTHORS: Wang CL; Shieh JY; Wang TG; Hsieh FJ AUTHOR AFFILIATION: Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: To investigate the value of ultrasonography in the diagnosis of posterior heel pain, 68 patients with normal plain x-ray findings of the posterior heel underwent ultrasonographic examination with a 10-MHz linear array probe. The findings included Achilles tendinosis (31 patients), retrocalcaneal bursitis (12), superficial Achilles bursitis (7), soft tissue mass (7), Achilles tendon rupture (4), xanthoma (3), tenosynovitis of the flexor hallucis longus tendon (2), and negative findings (2). Sixteen of these patients underwent surgery after ultrasonographic examination. The surgical diagnoses were consistent with the ultrasonographic diagnoses in all cases. With high-resolution ultrasonography, pathologic conditions of the posterior heel can be readily differentiated. NLM PUBMED CIT. ID: 10063275 SOURCE: J Formos Med Assoc 1999 Jan;98(1):56-61 14

NLM CIT. ID: 99149380
TITLE: [High energy shock wave treatment of the painful heel spur] VERNACULAR
TITLE: Hochenergetische Stosswellenbehandlung des schmerzhaften Fersensporns. AUTHORS: Perlick L; Boxberg W; Giebel G AUTHOR AFFILIATION: Abteilung fur Unfall- und Wiederherstellungschirurgie, Kreiskrankenhaus, Ludenscheid. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Ger
ABSTRACT: Extracorporal shock wave application (ESWA) has been used in the treatment of stones located in kidneys, bile, pancreas and the glandula parotis. In the last 2 years several studies have shown the benefit of the ESWA on the treatment of soft tissue disorders. The aim of this study was to explore the effect of high energy extracorporal shock waves in patients with painful calcaneus spurs. 83 patients who underwent medicophysical treatment without benefit were treated with 3000 impulses of 0.30 mj/mm2. Follow-ups after 12 weeks and 12 months showed that 51 of 83 patients became pain-free and 20 patients improved from the treatment. The results are showing the benefit of the high energy extracorporal shock wave application in the treatment of chronic plantar fasciitis. NLM PUBMED CIT. ID: 10025241 SOURCE: Unfallchirurg 1998 Dec;101(12):914-8 15

NLM CIT. ID: 99125600
TITLE: Infectious causes of heel pain. AUTHORS: Kosinski M; Lilja E AUTHOR AFFILIATION: Division of Medical Sciences, New York College of Podiatric Medicine, NY 10035, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Heel pain is often attributed to a biomechanical etiology or sports- related injury. However, failure to recognize an infectious cause can lead to a delay in proper treatment and result in severe patient disability. This article reviews some of the more common infectious etiologies of heel pain. NLM PUBMED CIT. ID: 9926684 SOURCE: J Am Podiatr Med Assoc 1999 Jan;89(1):20-3 16

NLM CIT. ID: 99125599
TITLE: Enthesitis, arthritis, and heel pain. AUTHORS: Lehman TJ AUTHOR AFFILIATION: Division of Pediatric Rheumatology, Hospital for Special Surgery, New York, New York, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Often, individuals who present with "isolated" heel pain but with normal laboratory findings are dismissed without diagnosis. However, if these patients are carefully questioned and examined, a significant proportion are found to have a spondyloarthropathy. The keys to making this diagnosis are obtaining a thorough medical history and performing a complete physical examination. The classic complaints of back pain and enthesitis in other areas are frequently not reported by patients unless specifically sought, because they are thought to be unrelated to the heel pain. NLM PUBMED CIT. ID: 9926683 SOURCE: J Am Podiatr Med Assoc 1999 Jan;89(1):18-9 17

NLM CIT. ID: 99095105
TITLE: Heel pain syndrome [letter; comment] AUTHORS: Skliar JD COMMENTS: Comment on: J Foot Ankle Surg 1998 Jul-Aug;37(4):267-8 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 9879055 SOURCE: J Foot Ankle Surg 1998 Nov-Dec;37(6):548-9 18

NLM CIT. ID: 99087501
TITLE: Outcome study of subjects with insertional plantar fasciitis. AUTHORS: Martin RL; Irrgang JJ; Conti SF AUTHOR AFFILIATION: University of Pittsburgh, Pennsylvania, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng NLM PUBMED CIT. ID: 9872466 SOURCE: Foot Ankle Int 1998 Dec;19(12):803-11 19

NLM CIT. ID: 99040968
TITLE: [5-years lithotripsy of plantar of plantar heel spur: experiences and results--a follow-up study after 36.9 months] VERNACULAR
TITLE: 5 Jahre Lithotripsie des plantaren Fersenspornes: Erfahrungen und Ergebnisse--eine Nachuntersuchung nach 36,9 Monaten. AUTHORS: Sistermann R; Katthagen BD AUTHOR AFFILIATION: Orthopadische Klinik, Stadtische Kliniken Dortmund, Klinikzentrum Mitte. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Ger
ABSTRACT: INTRODUCTION: Effectivity and application as well as possible complications and side effects of extracorporeal shock wave lithotripsy of plantar heel spurs should be evaluated. METHOD: We applied extracorporeal shock wave lithotripsy (ECSL) to treat plantar fasciitis in 54 patients (period from: 3/1/1993 to 3/1/1996). 20 persons were treated with Lithostar plus (group 1) and ultrasound focussing and 34 patients (group 2) were treated by a Lithostar and X-ray focussing. RESULTS: After 6 weeks 14 (70%) of group 1 and 27 (79.4%) of group 2 were free of pain. After 36.9 months 8 (40%) of group 1 and 23 (67.6%) of group 2 were still painfree. We could not recognize any severe complications after 36.9 months. CONCLUSION: ECSL is an effective and noninvasive method of treatment. It is not the method of choice for the first treatment of plantar fasciitis but is an alternative option for operation. NLM PUBMED CIT. ID: 9823634 SOURCE: Z Orthop Ihre Grenzgeb 1998 Sep-Oct;136(5):402-6 20

NLM CIT. ID: 99001584
TITLE: Unusual heel pain in a patient with primary oxalosis treated by liver- kidney transplantation [letter] AUTHORS: Javier RM; Moulin B; Durckel J; Sibilia J; Kuntz JL PUBLICATION TYPES: LETTER LANGUAGES: Eng REGISTRY NUMBERS: 0 (Oxalates) NLM PUBMED CIT. ID: 9785405 SOURCE: Rev Rhum Engl Ed 1998 Jul-Sep;65(7-9):517-8 21

NLM CIT. ID: 98444156
TITLE: Ultrasound guided injection of recalcitrant plantar fasciitis [see comments] AUTHORS: Kane D; Greaney T; Bresnihan B; Gibney R FitzGerald O AUTHOR AFFILIATION: Department of Diagnostic Imaging, St Vincent's Hospital, Dublin, Ireland. COMMENTS: Comment in: Ann Rheum Dis 1998 Dec;57(12):749-50 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 0 (Anesthetics, Local) 0 (Anti-Inflammatory Agents, Steroidal) 137-58-6 (Lidocaine) 76-25-5 (Triamcinolone Acetonide)
ABSTRACT: OBJECTIVE: To determine the effect of ultrasound guided injection in recalcitrant idiopathic plantar fasciitis. METHODS: Four patients with a clinical diagnosis of idiopathic plantar fasciitis, who were unresponsive to palpation guided injection with triamcinolone acetonide and local anaesthetic, underwent ultrasonographic examination of the heel. RESULTS: The following ultrasonographic features were noted:- (a) increased thickness of plantar fascia in symptomatic heels compared with asymptomatic heels, (b) loss of distinction of the distal plantar fascia borders, (c) reduced echogenicity of the plantar fascia. Ultrasound guided injection of the enlarged, hypoechoic plantar fascia resulted in complete relief in four of five heels (mean duration of follow up = 24 months) in three cases. One patient developed a recurrence of symptoms after six months. CONCLUSION: Ultrasound allows for confirmation of the clinical diagnosis and ultrasound guided injection produces a good clinical response when unguided injection is unsuccessful. The technique is quick, inexpensive, and entails no radiation exposure. NLM PUBMED CIT. ID: 9771217 SOURCE: Ann Rheum Dis 1998 Jun;57(6):383-4 22

NLM CIT. ID: 98406588
TITLE: Metastatic breast cancer presenting as heel pain. AUTHORS: Groves MJ; Stiles RG AUTHOR AFFILIATION: Northlake Regional Medical Center, Tucker, GA, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: The authors present a case of breast cancer metastasizing to the calcaneus that was confirmed by bone biopsy. The patient's complaint of heel pain provided the initial evidence of skeletal metastasis. Metastatic spread of cancer to the hand or foot (acrometastasis) is considered rare. However, the possibility of acrometastasis should be considered in any patient with a history of cancer presenting with skeletal pain, especially if the symptoms do not respond to therapy. NLM PUBMED CIT. ID: 9735627 SOURCE: J Am Podiatr Med Assoc 1998 Aug;88(8):400-5 23

NLM CIT. ID: 98406584
TITLE: Conservative treatment of plantar fasciitis. A prospective study. AUTHORS: Lynch DM; Goforth WP; Martin JE; Odom RD; Preece CK Kotter MW AUTHOR AFFILIATION: Department of Surgery, Texas A&M University Health Science Center, College of Medicine, Temple, USA. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng REGISTRY NUMBERS: 0 (Anti-Inflammatory Agents)
ABSTRACT: A randomized, prospective study was conducted to compare the individual effectiveness of three types of conservative therapy in the treatment of plantar fasciitis. One hundred three subjects were randomly assigned to one of three treatment categories: anti-inflammatory, accommodative, or mechanical. Subjects were treated for 3 months, with follow-up visits at 2, 4, 6, and 12 weeks. For the 85 patients who completed the study, a statistically significant difference was noted between groups, with mechanical treatment with taping and orthoses proving to be more effective than either anti-inflammatory or accommodative modalities. NLM PUBMED CIT. ID: 9735623 SOURCE: J Am Podiatr Med Assoc 1998 Aug;88(8):375-80 24

NLM CIT. ID: 98376637
TITLE: Entrapment neuropathy: the etiology of intractable chronic heel pain syndrome. AUTHORS: Hendrix CL; Jolly GP; Garbalosa JC; Blume P DosRemedios E AUTHOR AFFILIATION: New Britain General Hospital, CT 06050, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Chronic heel pain syndrome (CHPS) is a common clinical entity. The etiology of CHPS has never been completely defined and there are no clear treatment regimens in the literature. Most authors agree that nonoperative treatment is effective in most patients. However, in 5%- 10% of patients, operative intervention is required. Outcomes for these patients have been inconsistent. A series of 51 patients with intractable CHPS who were diagnosed with an entrapment of the posterior tibial nerve and its terminal branches is presented. Descriptive statistics were obtained for the demographic data and pre and postsurgical start-up and standing pain visual analog scale (VAS) scoring. Statistical testing of the VAS mean scores was performed using a paired t-test at the 0.01 level of significance. Pre- and postsurgical start-up and pre- and postsurgical standing pain VAS means were significantly different from each other (t = 19.6, p = .001 and t = 19.4, p = .001, respectively). Based on subjective and objective criteria, 96% of the patients experienced significant improvement and 90% reported completed resolution of heel pain. The presence of tarsal tunnel syndrome in all 51 patients strongly suggests entrapment neuropathy as the etiology of intractable CHPS. NLM PUBMED CIT. ID: 9710778 SOURCE: J Foot Ankle Surg 1998 Jul-Aug;37(4):273-9 25

NLM CIT. ID: 98376636
TITLE: Percutaneous plantar fasciotomy: a minimally invasive procedure for recalcitrant plantar fasciitis. AUTHORS: Benton-Weil W; Borrelli AH; Weil LS Jr; Weil LS Sr PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: A retrospective study was done to evaluate patient pain level and satisfaction after a percutaneous plantar fasciotomy. Between 1990 and 1996, 51 patients underwent percutaneous plantar fasciotomy for chronic plantar fasciitis associated with heel pain syndrome. All patients had undergone at least 6 months of conservative therapy. A questionnaire incorporating a visual analog pain scale was used to determine the effectiveness and patient satisfaction of the procedure. Of 35 patients who responded to the questionnaire, 27 were female and eight were male, ranging in age from 31 to 76 years with an average age of 47 years. Follow-up time after surgery ranged from 12 to 57 months, with an average of 34 months. Utilizing a visual analog pain scale, results showed a preoperative pain level of 8.7 (+/- 1.2) with a range of 6-10. Pain level at follow-up was 2.1 (+/- 2.7) with a range of 0-10. Eighty- three percent of the patients stated that the procedure met or exceeded their expectations. Percutaneous plantar fasciotomy is a simple and cost-effective method for surgical intervention of chronic heel pain syndrome. Complications are rare and the results compare favorably with other reported more invasive and costly techniques. NLM PUBMED CIT. ID: 9710777 SOURCE: J Foot Ankle Surg 1998 Jul-Aug;37(4):269-72 26

NLM CIT. ID: 98376635
TITLE: The heel pain syndrome [editorial] [see comments] AUTHORS: Weil LS Sr COMMENTS: Comment in: J Foot Ankle Surg 1998 Nov-Dec;37(6):548-9 PUBLICATION TYPES: EDITORIAL LANGUAGES: Eng NLM PUBMED CIT. ID: 9710776 SOURCE: J Foot Ankle Surg 1998 Jul-Aug;37(4):267-8 27

