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A Retrospective Analysis of 22 Patients Treated with Percutaneous Radiofrequency Nerve Ablation for Prolonged Moderate to Severe Heel Pain Associated with Plantar Fasciitis

Dr. Alan Shih
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Liden B, Simmons M, Landsman AS.

A retrospective study involving 22 patients (31 feet) with a history of prolonged moderate to severe heel pain associated with plantar fasciitis were examined to determine if ablation of the sensory branch of the medial calcaneal nerve would result in symptomatic relief.  Participants in this study were given subjective questionnaires and visual analog scales in order to rate their symptoms before and after nerve ablation using radiofrequency energy.  The results showed that the mean preintervention visual analog pain score was 8.12+/- 1.61 (with 10 being the worst pain the patient could imagine), and this dropped to 3.26 +/- 1.97 after 1 week and 1.46+/- 1.76 after 1 month, 1.96+/- 1.98 at 3 months, and 2.07+/-2.06 at 6 months, and the improvement was statistically significant (P<.001) at each stage of follow-up.  Furthermore, patients followed for up to 1 year showed no significant worsening of symptoms.  Adverse events were limited to hematoma at the site of the entry of the radiofrequency cannula.  These findings support the conclusion that radiofrequency nerve ablation be considered an alternative to repetitive corticosteroid injections or open surgical intervention for the treatment of recalcitrant plantar heel pain.  Level of Clinical Evidence: 4

J Foot & Ankle Surg.  Article in press; 2009.