Epin Calcanei/Topuk Dikeni
Title: Effectiveness of extracorporeal shock wave therapy in the treatment of epin calcanei
1.Nihan Cüzdan
2.Deniz Evcik
3.Saime Ay
Abstract
Objective: Epin calcanei is a common clinical problem with chronic plantar heel pain. ‘Extracorporeal Shock Wave Therapy (ESWT)’ is a non-surgical method
administered to patients along with a variety of other options such as corticosteroid injections, non-steroidal antiinflammatory drugs and physical therapy modalities. The aim of this prospective controlled study is to investigate the efficacy of ESWT in patients with clinical and radiological diagnosis of epin calcanei.
Materials-Methods: The study included 49 patients diagnosed with epin calcanei according to the clinical and radiological criteria. Patients were randomly
divided into two groups. Group 1 (n=25) used silicone insoles and received ESWT treatment as 1000 shots in each session at a frequency of 8 Hz, 3 sessions
in total with intervals of four days. Group 2 (n=24) was accepted as the control group and used silicone insoles alone. The severity of pain was evaluated using
the pain Visual Analog Scale (VAS) as pain at night, pain in the morning, on the first step, pain on motion, pain at rest, pain on uneven ground and pain at the
end of the day. The functional level of activity of the foot was evaluated by the Foot and Ankle Outcome Score (FAOS) index. Measurements were taken before
treatment and after 4 weeks of follow-up.
Results: After treatment, both groups showed statistically significant improvement in all parameters (p<0.05). Post-treatment VAS scores showed significant
improvements in pain at night and pain in the morning on the first step (p<0.05) in ESWT group. However there was no significant difference in other parameters
between the two groups (p>0.05).
Conclusion: According to the results of our study, ESWT application is seen as an effective conservative method in decreasing pain related to heel spur.
Keywords: ESWT, Epin calcanei, plantar pain
Title: Effects of extracorporeal shock wave therapy on plantar pressure distribution of patients with epin calcanei
Authors: Zehra Betül Karakoc*, Zübeyir Sarı, Eren Timurtas and Mine Gülden Polat
Abstract:
Purpose: Tis study aimed to determine the alteration of plantar pressure distribution of patients with epin calcanei diagnosis after Extracorporeal Shock Wave Therapy (ESWT). Methods: This study was completed between May and November 2015. A total of 112 patients diagnosed with epin calcanei were invited to participate. After screening, 22 patients met the inclusion criteria. Participants were treated with three sessions of ESWT at the Yavuz Selim Hospital. Pain levels and plantar pressure distribution were assessed using Visual Analog Scale (VAS) and EMED® pedobarographic system, respectively, before and after four weeks of treatment. The main outcome measures were VAS scores and max force and contact area.
Results: VAS scores decreased after treatment (p < 0.05). Maximum force and contact area values of total foot and forefoot increased (p < 0.05). Conclusions: We consider that increased max force value of total foot and forefoot area after ESWT is due to normal walking rate gained related to decreased pain. ESWT treatment may have positive effects on foot pressure distribution and body biomechanics.
Keywords: epin calcanei, plantar pressure, extracorporeal shock wave therapy, ESWT, heel pain
Title: Radial extracorporeal shockwave therapy on calcaneal spurs: a randomized controlled trial
Authors:
Desy Kurniawati Tandiyo
Ratna Darjanti Haryadi
Ari Probandari
Didik Gunawan Tamtomo
Abstract:
Backgraund: The effectiveness of extracorporeal shockwave therapy (ESWT) in handling pain and calcaneal spurs is still controversial, whereas research on the effectiveness of ESWT in the reactive ossification process of calcaneal spurs, involving osteoprotegerin (OPG) and the receptor activator of nuclear factor-kappa B (RANK), does not exist. This study was aimed to assess the effect of ESWT on pain, the length of the spur, plasma OPG and RANK level on the calcaneal spur.
Methods: This study was a randomized controlled trial in patients with calcaneal spurs. ESWT was administered at the pain point by applying 2,000 shocks, at an intensity of 2 bars, given six times with a 7â–10-day interval. The visual analog scale (VAS) data, plasma OPG and RANK level were analyzed using Mann–Whitney U test, whereas spur size was analyzed using chi-square test.
Results: One month after therapy at rest (p < 0.001) and when walking after getting up (p = 0.020), the VAS was lower than that in the control group. The plasma OPG level was lower than control group shortly after therapy (p < 0.001). The plasma RANK level was higher than control group shortly after therapy (p < 0.001). ESWT did not affect the reduction of spur measurement (p = 0.382).
Conclusions: ESWT reduced pain, decreased plasma OPG level, and increased plasma RANK level. Although ESWT did not have any effect on spur reduction, it affected plasma OPG and RANK level that play a role in the activity of osteoblasts and osteoclasts.
Keuwords: calcaneal spur, extracorporeal shockwave therapy
