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राचेल सैंडनर्स
Pain and discomfort in the inferior surface of the heel are common symptoms of chronic proximal plantar fasciitis, which appear shortly after stepping out of bed. An inferior calcaneal bone spur close to the plantar fascial enthesis is present in at least half of patients with heel discomfort. Changes in fascial mechanics (tensile changes in the fascia due to sclerosis and thickness), inflammation, or mechanical stimulation from the plantar soft tissues could all cause this spur. The heel spur is unlikely to be the cause of the distinctive heel pain. 18 The majority of current surgical studies recommend a partial surgical release of the medial plantar fascia without resection of the heel spur. 3 Heel spurs have also been seen in 10–27% of asymptomatic patients who had foot or ankle radiographs taken for reasons other than heel soreness. In a considerable number of patients, extracorporeal shock wave application to musculoskeletal tissues (Orthotripsy) results in symptom resolution or improvement. Since the Food and Drug Administration approved various devices in 2000, an additional nonincisional strategy to treating various musculoskeletal disorders has been employed in Europe since 1990 and is gaining increasing recognition in Asia and the United States.