NLM CIT. ID: 98369935
TITLE: Adaptive gait responses to plantar heel pain. AUTHORS: Levins AD; Skinner HB; Caiozzo VJ AUTHOR AFFILIATION: Department of Orthopaedic Surgery, College of Medicine, UCI Medical Center, Orange 92868, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Neuropathic foot ulcers in people with diabetes result from repetitive stress aggravated by a lack of protective sensation. Protective sensation causes individuals without this impairment to produce alterations in their gait in response to painful stimuli. This study evaluates the adaptive gait responses to pain in individuals with sensate feet. The gaits of 18 such control subjects were studied with a foot switch gait analyzer without painful stimuli. Each then had his or her gait analyzed with three successively larger painful stimuli (2, 3.3, and 4.6 mm beads) placed below the heel. This study showed that subjects compensated for the painful stimuli by reducing the single limb support duration of the affected side at bead sizes of 3.3 and 4.6 mm and by reducing the unaffected side's swing phase and single limb support as a percentage of the gait cycle at the 4.6-mm bead size only. Gait adaptations to painful stimuli may indicate another possible avenue, in addition to pressure redistribution, in the assessment of programs aimed at prevention and treatment of diabetic foot ulcers. NLM PUBMED CIT. ID: 9704312 SOURCE: J Rehabil Res Dev 1998 Jul;35(3):289-93 28

NLM CIT. ID: 98306886
TITLE: Tibial nerve entrapment and heel pain caused by a Baker's cyst [letter] AUTHORS: Willis JD; Carter PM PUBLICATION TYPES: LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 9642916 SOURCE: J Am Podiatr Med Assoc 1998 Jun;88(6):310-1 29

NLM CIT. ID: 98278215
TITLE: [Symptomatic low-energy shockwave therapy in heel pain and radiologically detected plantar heel spur] VERNACULAR
TITLE: Symptomatische niedrig-energetische Stosswellentherapie bei Fersenschmerzen und radiologisch nachweisbarem plantaren Fersensporn. AUTHORS: Krischek O; Rompe JD; Herbsthofer B; Nafe B AUTHOR AFFILIATION: Orthopadische Universitatsklinik Mainz. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Ger
ABSTRACT: QUESTION: The long-term analgetic effect of low-energetic shock-wave therapy in heel spur for two different numbers of applicated impulses is investigated. METHODS: 50 patients with recalcitrant heel pain and a plantar calcaneal spur on the X-ray received in a controlled, prospective and randomized study low-energetic extracorporal shock-wave- therapy. The first group received 3 x 500 impulses and the second group 3 x 100 impulses of 0.08 mJ/mm2 with an experimental device. The follow- up was 1 1/2, 3 and by telephone after 12 months. RESULTS: There was clear improvement and relief of pain in both groups on manual pressure and while walking and an increase of the pain-free walking ability from 10 minutes before the treatment to 2 and 3 hours respectively after 12 months. We saw a significantly better results after the treatment with 3 x 500 impulses. CONCLUSION: The extracorporal shock-wave therapy is an effective treatment in refractory heel pain. An amount of at least 3 x 500 impulses in the low energetic treatment is useful. NLM PUBMED CIT. ID: 9615981 SOURCE: Z Orthop Ihre Grenzgeb 1998 Mar-Apr;136(2):169-74 30

NLM CIT. ID: 98201985
TITLE: Differences in impulse distribution in patients with plantar fasciitis. AUTHORS: Bedi HS; Love BR AUTHOR AFFILIATION: Geelong Hospital, Victoria, Australia. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: The impulse distribution based upon vertical foot-floor reaction forces and time under the fore-, mid-, and hindfoot was determined using Tekscan's F-Scan system. This was compared in 40 barefoot patients with long-standing plantar fasciitis with an equal number of normal subjects. The patient group tended to load the hind- and midfoot to a lesser extent than the control group. Consequently, a greater proportionate load was borne by the forefoot. This result was highly significant for both the midfoot (P < 0.001) and forefoot (P = 0.002) comparisons. An objective biomechanical method such as this may be useful as a diagnostic aid, to identify individuals predisposed to this condition, and for evaluating the efficacy of various treatment modalities. NLM PUBMED CIT. ID: 9542986 SOURCE: Foot Ankle Int 1998 Mar;19(3):153-6 31

NLM CIT. ID: 98245350
TITLE: Management of heel pain in the inflammatory arthritides. AUTHORS: Geppert MJ; Mizel MS AUTHOR AFFILIATION: Orthopaedic & Trauma Specialists, Somersworth, NH, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Subcalcaneal pain is a common complaint presented to the orthopaedist. Excessive attention to mechanical or traumatic causes may result in an improper diagnosis if rheumatologic or systemic conditions are not considered in the differential diagnosis. Systemic conditions associated with heel pain are reviewed and a conservative treatment protocol is presented that should help to obtain a correct diagnosis and to lead to effective management of this common condition. NLM PUBMED CIT. ID: 9584371 SOURCE: Clin Orthop 1998 Apr;(349):93-9 32

NLM CIT. ID: 98238133
TITLE: I have recently taken up fast walking and have developed pain in my left foot, which my internist says in plantar fasciitis. She told me to hold off on walking for a while. Can you tell me about this condition? Is there anything else I can do to speed my recovery? PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng NLM PUBMED CIT. ID: 9577272 SOURCE: Harv Womens Health Watch 1998 Apr;5(8):8 33

NLM CIT. ID: 98181948
TITLE: A randomized controlled evaluation of low-intensity laser therapy: plantar fasciitis. AUTHORS: Basford JR; Malanga GA; Krause DA; Harmsen WS AUTHOR AFFILIATION: Department of Physical Medicine and Rehabilitation, Mayo Clinic and Foundation, Rochester, MN 55905, USA. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng
ABSTRACT: OBJECTIVE: To determine whether low-intensity laser irradiation, a widespread but controversial physical therapy agent, is an effective treatment of plantar fasciitis. DESIGN: A randomized, double-blinded, placebo-controlled clinical study. SETTING: A sports medicine clinic. SUBJECTS: Thirty-two otherwise healthy individuals with plantar fasciitis of more than 1 month's duration. INTERVENTION: Dummy or active irradiation with a 30 mW .83 microm GaAlAs continuous-wave infrared (IR) diode laser three times a week for 4 weeks. MEASUREMENTS: Morning pain, pain with toe walking, tenderness to palpation, windlass test response, medication consumption, and orthotic use were evaluated immediately before the study, as well as at the midpoint and end of treatment. Subjects were also evaluated at a follow-up 1 month after their last treatment. RESULTS: No significant differences were found between the groups in any of the outcome measures either during treatment or at the 1-month follow-up. Treatment, however, was well tolerated and side effects were minimal. CONCLUSIONS: Low-intensity IR laser therapy appears safe but, at least within the parameters of this study, is not beneficial in the treatment of plantar fasciitis. NLM PUBMED CIT. ID: 9523774 SOURCE: Arch Phys Med Rehabil 1998 Mar;79(3):249-54 34

NLM CIT. ID: 98164520
TITLE: Retrospective analysis of minimal-incision, endoscopic, and open procedures for heel spur syndrome. AUTHORS: Brekke MK; Green DR AUTHOR AFFILIATION: Scripps Mercy Medical Center, San Diego, CA, USA. PUBLICATION TYPES: HISTORICAL ARTICLE JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Forty-four patients with recalcitrant heel spur syndrome who underwent surgical correction (54 procedures) were studied retrospectively. The results of minimal-incision, endoscopic, and open plantar fasciotomy procedures were compared. This study focuses on patient satisfaction, pain reduction, convalescence, and postoperative problems. Although all procedure groups reported high degrees of patient satisfaction and reduction of pain, some notable differences among the three groups were observed. NLM PUBMED CIT. ID: 9503769 SOURCE: J Am Podiatr Med Assoc 1998 Feb;88(2):64-72 35

NLM CIT. ID: 98154548
TITLE: Iontophoresis of 0.4% dexamethasone for plantar fasciitis. AUTHORS: Chandler TJ AUTHOR AFFILIATION: Lexington Clinic Sports Medicine Center, Lexington, Kentucky, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 0 (Glucocorticoids, Synthetic) 50-02-2 (Dexamethasone) NLM PUBMED CIT. ID: 9490178 SOURCE: Clin J Sport Med 1998 Jan;8(1):68 36

NLM CIT. ID: 98142459
TITLE: Plantar fasciitis. Repeated corticosteroid injections are safe. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 0 (Adrenal Cortex Hormones) NLM PUBMED CIT. ID: 9481460 SOURCE: Can Fam Physician 1998 Jan;44:45, 51 37

NLM CIT. ID: 98126722
TITLE: Plantar fasciitis/calcaneal spur among security forces personnel. AUTHORS: Sadat-Ali M AUTHOR AFFILIATION: College of Medicine & Medical Sciences, King Faisal University, Saudi Arabia. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: A prospective single survey was conducted among Security Forces personnel at the Mobile Hospital, Ministry of Interior, Makkah Al- Mukarramah, Saudi Arabia. One hundred three patients presented to the orthopedic clinic with painful heel. A control group of patients from the other clinics without painful heel was also screened. The average age was 38.81 years and 38.1 years in the patient and the control group, respectively. The mean Quetelet index of body mass in the patient group was 30.36 kg/m2 and in the control group it was 26.71 kg/m2. There was a statistically significant difference of p < 0.05 between the two groups for Quetelet index of body mass. The right side was affected in 37 patients, the left side was involved in 45 patients, and 21 patients had pain bilaterally. Seventy-one patients had spur on the calcaneum. The prevalence of painful heel attributable to plantar fasciitis/calcaneum spur was 1.18%. This study suggests that obesity is a cause and initiator of heel pain and plantar fasciitis/calcaneal spur and that improper footwear aggravates the condition. NLM PUBMED CIT. ID: 9465574 SOURCE: Mil Med 1998 Jan;163(1):56-7 38

NLM CIT. ID: 98122739
TITLE: Effective treatment of chronic plantar fasciitis with dorsiflexion night splints: a crossover prospective randomized outcome study. AUTHORS: Powell M; Post WR; Keener J; Wearden S AUTHOR AFFILIATION: Department of Orthopaedics, West Virginia University, Morgantown 26505, USA. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng
ABSTRACT: Chronic plantar fasciitis frustrates patients and treating physicians. Our hypothesis was that use of a dorsiflexion night splint for 1 month would effectively treat patients with recalcitrant plantar fasciitis. A 6-month randomized crossover study included 37 patients with chronic plantar fasciitis. Patients were treated with dorsiflexion night splints for 1 month. Group A wore splints for the 1st month and group B for the 2nd month. No splints were used in either group for the final 4 months of the study. No other medications, stretching, or strengthening exercises were prescribed. Eighty-eight percent of patients who completed the study improved. Eighty percent of the involved feet improved subjectively. Results of the AOFAS Ankle-Hindfoot Rating System and the Mayo Clinical Scoring System demonstrated significant improvement for both groups during the period of splint wear. Improvements were maintained at study completion. Response to splinting did not correlate with foot type, degree of obesity, or the presence of heel spur on radiographs. We believe dorsiflexion splints provide relief from the symptoms of recalcitrant plantar fasciitis in the majority of patients. NLM PUBMED CIT. ID: 9462907 SOURCE: Foot Ankle Int 1998 Jan;19(1):10-8 39

NLM CIT. ID: 98026335
TITLE: Neonatal pain response to heel stick vs venepuncture for routine blood sampling. AUTHORS: Shah VS; Taddio A; Bennett S; Speidel BD AUTHOR AFFILIATION: Neonatal Intensive Care Unit, Southmead Hospital, Bristol. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng
ABSTRACT: Neonatal pain response and adverse effects and maternal anxiety were assessed in 27 infants who were randomly allocated to venepuncture or heel stick. Pain was assessed by nurses using the Neonatal Infant Pain Scale (NIPS) and a three point scale for the mothers. NIPS scores were higher in the heel stick group compared with the venepuncture group. Maternal anxiety was higher before the procedure while perception of an infant's pain was lower in the venepuncture group compared with the heel stick group. Venepuncture is less painful than heel stick in newborn infants undergoing routine blood sampling. NLM PUBMED CIT. ID: 9377140 SOURCE: Arch Dis Child Fetal Neonatal Ed 1997 Sep;77(2):F143-4 40

NLM CIT. ID: 98039111
TITLE: MRI of plantar fasciitis. AUTHORS: Roger B; Grenier P AUTHOR AFFILIATION: Service de Radiologie Polyvalente Diagnostique et Interventionelle, Hopital de la Pitie, 83, boulevard de l'Hopital, F-75651 Paris Cedex 13, France. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: At present, MRI is the only imaging method that can precisely visualize lesions of the superficial plantar aponeurosis, whether they be musculoaponeurositides, enthesopathies or tears, and whether they be acute or chronic, with or without complications. By its direct visualization of the lesion, MRI enables an accurate assessment of the injury to be made and thereby better orients the therapeutic strategy. NLM PUBMED CIT. ID: 9369509 SOURCE: Eur Radiol 1997;7(9):1430-5 41

NLM CIT. ID: 98059214
TITLE: An inexpensive "orthosis" for plantar fasciitis [letter; comment] AUTHORS: de Souza H; Reed L COMMENTS: Comment on: Med J Aust 1997 Jun 2;166(11):616 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 9397072 SOURCE: Med J Aust 1997 Nov 3;167(9):509 42

