Assessing The Role Of Radiofrequency Nerve Ablation For Plantar Fasciitis

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Author(s): 
Adam Landsman, DPM, FACFAS, PhD

   I have tried to perform radiofrequency nerve ablation with other painful conditions of the foot as well. One area in which I have had great success is with heel pain that is associated with scar tissue and nerve entrapment. This occasionally occurs following a percutaneous or open plantar fascia release where the incision site becomes hypertrophic. In combination with a steroid infiltration, the success rate becomes even higher for this procedure.

   Another application for radiofrequency nerve ablation is with Morton’s neuroma. My success rate with this condition has been good but this frequently requires more than one treatment. I have attributed this to the fact that the nerves are more difficult to localize due to their variable position within the interspace and the need to ablate both intermetatarsal nerves sufficiently to stop the pain.

   In many cases, I am able to partially ablate the nerves on the first treatment. Although this may reduce the pain, it may not eliminate it. However, subsequent ablation becomes easier as the area of pain is smaller. Since the area is smaller, localization of the nerve becomes easier.

In Summary

Radiofrequency nerve ablation has become an important part of my practice. I have found it to be a highly effective way to dramatically reduce pain associated with a variety of types of heel pain, particularly plantar fasciitis.

   Furthermore, I now consider it in the earliest phases of treatment, even before steroid injections, in order to avoid fat pad atrophy, spikes in blood glucose and other steroid-related complications. Typically, one can perform the procedure in 10 minutes or less.

   Dr. Landsman is the Chief of the Division of Podiatric Surgery at Cambridge Health Alliance in Cambridge, Mass. He is an Assistant Professor at the California School of Podiatric Medicine at Samuel Merritt University. Dr. Landsman is a Fellow of the American College of Foot and Ankle Surgeons.

References

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