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A Prospective, Randomized, Double-blinded Study with Crossover to Determine the Efficacy of Radio-frequency Nerve Ablation for the Treatment of Heel Pain

Adam S. Landsman Department of Surgery, Harvard Medical School, and Division of Podiatric Surgery, Cambridge Health Alliance, Cambridge, MA.

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Dominic J. Catanese Montefiore Medical Center, Bronx, NY.
Department of Orthopedic Surgery, Albert Einstein College of Medicine, Bronx, NY.

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Steven N. Wiener Allied Podiatry, Westminster, MD.

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Douglas H. Richie Jr. Alamitos Seal Beach Podiatry Group, Seal Beach, CA.

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Jason R. Hanft The Foot and Ankle Institute of South Florida, South Miami, FL.

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Background:

Previous studies have demonstrated that radio-frequency nerve ablation (RFNA) can be an effective treatment for plantar fasciosis. This study provides additional evidence in support of this treatment, with statistically significant data that demonstrate the success of this technique.

Methods:

In this multicenter, randomized, prospective, double-blinded study with crossover, 17 patients were divided into two groups, with eight initially receiving RFNA treatment and nine initially receiving sham treatment. If no improvement was observed after 4 weeks, a crossover was offered. Results of the treatment were evaluated by the patient and by a blinded physician using a visual analog pain scale to rate first-step pain, average pain, and peak pain in the heel region.

Results:

We observed a statistically significant improvement in the symptoms of plantar fasciosis in patients actively treated with RFNA and no significant improvement in the sham-treated group. More important, those treated with sham subsequently demonstrated statistically significant improvement after subsequent RFNA treatment.

Conclusions:

Using a prospective, randomized study with sham treatment and crossover, this study demonstrates the efficacy of RFNA for the treatment of plantar fasciosis. (J Am Podiatr Med Assoc 103(1): 8–15, 2013)

Corresponding author: Adam S. Landsman, DPM, PhD, Division of Podiatric Surgery, Cambridge Health Alliance, 1493 Cambridge St, Cambridge, MA 02139. (E-mail: alandsman@cha.harvard.edu)
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