NLM CIT. ID: 98048954
TITLE: [Heel pain and calcaneal spurs] AUTHORS: Lu H; Gu G; Zhu S AUTHOR AFFILIATION: Arthritis Clinic & Research Center, People's Hospital Beijing Medical University Beijng. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Chi
ABSTRACT: The authors of this paper have reviewed 137 X-ray films of the involved feet and followed up 30 patients all of them suffering from heel pain treated in the authors' hospital during 1980-1985, in order to find out the relationship between the length, shape and the direction of the spurs with the heel pain. We have found: (1) There are no clear relationship between heel pain and the length, shape and the direction of the calcaneal spur. (2) The plantar soft tissue of the painful foot was thickened, indicating the heel pain was due to inflammation in the plantar soft tissue. (3) Heel pain is related to the patient's age and sex. (4) The spurs still exist and grow even bigger after the syndrome disappears. NLM PUBMED CIT. ID: 9387707 SOURCE: Chung Hua Wai Ko Tsa Chih 1996 May;34(5):294-6 43

NLM CIT. ID: 98013837
TITLE: The role of bone scintigraphy and plain radiography in intractable plantar fasciitis. AUTHORS: Tudor GR; Finlay D; Allen MJ; Belton I AUTHOR AFFILIATION: Department of Radiology, Leicester Royal Infirmary NHS Trust, UK. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: The objective of this study was to assess the role of bone scintigraphy and plain film radiography in intractable plantar fasciitis. The bone scintigrams, radiographs and clinical histories of 33 patients with chronic plantar fasciitis were reviewed. These patients were refractory to conservative treatments and were being considered for surgical plantar fascia release. Twenty-eight patients had increased uptake on scintigraphy at the medial calcaneal tubercle, while a plantar spur was seen in 21 patients. Seventy-five percent of patients with increased uptake had a calcaneal spur; 95% of patients with a spur had increased uptake on scintigraphy. It would appear that plantar calcaneal spurs are more prevalent in this group of patients than in the general population and, although they may not be the primary cause of pain, they may predispose to it. Scintigraphy was helpful in patients without a spur or with atypical symptoms or signs. It did not provide any further information on the group of patients with a spur. NLM PUBMED CIT. ID: 9352552 SOURCE: Nucl Med Commun 1997 Sep;18(9):853-6 44

NLM CIT. ID: 97457528
TITLE: Clinical snapshot: plantar fasciitis. AUTHORS: Campbell-Giovaniello KJ AUTHOR AFFILIATION: Veterans Administration Outpatient Clinic, Redding, CA, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng NLM PUBMED CIT. ID: 9311337 SOURCE: Am J Nurs 1997 Sep;97(9):38-9 45

NLM CIT. ID: 97452806
TITLE: Plantar heel pain in the adult. AUTHORS: Hurwitz SH AUTHOR AFFILIATION: Department of Orthopedics, University of Virginia Health Sciences Center, Charlotiesville, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: The search for the cause of subcalcaneal heel pain involves a range of elements from the height of the patient's shoe heels to the presence of concomitant disease. Heel pain that interferes with daily activities, particularly when mobility is a job requirement, worries the patient and challenges the clinician. However, most patients improve with or without treatment. NLM PUBMED CIT. ID: 9307596 SOURCE: Hosp Pract (Off Ed) 1997 Sep 15;32(9):81-3, 86-8, 91-2 46

NLM CIT. ID: 97395411
TITLE: Fortnightly review. Plantar fasciitis. AUTHORS: Singh D; Angel J; Bentley G; Trevino SG AUTHOR AFFILIATION: Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng NLM PUBMED CIT. ID: 9251550 SOURCE: BMJ 1997 Jul 19;315(7101):172-5 47

NLM CIT. ID: 97401231
TITLE: Infracalcaneal heel pain in the athlete. AUTHORS: Agostinelli J; Ross JA AUTHOR AFFILIATION: Orthopedics/Podiatry Services, Eglin Air Force Base, Florida, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Heel-spur syndrome is a condition encountered on a daily basis by those practitioners who primarily treat athletes. The authors discuss anatomy, the clinical examination, radiographic evaluation, exercise, and alternative medicines. NLM PUBMED CIT. ID: 9257037 SOURCE: Clin Podiatr Med Surg 1997 Jul;14(3):503-9 48

NLM CIT. ID: 97396647
TITLE: Treatment of plantar fasciitis with night splint and shoe modifications consisting of a steel shank and anterior rocker bottom [letter; comment] AUTHORS: Ng A COMMENTS: Comment on: Foot Ankle Int 1996 Dec;17(12):732-5 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 9252820 SOURCE: Foot Ankle Int 1997 Jul;18(7):458 49

NLM CIT. ID: 97344828
TITLE: An inexpensive "orthosis" for plantar fasciitis [letter] [see comments] AUTHORS: White AD COMMENTS: Comment in: Med J Aust 1997 Nov 3;167(9):509 PUBLICATION TYPES: LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 9201195 SOURCE: Med J Aust 1997 Jun 2;166(11):616 50

NLM CIT. ID: 97376392
TITLE: Early clinical results of the use of radiofrequency lesioning in the treatment of plantar fasciitis. AUTHORS: Sollitto RJ; Plotkin EL; Klein PG; Mullin P AUTHOR AFFILIATION: Saddle Brook Surgicenter, NJ 07663, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: In this paper the authors discuss plantar fascial heel pain, including its etiology and treatment. The results of a retrospective study using radiofrequency lesioning on plantar fascial heel pain are presented and discussed. Thirty-nine patients were treated with radiofrequency lesioning, and 92% of the patients experienced complete resolution of symptoms following the procedure. NLM PUBMED CIT. ID: 9232502 SOURCE: J Foot Ankle Surg 1997 May-Jun;36(3):215-9; discussion 256 51

NLM CIT. ID: 97310910
TITLE: Treatment of plantar fasciitis by iontophoresis of 0.4% dexamethasone. A randomized, double-blind, placebo-controlled study. AUTHORS: Gudeman SD; Eisele SA; Heidt RS Jr; Colosimo AJ Stroupe AL AUTHOR AFFILIATION: Specialty Centers for Orthopaedic & Rehabilitative Excellence, Indianapolis, Indiana, USA. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng REGISTRY NUMBERS: 0 (Anti-Inflammatory Agents, Steroidal) 50-02-2 (Dexamethasone)
ABSTRACT: Plantar fasciitis is a common problem in running sports. This study was undertaken to determine whether iontophoresis of dexamethasone in conjunction with other traditional modalities provides more immediate pain relief than traditional modalities alone. Forty affected feet were randomly assigned to one of two groups. Group I feet were treated with traditional modalities and placebo iontophoresis. Group II feet received the traditional modalities plus iontophoresis of dexamethasone. Both groups were treated six times over 2 weeks. The subjects' clinical course was assessed using the Maryland Foot Score. At the conclusion of treatment, Group II patients had significantly greater improvement than Group I patients (increase on Maryland Foot Score of 6.8 +/- 5.6 for Group II and 3.1 +/- 4.1 for Group I). However, at followup 1 month after completion of treatment there was no significant difference between groups (increase of 5.6 +/- 8.0 for Group I and 7.4 +/- 6.3 for Group II). These results suggest that although traditional modalities alone are ultimately effective, iontophoresis in conjunction with traditional modalities provides immediate reduction in symptoms. Based on these results, iontophoresis of dexamethasone for plantar fasciitis should be considered when more immediate results are needed (i.e., performance athletes and active patients. NLM PUBMED CIT. ID: 9167809 SOURCE: Am J Sports Med 1997 May-Jun;25(3):312-6 52

NLM CIT. ID: 97281596
TITLE: Diagnostic imaging of heel pain and plantar fasciitis. AUTHORS: DiMarcangelo MT; Yu TC AUTHOR AFFILIATION: Department of Diagnostic Radiology and Nuclear Medicine, Cooper Hospital/University Medical Center, Camden, New Jersey, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Heel pain or calcaneodynia is a common clinical complaint which has a myriad of causes ranging from plantar fasciitis to stress fracture. In many instances, the etiology of the heel pain is difficult to ascertain simply on the basis of history and physical examination. Therefore, the clinician may enlist various diagnostic imaging modalities to clarify the source of pain. Of all the imaging techniques, magnetic resonance imaging (MRI) has proven its worth in the diagnosis of heel pain. This article outlines the various causes of heel pain and their associated imaging findings. NLM PUBMED CIT. ID: 9135904 SOURCE: Clin Podiatr Med Surg 1997 Apr;14(2):281-301 53

NLM CIT. ID: 97232439
TITLE: Plantar fasciitis: US evaluation [letter; comment] AUTHORS: Gibbon W; Long G COMMENTS: Comment on: Radiology 1996 Oct;201(1):257-9 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 9122410 SOURCE: Radiology 1997 Apr;203(1):290 54

NLM CIT. ID: 97257568
TITLE: Radiographs in heel pain [letter; comment] AUTHORS: Devitt N COMMENTS: Comment on: Bull Rheum Dis 1996 Jun;45(4):1-3 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 9104042 SOURCE: Bull Rheum Dis 1997 Apr;46(2):1 55

NLM CIT. ID: 97234118
TITLE: Immobilizing heel pain in a runner [see comments] AUTHORS: Sack KE AUTHOR AFFILIATION: Clinical Programs in Rheumatology, University of California, San Francisco, USA. COMMENTS: Comment in: Hosp Pract (Off Ed) 1997 May 15;32(5):25-6 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng NLM PUBMED CIT. ID: 9078986 SOURCE: Hosp Pract (Off Ed) 1997 Mar 15;32(3):243 56

NLM CIT. ID: 97328875
TITLE: A prospective study of Plantar fasciitis in Harare. AUTHORS: Chigwanda PC AUTHOR AFFILIATION: Department of Surgery, University of Zimbabwe Medical School, Avondale, Harare, Zimbabwe. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 0 (Anti-Inflammatory Agents, Steroidal) 53-36-1 (Depo-Medrol) 83-43-2 (Methylprednisolone)
ABSTRACT: OBJECTIVES: 1. To determine the sex distribution of Plantar fasciitis in Harare. 2. To determine the presence or absence of a calcaneal spur and its role in causation and hence treatment. 3. To determine unilateral or bilateral involvement. 4. To determine the response to steroidal injection. 5. To determine the role of occupation and/or activities if any. DESIGN: Patients presenting with heel pad pain were carefully examined, the age, sex and occupation recorded. They were followed up at two weekly intervals following treatment. SETTING: This prospective study was carried out at a private surgery in a low density suburb. Most patients were referred by their general practitioners and some by patients who had been treated successfully. A few were referred from towns in and around Mashonaland Central Province. SUBJECTS: All patients had to satisfy the diagnosis of Plantar fasciitis. Those presenting with well known causes of pain in and around the heel were excluded. INTERVENTIONS: All patients had radiographs of both heels requested. The painful heels were injected in the office with 80 mg of depo-medrol plus three to four mls of plain lignocaine using the lateral approach. RESULTS: The majority of patients (90%) were female, the mean age 48.5 years. Most patients (60%) had no calcaneal spur, 64% had unilateral disease and this was predominantly left-sided. 94% had relief of their symptoms following a single injection. CONCLUSIONS: In this study there were more females treated for Plantar fasciitis, the majority responded to a single injection. The role of occupation and/or activities require further study. NLM PUBMED CIT. ID: 9185376 SOURCE: Cent Afr J Med 1997 Jan;43(1):23-5 57

NLM CIT. ID: 97162568
TITLE: Evaluation of magnetic foil and PPT Insoles in the treatment of heel pain. AUTHORS: Caselli MA; Clark N; Lazarus S; Velez Z; Venegas L AUTHOR AFFILIATION: Department of Orthopedic Sciences, New York College of Podiatric Medicine, NY, USA. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng
ABSTRACT: The effect of a magnetic foil placed in the PPT/Rx Firm Molded Insole on the relief of heel pain was determined using the foot function index. Nineteen patients wore the PPT/Rx Firm Molded Insoles with the magnetic foil for 4 weeks and 15 patients wore the same PPT/Rx Firm Molded Insole with no magnetic foil for the same time. Approximately 60% of patients in both groups reported improvement. There was also no significant difference in the improvement between the magnetic foil group and the PPT/Rx Firm Molded Insole group in their scores on the post-treatment foot function index. These results suggest that the PPT/Rx Firm Molded Insole alone was effective in treating heel pain after only 4 weeks. The magnetic foil offered no advantage over the plain insole. NLM PUBMED CIT. ID: 9009543 SOURCE: J Am Podiatr Med Assoc 1997 Jan;87(1):11-6 58

NLM CIT. ID: 97164266
TITLE: Heel pain as the inaugural manifestation of metastatic prostate cancer [letter] AUTHORS: Gisserot O; Jaureguiberry JP; Carli P; Paris JF Jaubert D; Chagnon A PUBLICATION TYPES: LETTER REVIEW REVIEW OF REPORTED CASES LANGUAGES: Eng NLM PUBMED CIT. ID: 9010979 SOURCE: Rev Rhum Engl Ed 1996 Dec;63(11):870-1 59

