Ultrasound-Guided Radiofrequency Denervation of the Medial Calcaneal Nerve

Peter D. Counsel, Marcus Davenport, Angus Brown, Chin Chin Ooi, Jules Comin, Paul Marks, David A. Connell

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OBJECTIVE:: Plantar fasciosis is a common complaint of athletes, particularly for runners. The medial calcaneal nerve (MCN) may play a role in the pain syndrome, and radiofrequency (RF) denervation has been previously reported. The hypothesis is that ultrasound-guided denervation of the MCN results in symptomatic improvement. DESIGN:: Retrospective cohort. SETTING:: Private practice. PATIENTS:: Twenty-nine patients previously receiving ultrasound-guided RF denervation of the MCN, having failed conservative therapy, were assessed in 2 groups, those more than (group 1, n = 16) or less than (group 2, n = 13) 6 months since the procedure. INTERVENTIONS:: Ultrasound-guided RF denervation of the MCN. MAIN OUTCOME MEASURES:: Pain scores before denervation, as well as at maximal pain relief and the time of the interview. Levels of satisfaction and attitudes toward surgery were also assessed. RESULTS:: Pain scores decreased significantly in both groups, for both best and residual pain scores. Group 1 mean pain scores were 8.56 before procedure, 2.81 (P < 0.001 compared to baseline) at best pain score, and 3.75 (P < 0.01) residual pain score. Group 2 mean pain scores were 7.23 before procedure, 3.77 (P < 0.01) at best pain score and 4.92 (P < 0.01) residual pain score. Levels of satisfaction were predominantly positive (69% of group 1% and 54% of group 2 were either somewhat or very satisfied), with attitudes toward surgery unchanged. CONCLUSIONS:: For patients with refractory plantar heel pain, ultrasound-guided denervation of the MCN can potentially improve symptoms, although efficacy needs assessing in comparative studies. CLINICAL RELEVANCE:: Ultrasound-guided denervation of the MCN provides a further management option for patients with refractory plantar fasciosis.
Original languageEnglish
Pages (from-to)465-470
Number of pages6
JournalClinical Journal of Sport Medicine
Issue number6
Publication statusPublished - Nov 2016

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