Volume 20 - Issue 11 - November 2007
Cryosurgery is an effective pain relief modality that uses freezing temperatures for ablation of the nerves that provide sensation to the heel. While this treatment is relatively new for foot pain, physicians have utilized cryosurgery for pain relief for decades. This modality has proven to be a viable treatment and is an excellent choice for appropriate patients prior to considering more invasive procedures.
Heel pain has become an epidemic in our society. Diabetes, arthritis, weight gain, injuries, previous heel surgery and other medical conditions are known contributing factors.
As with any peripheral nerve surgery, tarsal tunnel surgery is demanding and can sometimes be excessively difficult. Additionally, one may not have a full appreciation of the outcome until some point in the postoperative period — if at all — when the nerve has had adequate time for recovery and/or regeneration.
Sadly, there are many misnomers in podiatric medicine and surgery. For example, the nomenclature of “tarsal tunnel syndrome” implies that the site of chronic nerve entrapment is at the level of the tarsal tunnel,
Over the years, podiatrists have become the primary health care providers for all forefoot conditions and most rearfoot conditions. With greater public awareness and increased referrals from primary care doctors, heel pain pathology is perhaps the most common foot pathology we treat in our offices. As a result, many new devices and surgical techniques have emerged in recent years to help improve our outcomes.
Unfortunately, some of these newer methods and techniques are not always necessary and may not demonstrate the same outcomes that some of the research states.
The world of orthotic therapy and foot biomechanics was somewhat shaken in 2006 when a randomized study found that “customized and prefabricated orthoses used in the trial (had) similar effectiveness in the treatment of plantar fasciitis.”1 Of course, there was a great deal more to this study than the one sentence but it sure stimulated discussion within podiatry and orthopedic surgery concerning the value of custom orthoses in comparison to prefabricated devices.
There are actually four relatively recent trials that compare prefabricated and custom orthoses relativ
Continuing Education »
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There may be a tendency to leap to a plantar fasciitis diagnosis when patients present with heel pain. However, this author emphasizes the importance of a thorough differential diagnosis. accordingly, he offers diagnostic insights on a variety of potential causes ranging from calcaneal spur fractures and neurogenic heel pain to systemic etiologies.
News and Trends »
Given that patients with diabetes can face extensive treatments due to the risk of complications, adherence to treatment regimens may be a problem due to a perceived decline in their quality of life.
A new study finds that although end-stage complications have the greatest effect on quality of life, comprehensive treatments affect quality of life to the degree that some patients were willing to forego years of healthy living to avoid treatments.
In the study, which was recently published in Diabetes Care, researchers interviewed 701 patients with diabetes a