NLM CIT. ID: 97129386
TITLE: Treatment of plantar fasciitis with a night splint and shoe modification consisting of a steel shank and anterior rocker bottom [see comments] AUTHORS: Mizel MS; Marymont JV; Trepman E AUTHOR AFFILIATION: Department of Orthopaedics, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. COMMENTS: Comment in: Foot Ankle Int 1997 Jul;18(7):458 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Seventy-one feet in 57 patients with plantar fasciitis were treated with the combination of a night splint and a shoe modification consisting of a steel shank and anterior rocker bottom. At average follow-up of 16 months, symptoms were resolved in 42 (59%), improved in 13 (18%), not changed in 11 (15%), and worse in 5 (7%) of the feet. No relation was found between outcome and age, gender, duration of symptoms, and bilateral involvement. The method is effective for the treatment of plantar fasciitis. NLM PUBMED CIT. ID: 8973894 SOURCE: Foot Ankle Int 1996 Dec;17(12):732-5 60

NLM CIT. ID: 97056014
TITLE: Sever's disease and other causes of heel pain in adolescents. AUTHORS: Madden CC; Mellion MB AUTHOR AFFILIATION: University of Nebraska Medical Center, Omaha, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Sever's disease, or apophysitis of the calcaneus, is a common but frequently undiagnosed source of heel pain in young athletes. This condition frequently occurs before or during the peak growth spurt in boys and girls, often shortly after they begin a new sport or season. Sever's disease often occurs in running and jumping sports, particularly soccer. Patients present with intermittent or continuous heel pain occurring with weight bearing. Findings include a positive squeeze test and tight heel cords. Sever's disease cannot be diagnosed radiographically. The condition usually resolves two weeks to two months after the initiation of conservative treatment, which may include rest, ice application, heel lifts, stretching and strengthening exercises, and, in more severe cases, nonsteroidal anti-inflammatory drugs. NLM PUBMED CIT. ID: 8900359 SOURCE: Am Fam Physician 1996 Nov 1;54(6):1995-2000 61

NLM CIT. ID: 96413393
TITLE: Plantar fasciitis: sonographic evaluation [see comments] AUTHORS: Cardinal E; Chhem RK; Beauregard CG; Aubin B Pelletier M AUTHOR AFFILIATION: Department of Radiology, Saint-Luc Hospital, Montreal, Quebec, Canada. COMMENTS: Comment in: Radiology 1997 Apr;203(1):290 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: PURPOSE: To evaluate the sonographic findings of plantar fasciitis. MATERIALS AND METHODS: Both feet of 15 patients who had a clinical diagnosis of plantar fasciitis were evaluated with ultrasound (US) by using a 7.0-MHz linear-array transducer. Heel pain was unilateral in 11 patients and bilateral in four. Sagittal sonograms were obtained, and the thickness of the plantar fascia was measured at its proximal end near its insertion into the calcaneus. Other observations included hypoechoic fascia, fiber rupture, perifascial fluid collections, and calcifications. Both feet of 15 healthy volunteers were also evaluated as a control group. RESULTS: Plantar fascia thickness was significantly increased in the heels in patients with plantar fasciitis (3.2-6.8 mm; mean, 5.2 mm +/- 1.13) compared with their asymptomatic heels (2.0-4.0 mm; mean, 2.9 mm +/- 0.70) (P < .0001) and compared with the heels of the patients in the control group (1.6-3.8 mm; mean, 2.6 mm +/- 0.48) (P < .0001). The proximal plantar fascia of 16 (84%) symptomatic heels were diffusely hypoechoic compared with none of the patients' asymptomatic heels and only one heel of a patient in the volunteer group. No fascia rupture, perifascial fluid collection, or calcifications were identified. CONCLUSION: Increased thickness of the fascia and hypoechoic fascia are sonographic findings of plantar fasciitis. US may be a valuable noninvasive technique for the diagnosis of plantar fasciitis. NLM PUBMED CIT. ID: 8816554 SOURCE: Radiology 1996 Oct;201(1):257-9 62

NLM CIT. ID: 97041507
TITLE: Outcome of nonsurgical treatment for plantar fasciitis [published erratum appears in Foot Ankle Int 1996 Nov;17(11):722] AUTHORS: Gill LH; Kiebzak GM AUTHOR AFFILIATION: Miller Orthopaedic Clinic, Charlotte, North Carolina 28203, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Four hundred eleven patients with a clinical diagnosis of plantar fasciitis were assessed for predisposing factors. Each patient completed an outcomes assessment survey instrument that ranked effectiveness of various nonsurgical treatment modalities. Listed in descending order of effectiveness, the treatment modalities assessed were short leg walking cast, steroid injection, rest, ice, runner's shoe, crepe-soled shoe, aspirin or nonsteroidal anti-inflammatory drug, heel cushion, low-profile plastic heel cup, heat, and Tuli's heel cup. Treatment with a cast ranked the best. The Tuli's heel cup ranked the poorest. Most of the treatments were found to be unpredictable or minimally effective. The ineffectiveness of nonsurgical treatments noted in this outcomes study is at variance with most published clinical studies in which generally favorable results are reported after nonsurgical treatment for plantar fasciitis. NLM PUBMED CIT. ID: 8886778 SOURCE: Foot Ankle Int 1996 Sep;17(9):527-32 63

NLM CIT. ID: 97041506
TITLE: Surgical treatment of recalcitrant plantar fasciitis. AUTHORS: Sammarco GJ; Helfrey RB AUTHOR AFFILIATION: Center for Orthopaedic Care, Inc., Cincinnati, Ohio 45219, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Twenty-six patients (35 feet) underwent partial plantar fasciectomy with neurolysis of the nerve to the abductor digiti quinti muscle. Nonsurgical treatment for plantar fasciitis had been unsuccessful in these patients. Patients were followed after surgery for an average of 37.5 months. Six patients were male and 20 patients were female; the average age was 49 years. All patients had failed to respond to nonsurgical treatment for an average of 21.5 months. In addition to routine history and physical examination patients were evaluated before and after surgery with a subjective foot rating system, and a detailed questionnaire was used to assess post-operative functional outcome. Thirty-two patients (92%) had a satisfactory functional outcome, and three patients (8%) had an unsatisfactory result (21 excellent, 11 good, 3 fair, 0 poor). The Maryland Foot Score increased from a preoperative average of 74.8/100 points to a postoperative average of 90.6/100 points. Four patients (11%) had postoperative complications, including superficial wound infection (two patients), deep venous thrombosis (one patient), and superficial phlebitis (one patient), all of which resolved uneventfully with treatment. Ten patients (28.6%) reported some degree of heel pain after surgery. All 10 patients denied limitation in activity related to postoperative pain. The average period before return to daily activity and restricted work duty was 5.6 weeks and to full work duty without restriction was 8.7 weeks. Although the length of time for partial or complete resolution of symptoms is variable, a successful treatment outcome can be expected in most patients who are treated for recalcitrant plantar fasciitis. NLM PUBMED CIT. ID: 8886777 SOURCE: Foot Ankle Int 1996 Sep;17(9):520-6 64

NLM CIT. ID: 96384149
TITLE: Plantar fasciitis: a prospective randomized clinical trial of the tension night splint. AUTHORS: Batt ME; Tanji JL; Skattum N AUTHOR AFFILIATION: Department of Family Practice, University of California at Davis School of Medicine, Sacramento, USA. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng REGISTRY NUMBERS: 0 (Anti-Inflammatory Agents)
ABSTRACT: OBJECTIVE: The objective of this study was to evaluate the efficacy of a tension night splint (TNS) as part of a treatment regimen for the management of plantar fasciitis. DESIGN: The design was a randomized clinical trial. SETTING: The setting was a university-based primary care sports medicine clinic in California. PATIENTS: Forty patients with plantar fasciitis entered the study (age range, 20-74 years; average age, 45.7 years). Excluded from the study were patients with other concomitant ankle or foot pathology. Thirty-two patients (21 women, 11 men) completed the study with 33 treated feet. INTERVENTION: The patients were randomized to one of two treatment groups. The control group (n = 17) received standard treatment of antiinflammatory medication (Ibuprofen), a Viscoheel sofspot heel cushion (Bauerfeind USA, Kennesaw, GA, U.S.A.) and a stretching program for the gastrocnemius and soleus muscles. The tension night split group (n = 16) received the same standard treatment protocol and additionally an office manufactured custom fitted posterior splint to be used at night. Those patients in the control group not responding to treatment after 8- 12 weeks were crossed over to the tension night splint group. Patients were reviewed every 4 weeks for symptom assessment and compliance. MAIN OUTCOME MEASURES: The main outcome measures were subjective assessment of pain (Visual analogue scale), plantar fascial tenderness, and ankle range of motion. Patients were discharged from either arm of the trial when they had resumed normal activities with minimal or no discomfort. This end point was recorded as weeks to cure. MAIN RESULTS: There was no significant difference in the demographics of the two groups (p > 0.05). In the control group, 6 of 17 were cured after an average interval of 8.8 weeks. The remaining 11 of 17 control group patients were crossed over to receive a TNS in addition to control modalities. Following cross over 8 of 11 of this group were cured after an average of 13 weeks. Three of the 11 failed to significantly respond. Of the 15 patients (16 feet) originally randomly assigned to the TNS group 16 of 16 were cured with an average treatment time of 12.5 weeks. The TNS treatment protocol was a significantly more efficacious treatment regime (p < 0.05). Thus, of 33 cases of plantar fasciitis treated in this study three failed treatment. CONCLUSION: When used in combination with a visco-elastic heel pad, stretching program and nonsteroidal anti- inflammatory drugs, the TNS is an effective treatment of plantar fasciitis. NLM PUBMED CIT. ID: 8792046 SOURCE: Clin J Sport Med 1996 Jul;6(3):158-62 65

NLM CIT. ID: 96305549
TITLE: [Radiotherapy of plantar heel spurs: indications, technique, clinical results at different dose concepts] VERNACULAR
TITLE: Radiotherapie beim plantaren Fersensporn. Indikation, Technik, klinische Ergebnisse bei unterschiedlichen Dosiskonzepten. AUTHORS: Seegenschmiedt MH; Keilholz L; Stecken A Katalinic A; Sauer R AUTHOR AFFILIATION: Strahlentherapeutische Klinik und Poliklinik, Universitat Erlangen- Nurnberg. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Ger
ABSTRACT: BACKGROUND: In a retrospective study the efficacy of orthovoltage radiotherapy for refractory painful plantar heel spur was analyzed for 3 different radiation dose concepts. PATIENTS AND METHODS: From 1.1 1984 through 1.3.1994, 182 patients with refractory painful heel symptoms and radiologically proven plantar heel spur received radiotherapy. A total of 141 patients and 170 heels (due to double- sided symptoms) were completely documented in long-term follow-up. Clearly defined semi-quantitative criteria (9-point score) were used to analyze heel pain and ankle function prior to RT, 6 to 12 weeks post- radiation, and at last follow-up. The treatment outcome, i.e. (un)favourable response, of 3 radiation dose concepts were compared: Group A (n = 72 heels) received 12 Gy total radiation dose in 3 fractions per week and 2 series (6 x 1 Gy per series) separated by 6 weeks; group B (n = 98 heels) received 3 Gy total radiation dose in 10 fractions of 0.3 Gy (n = 50) or 5 Gy (10 x 0.5 Gy) (n = 48) with conventional fractionation in 1 series. RESULTS: Radiotherapy was very effective: at last follow-up 67% (group A) and 71% (group B) remained completely free of pain. The rate of "complete pain relief" (i.e. free of any pain symptoms) was not different between the 3 radiation concepts. However, significant differences were observed with regard to "incomplete or insufficient pain relief", i.e. a subjective pain relief of less than 80%, a delayed pain relief after more than 4 weeks or a relapse of pain symptoms in long-term follow-up. More favourable results were achieved in patients receiving 5 Gy or 12 Gy total dose, while patients with 3 Gy total dose had significantly worse results. Prognostic factors for "complete pain relief" were short duration of pain symptoms and acute pain symptoms prior to radiotherapy; with regard to "in-complete or insufficient pain relief" the total dose was found to be a prognostic parameter. CONCLUSIONS: Patients with refractory heel pain can yield a high response to radiotherapy even after failing various conventional treatments previously. Thus, radiotherapy should not be solely regarded as a last resort due to its low costs and high efficacy at low radiation doses. NLM PUBMED CIT. ID: 8693404 SOURCE: Strahlenther Onkol 1996 Jul;172(7):376-83 66

NLM CIT. ID: 96257173
TITLE: Heel spur: radiation therapy for refractory pain--results with three treatment concepts. AUTHORS: Seegenschmiedt MH; Keilholz L; Katalinic A Stecken A; Sauer R AUTHOR AFFILIATION: Department of Radiation Therapy, University Erlangen-Nurnberg, Strahlenstherapeutische Universitatsklinik, Germany. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: PURPOSE: To evaluate radiation therapy (RT) to treat refractory pain in plantar heel spur. MATERIALS AND METHODS: From 1984 to 1994, 141 patients with refractory painful plantar heel spur (170 heels, because of bilateral disease) underwent RT. Quantitative criteria were used to evaluate heel pain and ankle function prior to RT, 6-12 weeks after RT, and at last follow-up (median, 4 years). Patients were divided into three treatment groups: group A (n = 72 heels [two courses, 1.0-Gy fractions, 12-Gy total RT dose]), group B1 (n = 50 heels [one course, 0.3-Gy fractions, 3-Gy total dose]), and group B2 (n = 48 heels [one course, 0.5-Gy fractions, 5-Gy total dose]). RESULTS: At last follow- up, complete pain relief was achieved in 48 (67%) of 72 group A heels and in 71 (72%) of 98 group B heels. Statistically significant (P < .05) differences between groups were found for insufficient pain relief (< 80%) in patients in whom the response time after RT was longer than 4 weeks or in whom pain recurred during follow-up. The best results were achieved with the 5-Gy total RT dose (P < .05). Prognostic factors for complete pain relief were acute pain and short duration of pain prior to RT. The prognostic factor for insufficient pain relief was total RT dose. CONCLUSION: Refractory heel pain is effectively treated with RT, which should be considered a primary treatment approach rather than a last resort. NLM PUBMED CIT. ID: 8657925 SOURCE: Radiology 1996 Jul;200(1):271-6 67

NLM CIT. ID: 96384622
TITLE: Diagnosis and treatment of heel pain in chronic inflammatory arthritis using ultrasound. AUTHORS: Cunnane G; Brophy DP; Gibney RG; FitzGerald O AUTHOR AFFILIATION: University Department of Rheumatology, University College Dublin, St. Vincent's Hospital, Ireland. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 0 (Adrenal Cortex Hormones)
ABSTRACT: The authors examined the role of ultrasound (US) in diagnosis and management of heel pain in chronic inflammatory arthritis. Nineteen patients underwent US examination. Eight patients (2 with previously unsuccessful nonguided injections), had 11 US-guided corticosteroid injections for treatment of retrocalcaneal bursitis (n = 6), plantar fasciitis (n = 3), and posterior tibial tenosynovitis (n = 2). US- demonstrated Achilles tendon rupture (n = 2), Achilles tendinitis (n = 8), posterior tibial tenosynovitis (n = 6), peroneus longus tenosynovitis (n = 2), retrocalcaneal bursitis (n = 13), and plantar fasciitis (n = 4). Loss of smooth bone contour (n = 13) correlated with bone erosions on plain radiographs in all but one case. Ten of 11 guided injections resulted in full resolution of heel pain. The diverse causes of heel pain are highlighted, and the ability of US to provide information with management implications is confirmed. US-guided corticosteroid injection is beneficial, especially after failure of nonguided injection. NLM PUBMED CIT. ID: 8792510 SOURCE: Semin Arthritis Rheum 1996 Jun;25(6):383-9 68

NLM CIT. ID: 96266724
TITLE: A review of subcalcaneal heel pain and plantar fasciitis. AUTHORS: Brown C AUTHOR AFFILIATION: Department of Orthopaedics, Modbury Public Hospital. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Pain beneath the heel is a common and sometimes very debilitating condition. Although usually described as plantar fasciitis' it can be caused by several different conditions. Adequate treatment is aided by determining which cause or causes of subcalcaneal pain is present in a particular patient. This article discusses the approach to the diagnosis and management of pain underneath the calcaneus. NLM PUBMED CIT. ID: 8687311 SOURCE: Aust Fam Physician 1996 Jun;25(6):875-81; 884-5 69

NLM CIT. ID: 96266754
TITLE: Case management study: heel pain in the adult [see comments] AUTHORS: Hurwitz SR AUTHOR AFFILIATION: University of Virginia Medical Center, Charlottesville, USA. COMMENTS: Comment in: Bull Rheum Dis 1997 Apr;46(2):1 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 0 (Anti-Inflammatory Agents, Non-Steroidal) NLM PUBMED CIT. ID: 8680528 SOURCE: Bull Rheum Dis 1996 Jun;45(4):1-3 70

NLM CIT. ID: 96210170
TITLE: Plantar fasciitis, posterior night splints and activity during recovery [letter] AUTHORS: Weise J PUBLICATION TYPES: LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 8623714 SOURCE: Am Fam Physician 1996 May 1;53(6):1994 71

NLM CIT. ID: 96210169
TITLE: Plantar fasciitis, posterior night splints and activity during recovery [letter; comment] AUTHORS: Zamorski M COMMENTS: Comment on: Am Fam Physician 1995 Sep 1;52(3):891-8, 901-2 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 8623712 SOURCE: Am Fam Physician 1996 May 1;53(6):1993; discussion 1993-4 72

NLM CIT. ID: 96210168
TITLE: Plantar fasciitis, posterior night splints and activity during recovery [letter; comment] AUTHORS: Little RB COMMENTS: Comment on: Am Fam Physician 1995 Sep 1;52(3):891-8, 901-2 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 8623711 SOURCE: Am Fam Physician 1996 May 1;53(6):1993; discussion 1993-4 73

NLM CIT. ID: 96272448
TITLE: The diagnosis and management of plantar fasciitis. AUTHORS: Quaschnick MS AUTHOR AFFILIATION: Presentation College Lakota Campus, Eagle Butte, S.D., USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Plantar fasciitis is the most common diagnosis for pain in the inferior aspect of the heel and accounts for 10% of running injuries seen. It primarily afflicts the middle-aged and elderly populations and athletes. The diagnosis is relatively easy for the primary care provider to establish because of the typical presentation. Diagnostic studies usually are not warranted, but a careful history and physical examination are essential in identifying various predisposing anatomical, biomechanical, and environmental factors. This article addresses a wide array of conservative measures available in developing an individualized management approach based on the contributing factors identified. Because 90% or more respond to conservative measures, the primary care provider can manage the care of the majority of clients who present with plantar fasciitis. To avoid painful recurrence, measures effective in relieving symptoms need to be included in an ongoing plan of prevention. NLM PUBMED CIT. ID: 8801492 SOURCE: Nurse Pract 1996 Apr;21(4):50-4, 60-3, quiz 64-5 74

NLM CIT. ID: 96297334
TITLE: How effective is therapeutic ultrasound in the treatment of heel pain? AUTHORS: Crawford F; Snaith M AUTHOR AFFILIATION: London Foot Hospital & School of Podiatric Medicine, United Kingdom. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng
ABSTRACT: OBJECTIVES: To evaluate the therapeutic effect from ultrasound in the treatment of plantar heel pain by physiotherapists and podiatrists, and to quantify the placebo effect of this electrophysical agent. METHODS: Patients experiencing episodes of plantar heel pain were allocated randomly, at each episode, to receive either true ultrasound (machine calibrated to deliver a dose of ultrasound at 0.5 w/cm2, 3 MHz, pulsed 1:4), for eight minutes, or sham ultrasound (only the timer on the machine activated). Each episode was treated, according to randomisation, eight times. An independent observer set the equipment before obscuring the control panel with a drape. All treatments were undertaken by the same operator. Patients' pain scores were measured on a 10 cm linear analogue scale before the course of eight treatments commenced and at the end of the course, and analysed using a Wilcoxon Signed-Ranks test. RESULTS: Nineteen patients experienced episodes of heel pain (seven bilateral). Both groups showed a reduction in pain; the improvement was 30% in the treated group and 25% in the placebo group (p = 0.5). CONCLUSIONS: Therapeutic ultrasound at a dosage of 0.5 w/cm2, 3 MHz, pulsed 1:4, for eight minutes is no more effective than placebo in the treatment of plantar heel pain. NLM PUBMED CIT. ID: 8733444 SOURCE: Ann Rheum Dis 1996 Apr;55(4):265-7 75

NLM CIT. ID: 97021190
TITLE: Magnetic resonance imaging in the evaluation of heel pain. AUTHORS: Hall RL; Erickson SJ; Shereff MJ; Johnson JE Kneeland JB AUTHOR AFFILIATION: Division of Orthopedic Surgery, Duke University Medical Center, Durham, NC 27710, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: This study demonstrates magnetic resonance findings in 16 patients (25 heels) with heel pain. Sixteen of 25 (64%) studies demonstrated abnormalities which could be related to the etiology of their heel pain. Eleven of 16 abnormal scans demonstrated thickening of the plantar aponeurosis with associated fibrosis (7 of 11), and a tear of the flexor digitorum brevis (1 of 11). One study demonstrated changes in the heel pad consistent with fluid. The other four abnormal studies demonstrated changes thought to be consistent with bilateral fibrous calcaneonavicular coalitions, subtalar arthrosis and tenosynovitis of the posterior tibial, flexor digitorum longus, and flexor hallucis longus tendons. NLM PUBMED CIT. ID: 8867550 SOURCE: Orthopedics 1996 Mar;19(3):225-9 76

NLM CIT. ID: 96303061
TITLE: A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome [letter; comment] AUTHORS: Wander DS COMMENTS: Comment on: J Foot Ankle Surg 1995 May-Jun;34(3):305-11 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 8722893 SOURCE: J Foot Ankle Surg 1996 Mar-Apr;35(2):183-4 77

NLM CIT. ID: 96418501
TITLE: Chronic plantar heel pain: treatment with a short leg walking cast. AUTHORS: Tisdel CL; Harper MC AUTHOR AFFILIATION: Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Ohio 44195, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: The efficacy of a short leg walking cast in the treatment of chronic plantar heel pain was assessed for 32 patients with 37 involved extremities treated over a 2-year period. All patients had failed numerous other treatment modalities and had been symptomatic for an average of 1 year. Long-term follow-up for 24 patients with 28 involved extremities revealed complete resolution of pain for 7 extremities (25%), improvement for 17 (61%), and no improvement for 4 (14%). Ten (42%) patients were completely satisfied with cast treatment, 3 (12%) were satisfied with reservations, and 11 (46%) were dissatisfied. Casting appears to be a reasonable option for patients with recalcitrant heel pain and should be offered before surgical intervention. NLM PUBMED CIT. ID: 8821286 SOURCE: Foot Ankle Int 1996 Jan;17(1):41-2 78

NLM CIT. ID: 96207605
TITLE: Comparison of newborn circumcision pain to calcaneal heel puncture pain: is newborn circumcision pain control clinically warranted? [see comments] AUTHORS: Holton ME COMMENTS: Comment in: J Am Osteopath Assoc 1996 May;96(5):273; discussion 274-5 Comment in: J Am Osteopath Assoc 1996 May;96(5):273-4; discussion 274-5 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: In newborns, elective male circumcision and calcaneal puncture for obtaining blood samples both cause pain. With elective male circumcision, dorsal penile nerve block (DPNB) is recommended for pain control, but no pain control is routinely recommended or used during calcaneal puncture. A prospective investigation was conducted to compare pain during elective circumcision (with and without DPNB) and calcaneal puncture to determine whether pain control should be used with the latter procedure. The study was conducted at a community hospital during a 4-month period. Two nurses observed newborn behavior during elective circumcision and routine calcaneal puncture and rated pain reactions by using a modified Gronigen Distress Scale. Ninety-one male newborns were circumcised without DPNB, and eight male newborns were circumcised with DPNB. Calcaneal puncture for blood samples was performed in 97 newborns (males and females). Pain scores during circumcision with and without DPNB were comparable with those during calcaneal puncture (2.1, 2.4, and 2.2, respectively). Pain control during circumcision may thus be considered, but caution should be taken that measures to prevent pain do not create new patient risk or additional pain. NLM PUBMED CIT. ID: 8626229 SOURCE: J Am Osteopath Assoc 1996 Jan;96(1):31-3 79

NLM CIT. ID: 96075447
TITLE: Scintigraphic localisation of steroid injection site in plantar fasciitis. AUTHORS: Dasgupta B; Bowles J AUTHOR AFFILIATION: Southend Health Care Trust, Westcliff-on-Sea, Essex, UK. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 0 (Steroids) 63347-66-0 (Technetium Tc 99m Medronate)
ABSTRACT: Plantar fasciitis is a common cause of heel pain. We evaluated scintigraphic localisation of the inflammatory focus in 15 patients with this condition. Technetium-labelled bone scans precisely localised abnormal discrete areas of tracer uptake in 12 (80%) of patients in the medial and posterior aspect below the inferior surface of the calcaneum. Steroid injection at the inflammatory site abolished local tenderness and reduced pain in all 12. Our findings support an injection approach through the medial heel border posterior to the point of heel tenderness. Technetium scintigraphy may be a useful investigation to localise the steroid injection site in resistant cases of plantar fasciitis. NLM PUBMED CIT. ID: 7475824 SOURCE: Lancet 1995 Nov 25;346(8987):1400-1 80

NLM CIT. ID: 96191711
TITLE: Does a local anaesthetic cream (EMLA) alleviate pain from heel-lancing in neonates? AUTHORS: Larsson BA; Jylli L; Lagercrantz H; Olsson GL AUTHOR AFFILIATION: Department of Paediatric Anaesthesia and Intensive Care, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng REGISTRY NUMBERS: 0 (Anesthetics, Local) 0 (Drug Combinations) 0 (EMLA) 137-58-6 (Lidocaine) 721-50-6 (Prilocaine)
ABSTRACT: EMLA cream is an effective local anaesthetic agent for venipunctures in adults and children. The aim of this double-blind, randomised, and placebo-controlled study was to evaluate the effect of EMLA when heel- lancing was performed in neonates. On their third day of life, fullterm healthy infants, who underwent testing for phenylketonuria (PKU) by heel-lancing, were consecutively included in the study. One hundred and twelve neonates were allocated to eight groups according to the application time of EMLA or placebo (10 to 120 minutes). Thus in each group seven infants received active substance and seven placebo. The response to the nociceptive stimulation was assessed by studying the occurrence of a pain cry. No analgesic effect of EMLA was found. There were no adverse effects. NLM PUBMED CIT. ID: 8607303 SOURCE: Acta Anaesthesiol Scand 1995 Nov;39(8):1028-31 81

NLM CIT. ID: 96027749
TITLE: Spur formation and heel pain [letter; comment] AUTHORS: Kelly A; Wainwright A; Winson I COMMENTS: Comment on: Clin Orthop 1994 Sep;(306):192-6 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 7554647 SOURCE: Clin Orthop 1995 Oct;(319):330 82

NLM CIT. ID: 96052315
TITLE: Misdiagnosed recalcitrant heel pain associated with HLA-B27 antigen. AUTHORS: Scherer PR; Gordon D; Kashanian A; Belvill A AUTHOR AFFILIATION: Department of Biomechanics, California College of Podiatric Medicine, San Francisco, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 0 (HLA-B27 Antigen) NLM PUBMED CIT. ID: 7473086 SOURCE: J Am Podiatr Med Assoc 1995 Oct;85(10):538-42 83

NLM CIT. ID: 95381953
TITLE: Use of posterior night splints in the treatment of plantar fasciitis [see comments] AUTHORS: Ryan J AUTHOR AFFILIATION: Department of Family Medicine, University of Wisconsin Medical School, Madison 53715, USA. COMMENTS: Comment in: Am Fam Physician 1996 May 1;53(6):1993; discussion 1993-4 PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Plantar fasciitis is a frequent cause of heel pain in athletes, as well as in persons who are not involved in sports. Stretching, strengthening, correction of training errors and orthotics are essential components in any treatment program. For patients who do not respond to these interventions, posterior night splints can obviate the need for invasive therapies such as corticosteroid injections and surgery. NLM PUBMED CIT. ID: 7653427 SOURCE: Am Fam Physician 1995 Sep 1;52(3):891-8, 901-2 84

NLM CIT. ID: 96027073
TITLE: Sucrose reduces pain reaction to heel lancing in preterm infants: a placebo-controlled, randomized and masked study. AUTHORS: Bucher HU; Moser T; von Siebenthal K; Keel M; Wolf M Duc G AUTHOR AFFILIATION: Department Obstetrics and Gynaecology, University Hospital, Zurich, Switzerland. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGES: Eng REGISTRY NUMBERS: 0 (Analgesics) 0 (Hemoglobins) 0 (Oxyhemoglobins) 57-50-1 (Sucrose) 9008-02-0 (deoxyhemoglobin)
ABSTRACT: In term infants sucrose given by mouth has been reported to reduce duration of crying after a heel prick. This study was designed primarily to investigate the effect of sucrose administered orally immediately before heel lancing on the nociceptive reaction in preterm infants as assessed by change in heart rate and duration of crying. A secondary objective was to document changes in cerebral blood volume during acute pain. We used a randomized, masked, placebo-controlled, crossover trial in a neonatal intermediate care unit in a level 3 perinatal center. The patients studied were 16 preterm infants; birth weight, 900-1900 g; gestational wk, 27-34; corrected postmenstrual age at time of investigation, 33-36 wk. Each infant was assessed twice receiving 2 mL of sucrose 50% or 2 mL of distilled water in random order immediately before heel lance. Heart rate, thoracic movements, and transcutaneous blood gases were monitored continuously. Crying during the procedure was documented by a video-camera. A change in cerebral blood volume was assessed by near-infrared spectroscopy. We found the heart increased by a mean of 35 beats/min (bpm) after sucrose and 51 bpm after placebo (median difference 16 bpm, interquartile range 1-30 bpm, p = 0.005). Infants cried 67% of time after sucrose and 88% after placebo (median difference 10%, interquartile range 3-33%, p = 0.002). Cerebral blood volume decreased in 5 of 14 infants after sucrose and in 6 of 14 infants after placebo (difference not significant). NLM PUBMED CIT. ID: 7494655 SOURCE: Pediatr Res 1995 Sep;38(3):332-5 85

NLM CIT. ID: 96023658
TITLE: A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome [see comments] AUTHORS: Tomczak RL; Haverstock BD AUTHOR AFFILIATION: College of Podiatric Medicine and Surgery, University of Osteopathic Medicine and Health Sciences, Des Moines, Iowa, USA. COMMENTS: Comment in: J Foot Ankle Surg 1996 Mar-Apr;35(2):183-4 PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: The authors review the etiologies and treatments of plantar fasciitis or heel spur syndrome. They offer results of a retrospective study. Comparison of the return to work time after surgery for this condition, examinations of the effects of patient age at the time of surgery, gender, duration of pain prior to surgery, and type of surgical procedure, either endoscopic plantar fasciotomy or open plantar fasciotomy with heel spur resection, is provided. NLM PUBMED CIT. ID: 7550197 SOURCE: J Foot Ankle Surg 1995 May-Jun;34(3):305-11 86

NLM CIT. ID: 95182390
TITLE: Heel spur surgery. Another new approach. AUTHORS: Licopantis DP AUTHOR AFFILIATION: American Board of Podiatric Surgery, New City, NY. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng NLM PUBMED CIT. ID: 7877105 SOURCE: J Am Podiatr Med Assoc 1995 Feb;85(2):100-3 87

NLM CIT. ID: 95141102
TITLE: Metastatic breast carcinoma to the os calcis presenting as heel pain. AUTHORS: Freedman DM; Henderson RC AUTHOR AFFILIATION: Department of Orthopaedics, University of North Carolina, Chapel Hill. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: A 47-year-old woman who had been treated for breast carcinoma 11 years previously developed significant heel pain of unclear etiology, which ultimately proved to be metastatic adenocarcinoma. A low index of suspicion and falsely negative plain radiographs contributed to a delay in diagnosis. No other osseous metastases besides those to the foot were identifiable at the time of diagnosis. Breast carcinoma is one of the most common malignancies and frequently metastasizes to bone. Despite this, metastases to the hands or feet (acrometastases) have been identified in only a few cases. It is likely that acrometastases are more common than reported but unrecognized. NLM PUBMED CIT. ID: 7839171 SOURCE: South Med J 1995 Feb;88(2):232-4 88

NLM CIT. ID: 95167427
TITLE: Bone scintigraphy in evaluation of heel pain in Reiter's disease: compared with radiography and clinical examination. AUTHORS: Lin WY; Wang SJ; Lang JL; Hsu CY; Kao CH; Liao SQ Yeh HW AUTHOR AFFILIATION: Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan, R.O.C. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 63347-66-0 (Technetium Tc 99m Medronate)
ABSTRACT: Tc-99m MDP bone scans were used to evaluate the heel pain (talalgia) in 38 patients with Reiter's disease, and compared with clinical examination and radiologic findings. In our work, 58% (22/38) patients presented talalgia with a total of 35 lesions. Only two lesions of clinical talalgia were missed by the bone scan. The diagnostic sensitivity was as high as 94% (33/35). However, the diagnostic sensitivity of radiography was only 69% (11/16) when the disease duration was more than one year; furthermore, it declined to 33% (4/12) when the disease duration was less than one year. Based on the bone scans, the correlation between positive scintigraphic findings and clinical talalgia was extremely good. Clinical talalgia occurred in all the 33 lesions demonstrated by bone scan. However, three lesions demonstrated by radiography were not consistent with clinical talalgia and not visualized by radioscintigraphy. Our data show that the radionuclide scan is a more sensitive indicator and has better correlation with clinical talalgia than radiography. We consider that bone scintigraphy is superior to radiography in the evaluation of heel pain in Reiter's disease. NLM PUBMED CIT. ID: 7863272 SOURCE: Scand J Rheumatol 1995;24(1):18-21 89

NLM CIT. ID: 95165366
TITLE: [Magnetic resonance imaging of lesions of the superficial plantar fasciitis] VERNACULAR
TITLE: Imagerie par resonance magnetique des lesions de l'aponevrose plantaire superficielle. AUTHORS: Helie O; Dubayle P; Boyer B; Pharaboz C AUTHOR AFFILIATION: Service de Radiologie, HIA Begin, Saint-Mande. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Fre
ABSTRACT: MRI is an efficient imaging modality to establish the diagnosis of plantar fascia tear and plantar fasciitis. MRI allow to differentiate recent rupture from scar and fasciitis. NLM PUBMED CIT. ID: 7861367 SOURCE: J Radiol 1995 Jan;76(1):37-41 90

NLM CIT. ID: 95190421
TITLE: A comparative radiologic examination for unresponsive plantar fasciitis [letter; comment] AUTHORS: Subotnick SI COMMENTS: Comment on: J Manipulative Physiol Ther 1994 Jun;17(5):329-34 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 7884337 SOURCE: J Manipulative Physiol Ther 1994 Nov-Dec;17(9):623; discussion 623-4 91

NLM CIT. ID: 95190420
TITLE: A comparative radiologic examination for unresponsive plantar fasciitis [letter; comment] AUTHORS: Brantingham J; Snyder WR COMMENTS: Comment on: J Manipulative Physiol Ther 1994 Jun;17(5):329-34 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 7884336 SOURCE: J Manipulative Physiol Ther 1994 Nov-Dec;17(9):621-2; discussion 623-4 92

NLM CIT. ID: 95162400
TITLE: Heel pain: diagnosis and management. AUTHORS: Campbell P; Lawton JO AUTHOR AFFILIATION: Department of Orthopaedic Surgery, Leeds General Infirmary. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Chronic non-traumatic heel pain is not an uncommon symptom in patients presenting to GP, orthopaedic or rheumatological clinics. A full history and examination will provide a diagnosis in most cases. Rarer causes need to be excluded in certain patients. This article outlines the differential diagnosis and discusses the more common causes. NLM PUBMED CIT. ID: 7858827 SOURCE: Br J Hosp Med 1994 Oct 19-Nov 1;52(8):380-5 93

NLM CIT. ID: 95112224
TITLE: Nerve entrapment causing heel pain. AUTHORS: Johnston MR AUTHOR AFFILIATION: University of Texas Health Science Center at San Antonio. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Subcalcaneal heel pain is one of the most common foot ailments, yet the exact etiology is still controversial. Much attention and evidence have recently been presented implicating nerve entrapment as a causative factor for pain. Careful evaluation is needed to discern a nerve entrapment from other possible causes of heel pain. The majority of heel pain cases respond to thoughtful, conservative care; however, this care may take several weeks to months. In the few instances that surgery is necessary, the available reports show good to excellent results in most cases. NLM PUBMED CIT. ID: 7812907 SOURCE: Clin Podiatr Med Surg 1994 Oct;11(4):617-24 94

NLM CIT. ID: 94365090
TITLE: Plantar heel pain [letter; comment] AUTHORS: Howells RJ COMMENTS: Comment on: J Bone Joint Surg Br 1994 Jan;76(1):140-2 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 8083288 SOURCE: J Bone Joint Surg Br 1994 Sep;76(5):850 95

NLM CIT. ID: 94349686
TITLE: The relationship of pes planus and calcaneal spur to plantar heel pain [see comments] AUTHORS: Prichasuk S; Subhadrabandhu T AUTHOR AFFILIATION: Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medicine, Bangkok, Thailand. COMMENTS: Comment in: Clin Orthop 1995 Oct;(319):330 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: A prospective study of pes planus by using calcaneal pitch and calcaneal spur was carried out in 82 patients with plantar heel pain and in 400 normal subjects. The mean normal calcaneal pitch was 20.54 degrees. The mean calcaneal pitch in patients with plantar heel pain was 15.99 degrees, which was significantly lower than in normal subjects. The incidence of calcaneal spur in normal subjects and in patients with plantar heel pain was 15.5% percent (62 of 400) and 65.9% (54 of 82), respectively. Again, this was a highly significant difference. Excessive weight gain, aging, and gender may be important factors effecting the lowering of the pitch and the increasing of spur formation. These factors could lead to the development of plantar heel pain. NLM PUBMED CIT. ID: 8070194 SOURCE: Clin Orthop 1994 Sep;(306):192-6 96

NLM CIT. ID: 95016315
TITLE: A comparative radiologic examination for unresponsive plantar fasciitis [see comments] AUTHORS: Kell PM COMMENTS: Comment in: J Manipulative Physiol Ther 1994 Nov-Dec;17(9):621-2; discussion 623-4 Comment in: J Manipulative Physiol Ther 1994 Nov-Dec;17(9):623; discussion 623-4 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: OBJECTIVE: To report a method of radiographically assessing the presence of the posterior calcaneus subluxation involved in cases of unresponsive plantar fasciitis. Complete resolution of pain occurred following short lever manipulative procedures directed at the calcaneus. CLINICAL FEATURES: Two cases of plantar fasciitis which previously had received comprehensive podiatric treatment were referred for chiropractic assessment. Bilateral radiographs of the lateral feet were compared. The relative position of the calcaneus in relationship to the proximal head of the 5th metatarsal were compared with the less affected or asymptomatic foot. A comparative postview of the plantar fascial foot was then taken at the conclusion of treatment. Kell's line assists the clinician in measuring and comparing the calcaneus/5th metatarsal distances. INTERVENTION: Short lever (chiropractic) manipulative procedures were directed at the posteriorward calcaneus. CONCLUSION: Radiographic assessment for unresponsive plantar fasciitis assists in determining where the site of short lever manipulation be delivered in order to improve calcaneus position and release sagittal stress on the plantar fascia. NLM PUBMED CIT. ID: 7930967 SOURCE: J Manipulative Physiol Ther 1994 Jun;17(5):329-34 97

NLM CIT. ID: 94256801
TITLE: Alleviation of the pain of heel prick in preterm infants. AUTHORS: McIntosh N; van Veen L; Brameyer H AUTHOR AFFILIATION: Department of Child Life and Health, University of Edinburgh. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 0 (Anesthetics, Local) 0 (Drug Combinations) 0 (EMLA) 0 (Ointments) 124-38-9 (Carbon Dioxide) 137-58-6 (Lidocaine) 721-50-6 (Prilocaine)
ABSTRACT: The hypothesis that the variability of physiological parameters may indicate pain or stress in the neonate was examined. Four parameters (heart rate, respiratory rate, transcutaneous oxygen tension, and carbon dioxide tension) were examined over a 2 minute epoch in response to a heel prick in an attempt to measure stress/pain in 35 preterm newborn infants (26-34 weeks' gestation) half of whom were receiving intensive care. The change in absolute values of these parameters did not discriminate a dummy procedure without prick from the actual procedure containing the prick (paired t test), but the variability of the parameters during an epoch showed significant discrimination. Three procedures were evaluated to reduce this distress using unpaired t test. The use of local anaesthetic cream was not successful. The components of the mixture cause vasoconstriction that would reduce blood flow to the heel and lead to more squeezing which is likely to be painful in the presence of tissue damage. A nurse comforting the infant with tactile and vocal stimulation was slightly helpful but the use of a spring loaded lance was most successful in reducing the distress. The use of spring loaded lances may be more humane for heel pricks. NLM PUBMED CIT. ID: 8198410 SOURCE: Arch Dis Child Fetal Neonatal Ed 1994 May;70(3):F177-81 98

NLM CIT. ID: 94362654
TITLE: Endoscopic plantar fasciotomy versus traditional heel spur surgery [letter; comment] AUTHORS: Wander DS COMMENTS: Comment on: J Foot Ankle Surg 1993 Nov-Dec;32(6):595-603 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 8081343 SOURCE: J Foot Ankle Surg 1994 May-Jun;33(3):322 99

NLM CIT. ID: 94288699
TITLE: Heel pain. AUTHORS: Gibbon WW; Cassar-Pullicino VN AUTHOR AFFILIATION: Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire, United Kingdom. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng NLM PUBMED CIT. ID: 8017990 SOURCE: Ann Rheum Dis 1994 May;53(5):344-8 100

NLM CIT. ID: 94290480
TITLE: New treatment for chronic heel pain [letter] AUTHORS: Weil LS PUBLICATION TYPES: LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 8019546 SOURCE: J Foot Ankle Surg 1994 Mar-Apr;33(2):216-9 101

NLM CIT. ID: 94290479
TITLE: Endoscopic plantar fasciotomy vs. traditional heel spur surgery [letter; comment] AUTHORS: Barrett SL; Day SV COMMENTS: Comment on: J Foot Ankle Surg 1993 Nov-Dec;32(6):595-603 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 8019545 SOURCE: J Foot Ankle Surg 1994 Mar-Apr;33(2):214-6 102

NLM CIT. ID: 95039646
TITLE: Conservative treatment of plantar heel pain: long-term follow-up. AUTHORS: Wolgin M; Cook C; Graham C; Mauldin D AUTHOR AFFILIATION: Southwest Orthopedic Institute, Dallas, Texas. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: In order to evaluate the long-term results of patients treated conservatively for plantar heel pain, a telephone follow-up survey was conducted. After eliminating those patients with worker's compensation- related complaints and those with documented inflammatory arthritides, data on 100 patients (58 females and 42 males) were available for review. The average patients was 48 years old (range 20-85 years). The average follow-up was 47 months (24-132 months). Clinical results were classified as good (resolution of symptoms) for 82 patients, fair (continued symptoms but no limitation of activity or work) for 15 patients, and poor (continued symptoms limiting activity or changing work status) in 3 patients. The average duration of symptoms before medical attention was sought was 6.1, 18.9, and 10 months for the three groups, respectively. The three patients with poor results all had bilateral complaints, but had no other obvious risk factors predictive of their poor result. Thirty-one patients stated that, even with the understanding that surgical treatment carries significant risk, they would have seriously considered it at the time medical attention was sought; twenty-two of these patients eventually had resolution of symptoms. Although the treatment of heel pain can be frustrating due to its indolent course, a given patient with plantar fasciitis has a very good chance of complete resolution of symptoms. There is a higher risk for continued symptoms in over-weight patients, patients with bilateral symptoms, and those who have symptoms for a prolonged period before seeking medical attention. NLM PUBMED CIT. ID: 7951946 SOURCE: Foot Ankle Int 1994 Mar;15(3):97-102 103

NLM CIT. ID: 96052655
TITLE: Magnetic resonance imaging of plantar fasciitis and other causes of heel pain. AUTHORS: Kier R AUTHOR AFFILIATION: Musculoskeletal and Body MRI, Bridgeport MRI Center, Connecticut, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Heel pain can be caused by disorders of either the plantar fascia, calcaneus, tendons, or adjacent nerves. Because these conditions can lead to pain located in a small area of the heel, a precise clinical diagnosis may be difficult. This article describes some of these various causes of heel pain and how MR imaging helps to characterize them. NLM PUBMED CIT. ID: 7584243 SOURCE: Magn Reson Imaging Clin N Am 1994 Feb;2(1):97-107 104

NLM CIT. ID: 94132104
TITLE: The heel pad in plantar heel pain [see comments] AUTHORS: Prichasuk S AUTHOR AFFILIATION: Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medicine, Mahidol University, Ramathibodi Hospital, Bangkok, Thailand. COMMENTS: Comment in: J Bone Joint Surg Br 1994 Sep;76(5):850 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: A study of heel-pad thickness and compressibility using lateral radiographs, loaded and unloaded by body-weight, was carried out on 70 patients with plantar heel pain and 200 normal subjects. The heel-pad thickness and the compressibility index (resistance to compression) were greater in the patients than in normal subjects and significantly increased with age. In normal subjects, the thickness was greater in males than in females, but there was no significant difference in the compressibility. Increased weight led to an increase in heel-pad thickness and compressibility index. The body mass index was greater in patients with plantar heel pain than in normal subjects and 40% of the patients were considered to be overweight. Increase in the compressibility index indicates loss of elasticity and an increased tendency to develop plantar heel pain. NLM PUBMED CIT. ID: 8300659 SOURCE: J Bone Joint Surg Br 1994 Jan;76(1):140-2 105

NLM CIT. ID: 94119546
TITLE: Subcalcaneal heel pain. AUTHORS: Karr SD AUTHOR AFFILIATION: Orthopaedics Northeast Foot and Ankle Center, Fort Wayne, Indiana. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, MULTICASE LANGUAGES: Eng
ABSTRACT: Subcalcaneal heel pain is a very common presenting complaint. Careful evaluation is necessary to guide treatment decisions. By far, most subcalcaneal heel pain resolves with appropriate conservative treatment over a period of weeks to months. Occasionally, when surgery is necessary, the goal of the procedure is adequate decompression in the area of the origin of the plantar fascia and medial calcaneal tubercle. NLM PUBMED CIT. ID: 8290225 SOURCE: Orthop Clin North Am 1994 Jan;25(1):161-75 106

NLM CIT. ID: 94177167
TITLE: Endoscopic plantar fasciotomy versus traditional heel spur surgery: a prospective study [see comments] AUTHORS: Kinley S; Frascone S; Calderone D; Wertheimer SJ Squire MA; Wiseman FA AUTHOR AFFILIATION: Department of Podiatric Surgery, St. John Hospital-Macomb Center, Mount Clemens, Michigan. COMMENTS: Comment in: J Foot Ankle Surg 1994 Mar-Apr;33(2):214-6 Comment in: J Foot Ankle Surg 1994 May-Jun;33(3):322 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: A comparative study of endoscopic plantar fasciotomy versus traditional type heel spur surgery has been performed involving 76 patients and 92 procedures. Sixty-six of those procedures consisted of endoscopic fasciotomy, whereas 26 involved traditional type surgery. Those patients in which the endoscopic fasciotomy was performed had significantly less postoperative pain, returned to regular activities 4 weeks earlier, and had fewer complications postoperatively than those patients involving traditional heel spur surgery. An overview of the surgical technique involving endoscopic fasciotomies is presented, as well as factors influencing the postoperative outcome, such as duration of preoperative symptoms, extent of conservative care, and obesity. NLM PUBMED CIT. ID: 8130790 SOURCE: J Foot Ankle Surg 1993 Nov-Dec;32(6):595-603 107

NLM CIT. ID: 94077778
TITLE: Plantar fasciitis. AUTHORS: DeMaio M; Paine R; Mangine RE; Drez D Jr AUTHOR AFFILIATION: US Navy, Oakland, Calif. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng REGISTRY NUMBERS: 0 (Anti-Inflammatory Agents, Non-Steroidal) NLM PUBMED CIT. ID: 8255812 SOURCE: Orthopedics 1993 Oct;16(10):1153-63 108

NLM CIT. ID: 94074956
TITLE: Ultrasound diagnosis of plantar fasciitis. AUTHORS: Wall JR; Harkness MA; Crawford A AUTHOR AFFILIATION: Centre for Medical and Health Physics, Queensland University of Technology, Brisbane, Australia. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: There is currently no objective reliable diagnostic test for plantar fasciitis inasmuch as diagnosis cannot be made on the basis of finding a heel spur on radiography (x-ray). In this single-blind observational study, ultrasonography was used to measure plantar fascia thickness in subjects with clinically suspected plantar fasciitis and in control subjects. It was concluded that the population mean plantar fascia thickness is greater for people with plantar fasciitis than for people without heel pain (P < .0005) and that the difference is clinically significant. The ultrasonic appearance of the plantar fascia in plantar fasciitis indicated inflammatory changes. NLM PUBMED CIT. ID: 8253440 SOURCE: Foot Ankle 1993 Oct;14(8):465-70 109

NLM CIT. ID: 93294736
TITLE: Transverse plantar incision for heel spur surgery. Four-year follow-up survey of 35 patients. AUTHORS: Self TC; Kunz RE; Young G AUTHOR AFFILIATION: Doxey-Hatch Medical Center/Veterans Affairs Medical Center, Salt Lake City, UT 84148. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: A transverse plantar incisional approach was used on 35 patients who underwent heel spur surgery from 1982 through 1990. Ten bilateral procedures were performed on a total of 45 feet. A medial approach was used for five of the bilateral surgeries. The average age of the patient was 47 years, and the average follow-up period was 49 months. Of the 34 plantar approach cases in which complete data were obtained, 94% showed either good or excellent results. The authors illustrate a technique using a transverse plantar incision as an alternative to the medial approach for heel spur surgery. NLM PUBMED CIT. ID: 8515372 SOURCE: J Am Podiatr Med Assoc 1993 May;83(5):259-62 110

NLM CIT. ID: 93310380
TITLE: A biomechanical approach to the prevention, treatment and rehabilitation of plantar fasciitis. AUTHORS: Chandler TJ; Kibler WB AUTHOR AFFILIATION: Lexington Clinic, Sports Medicine Center, Kentucky. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Plantar fasciitis is a repetitive microtrauma overload injury of the attachment of the plantar fascia at the inferior aspect of the calcaneus. The diagnosis of plantar fasciitis is common among athletes in many sports, primarily those sports that involve running. Common treatments for plantar fasciitis, including ice, stretching, ultrasound, and shoe inserts are helpful in reducing the symptoms. However, recurrence of the problem is common. By understanding the potential biomechanical causes of this disorder it may be possible to correct the anatomical and biomechanical variables that cause plantar fasciitis and reduce the rate of recurrence as well as speed the rehabilitation process. It may also be possible to identify predisposing maladaptations that can be corrected, therefore, preventing the initial occurrence of plantar fasciitis. NLM PUBMED CIT. ID: 8100639 SOURCE: Sports Med 1993 May;15(5):344-52 111

NLM CIT. ID: 93259532
TITLE: Heel pain syndrome: electrodiagnostic support for nerve entrapment. AUTHORS: Schon LC; Glennon TP; Baxter DE AUTHOR AFFILIATION: Foot and Ankle Center, Union Memorial Hospital, Baltimore, Maryland 21218. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: A local entrapment neuropathy has been proposed as one of the etiologies of heel pain, but it has never been documented by electrodiagnostic studies. Primary symptoms in patients suspected of having a neurologic basis for their heel pain include neuritic medial heel pain and radiation either proximally or distally. On physical examination, all patients in our series had reproduction of their symptomatology with palpation over the proximal aspect of the abductor hallucis and/or the origin of the plantar fascia from the medial tubercle of the calcaneus. Twenty-seven patients (20 women and seven men; average age 49) with these clinical characteristics were examined by electromyography and motor/sensory/mixed nerve conduction studies. Bilateral heel signs and symptoms were present in 11 patients. Ten of the patients had a significant history of back pain with referral to the legs. In 23 of the 38 symptomatic heels, abnormalities were identified in the lateral and/or the medial plantar nerves. The number of abnormal values per heel ranged from one to four, with a mean of 2.1. The most common finding was involvement of the medial nerve (57%). Thirty percent of the heels had isolated findings in the lateral plantar nerve and 13% had abnormalities in both plantar nerves. Two patients had electrophysiologic evidence of active S1 radiculopathy, with ipsilateral evidence of plantar nerve entrapment suggesting a "double crush" syndrome. The results of this study support the presence of abnormalities of plantar nerve function in a selected group of patients with neuritic heel pain. NLM PUBMED CIT. ID: 8491426 SOURCE: Foot Ankle 1993 Mar-Apr;14(3):129-35 112

NLM CIT. ID: 93189293
TITLE: The pain of heel prick and its measurement in preterm infants. AUTHORS: McIntosh N; Van Veen L; Brameyer H AUTHOR AFFILIATION: Department of Child Life and Health, University of Edinburgh, UK. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 124-38-9 (Carbon Dioxide) 7782-44-7 (Oxygen)
ABSTRACT: Variability of physiological parameters was used as a measure of stress in the newborn infant. There was a significant increase in variability of the heart rate (P < 0.01) when the stab of the heel prick occurred in addition to the other elements of the procedure (positioning, warming, alcohol swab cleansing and squeezing). This dummy procedure itself caused some increase in variability although this was not significant at the 5% level. There were similar significant increases in variability of the respiratory rate and O2 and CO2 tensions in the blood (P < 0.05) during the stab procedure. NLM PUBMED CIT. ID: 8446439 SOURCE: Pain 1993 Jan;52(1):71-4 113

NLM CIT. ID: 93161217
TITLE: Heel pain in the older patient. AUTHORS: Black JR; Bernard JM; Williams LA AUTHOR AFFILIATION: J. A. Haley Veterans Hospital, Tampa, Florida. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGES: Eng
ABSTRACT: Older Americans are the fastest growing segment of the US population. For this group, mobility is a significant factor in individual well- being. Heel pain is primarily a symptom found in adults, and like most health problems, increased age has a compounding effect on most disease processes. If heel pain becomes the cause of immobility in an older patient, significant consequences may arise. The true prevalence of heel pain in older individuals is not known precisely. The frequency may lie between 12.5% and 15% on the basis of reports in the literature. The scientific basis of these figures, however, is open to question. No one method of organizing heel pain according to a causative agent or condition is accepted universally. A review of the literature, however, reveals that most reporters ultimately include the same elements in whatever schema they use. In general terms, management of heel pain, regardless of the cause, can be organized according to noninvasive to invasive treatment methods. The authors have found the categories of mechanical, pharmacologic, and surgical to be useful. Selection of a therapeutic method is based on the patient's specific physical circumstance and social situation. NLM PUBMED CIT. ID: 8431831 SOURCE: Clin Podiatr Med Surg 1993 Jan;10(1):113-9 114

NLM CIT. ID: 93124390
TITLE: Heel spur surgery. A transverse plantar approach. AUTHORS: Boike AM; Snyder AJ; Roberto PD; Tabbert WG AUTHOR AFFILIATION: Department of Podiatric Surgery, Ohio College of Podiatric Medicine, Cleveland. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng NLM PUBMED CIT. ID: 8419629 SOURCE: J Am Podiatr Med Assoc 1993 Jan;83(1):39-42 115

NLM CIT. ID: 92289106
TITLE: Treatment of chronic heel pain by surgical release of the first branch of the lateral plantar nerve. AUTHORS: Baxter DE; Pfeffer GB AUTHOR AFFILIATION: Baylor College of Medicine, Department of Orthopaedics, Houston, Texas. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Sixty-nine heels (53 patients) with chronic heel pain had a surgical release of the first branch of the lateral plantar nerve. The average duration of heel-pain symptoms was 23 months (range, six months to eight years). No patient had less than six months of conservative treatment before surgery. The average duration of preoperative conservative treatment was 14 months. Forty-four patients (83%) had taken nonsteroidal antiinflammatory agents. Sixty-three heels (91%) had used heel cups and/or orthoses. Fifty-nine heels (86%) had received one or more injections of a steroid preparation. Thirty-four heels had developed pain initially during a sports activity. Postoperatively, 61 heels (89%) had excellent or good results; 57 heels (83%) had complete resolution of pain. The average follow-up period was 49 months. In general, heel pain resolves with conservative treatment. In recalcitrant cases, however, entrapment of the first branch lateral plantar nerve should be suspected. Surgical release of this nerve can be expected to provide excellent relief of pain and facilitate return to normal activity. NLM PUBMED CIT. ID: 1600660 SOURCE: Clin Orthop 1992 Jun;(279):229-36 116

NLM CIT. ID: 93139684
TITLE: Operative treatment of plantar fasciitis. AUTHORS: Kulthanan T AUTHOR AFFILIATION: Department of Orthopaedics Surgery and Rehabilitation, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Ten patients undergoing 12 fasciotomy by stripping the plantar fascia and superficial plantar muscles from the calcaneus have been reviewed for an average of 24.9 months after the operation. All patients failed to respond to conservative treatment by anti-inflammatory medication, heel pads and local steroid injections for a duration of 6 months to 3 years (average 15 months). There were 7 females and 3 males. Their work was of a light nature and none of them were professional athletes. The results indicated 91.6 per cent excellent, 8.4 per cent good and no failure. Complete pain relief at rest and walking was obtained in 11 of 12 for an average of 11.75 months (from 8 months to 18 months) after surgery. There was only 1 of 12 who had mild pain at walking that did not impair activity. All patients could return to their jobs about 4-6 weeks after surgery. Bloodless operation (under tourniquet control) was performed under general anaesthesia. NLM PUBMED CIT. ID: 1487681 SOURCE: J Med Assoc Thai 1992 Jun;75(6):337-40 117

NLM CIT. ID: 92339957
TITLE: Plantar fasciotomy for intractable plantar fasciitis: clinical results and biomechanical evaluation. AUTHORS: Daly PJ; Kitaoka HB; Chao EY AUTHOR AFFILIATION: Mayo Graduate School of Medicine, Rochester, Minnesota 55905. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Thirteen consecutive patients underwent plantar fasciotomy in 16 feet for intractable plantar fasciitis and had follow-up from 4.5 to 15 years. Plantar fasciotomy was successful (good or excellent results) for 71% of the 14 feet operated on and for which follow-up data were available. However, time to full recovery was prolonged, additional treatment was frequently required, and abnormalities of foot function persisted. Flattening of the longitudinal arch occurred. Dynamic force- plate studies showed differences in peak vertical, fore-aft, and lateral-medial forces between patients and matched controls. More rapid progression of weightbearing along the longitudinal axis of the foot during stance phase in patients indicated avoidance of heel loading. NLM PUBMED CIT. ID: 1634150 SOURCE: Foot Ankle 1992 May;13(4):188-95 118

NLM CIT. ID: 92355899
TITLE: Retrospective analysis of calcaneal spur removal and complete fascial release for the treatment of chronic heel pain. AUTHORS: Gormley J; Kuwada GT PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: Doctors Gormley and Kuwada investigate the pathology of chronic heel pain secondary to soft tissue and osseous inflammatory conditions. Pertinent literature review regarding success following fascial release as well as bone spur removal is provided. Ninety-four patients are reported having sustained spur removal with fascia resection according to the authors' technique. They report a 95% success rate postoperatively. NLM PUBMED CIT. ID: 1645003 SOURCE: J Foot Surg 1992 Mar-Apr;31(2):166-9 119

NLM CIT. ID: 92080721
TITLE: Plantar fasciitis: US imaging [letter; comment] AUTHORS: Gibbon WW COMMENTS: Comment on: Radiology 1991 Jun;179(3):665-7 PUBLICATION TYPES: COMMENT LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 1727300 SOURCE: Radiology 1992 Jan;182(1):285 120

NLM CIT. ID: 92228569
TITLE: Plantar fasciitis [letter] AUTHORS: Boyd HS PUBLICATION TYPES: LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 1565508 SOURCE: Orthop Rev 1992 Jan;21(1):116 121

NLM CIT. ID: 92161274
TITLE: Heel blisters and epidural analgesia for postoperative pain relief [letter] AUTHORS: O'Toole DP; O'Dwyer E PUBLICATION TYPES: LETTER LANGUAGES: Eng NLM PUBMED CIT. ID: 1536428 SOURCE: Anaesthesia 1992 Jan;47(1):81 122

NLM CIT. ID: 92165271
TITLE: The use of night splints for treatment of recalcitrant plantar fasciitis. AUTHORS: Wapner KL; Sharkey PF AUTHOR AFFILIATION: Division of Foot and Ankle Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: This study reports the results of the use of molded ankle foot orthosis night splints for the treatment of recalcitrant plantar fasciitis on 14 patients with a total of 18 symptomatic feet. All patients had symptoms for greater than 1 year and had previously undergone treatment with non- steroidal anti-inflammatory medicines, cortisone injections, shoe modifications, and physical therapy without resolution. All patients were provided with custom-molded polypropylene ankle foot orthoses in 5 degrees of dorsiflexion to be used as a night splint. With continued use of nonsteroidal anti-inflammatory medication, Tuli heel cups, Spenco liners, and general stretching exercises, successful resolution occurred in 11 patients in less than 4 months. There were three failures. It is felt that the use of night splints provides a useful, cost-effective adjunct to current therapeutic regimens of plantar fasciitis. NLM PUBMED CIT. ID: 1791004 SOURCE: Foot Ankle 1991 Dec;12(3):135-7 123

NLM CIT. ID: 92121619
TITLE: Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: surgical technique--early clinical results. AUTHORS: Barrett SL; Day SV PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: A new, minimally traumatic endoscopic approach to plantar fasciotomy has been developed by the authors. This technique can be performed comfortably under a local anesthetic. Patients are immediately weightbearing and all returned to regular type shoes on the 3rd postoperative day. An earlier return to regular activity and work, with less pain and patient discomfort was found, as compared with traditional heel spur surgery techniques. NLM PUBMED CIT. ID: 1770208 SOURCE: J Foot Surg 1991 Nov-Dec;30(6):568-70 124

NLM CIT. ID: 92014783
TITLE: TL-61 versus Rohadur orthoses in heel spur syndrome. AUTHORS: Ferguson H; Raskowsky M; Blake RL; Denton JA AUTHOR AFFILIATION: Center for Sports Medicine, Saint Francis Memorial Hospital, San Francisco, CA 94109. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: The authors present the subjective responses of 40 patients with heel spur syndrome or plantar fascitis to orthotic treatment. Twenty patients had Rohadur orthoses and 20 patients had TL-61 orthoses. These data show no difference in the response to or problems created by either TL-61 or Rohadur orthoses. The authors recommend TL-61 as one alternative to Rohadur, now that that latter is unavailable. NLM PUBMED CIT. ID: 1920106 SOURCE: J Am Podiatr Med Assoc 1991 Aug;81(8):439-42 125

NLM CIT. ID: 91227475
TITLE: Plantar fasciitis: MR imaging [see comments] AUTHORS: Berkowitz JF; Kier R; Rudicel S AUTHOR AFFILIATION: Department of Radiology, Yale University School of Medicine, New Haven, Conn. COMMENTS: Comment in: Radiology 1992 Jan;182(1):285 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng
ABSTRACT: The clinical presentation of plantar fasciitis may be mimicked by a number of other painful heel conditions. Thus, magnetic resonance (MR) imaging was used to develop objective morphologic criteria to establish a diagnosis of plantar fasciitis in eight patients. Sagittal T1- weighted and coronal intermediate and T2-weighted images of symptomatic and asymptomatic feet were obtained; additional sequences were used for symptomatic feet. Maximum thickness of the plantar fascia was significantly increased (P less than .0001) in patients with plantar fasciitis (sagittal, 7.40 mm +/- 1.17, and coronal, 7.56 mm +/- 1.01) compared with age- and sex-matched volunteers (sagittal, 3.22 mm +/- 0.44, and coronal, 3.44 mm +/- 0.53) and young male controls (sagittal, 3.00 mm +/- 0.8, and coronal, 3.00 mm +/- 0.0). Furthermore, nine of 10 feet with plantar fasciitis had areas of moderately increased signal intensity in the substance of the fascia. MR imaging may provide an objective assessment of the morphologic changes associated with plantar fasciitis, as well as assist in excluding other causes of heel pain. NLM PUBMED CIT. ID: 2027971 SOURCE: Radiology 1991 Jun;179(3):665-7 126

NLM CIT. ID: 91275397
TITLE: Evaluation of plantar fasciitis by three-phase bone scintigraphy. AUTHORS: Intenzo CM; Wapner KL; Park CH; Kim SM AUTHOR AFFILIATION: Division of Nuclear Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng REGISTRY NUMBERS: 63347-66-0 (Technetium Tc 99m Medronate)
ABSTRACT: Fifteen patients complaining of chronic heel pain underwent three-phase Tc-99m MDP bone scintigraphy. Ten patients demonstrated abnormal scan findings consistent with plantar fasciitis (PF) and had responded to conventional therapy. Two patients were found to have calcaneal stress fractures, and one patient demonstrated a calcaneal spur that required no treatment. The remaining two patients had normal scans and did not appear clinically to have PF. The three-phase bone scan is therefore very useful in diagnosing PF and in distinguishing it from other etiologies of the painful heel syndrome. NLM PUBMED CIT. ID: 2054987 SOURCE: Clin Nucl Med 1991 May;16(5):325-8 127

NLM CIT. ID: 91208799
TITLE: Plantar fasciitis. Etiology, treatment, surgical results, and review of the literature. AUTHORS: Schepsis AA; Leach RE; Gorzyca J AUTHOR AFFILIATION: Department of Orthopaedic Surgery, Boston University Medical School, Massachuse