Introduction
Plantar fasciitis is a common cause of heel pain. Some individuals may experience recurring pain that interferes with their daily activities. Plantar fasciitis has numerous treatment options. Radiofrequency nerve ablation is an effective therapy for chronic pain in plantar fasciitis. For the treatment of plantar fasciitis, radiofrequency ablation is a safe and effective alternative to surgery. The benefits of radiofrequency ablation for plantar fasciitis include the potential for patients to quickly return to work and resume weight-bearing activities. Read this article to learn more about the use of radiofrequency ablation in plantar fasciitis.
What Is Plantar Fasciitis?
Inflammation within the plantar fascia is the most typical reason for heel pain and can lead to disability. It is also known as plantar fasciitis. It is more common in persons who lead sedentary lifestyles or who exercise. Plantar fasciitis causes approximately 11 to 15 percent of foot complaints. Bilateral plantar fasciitis occurs in 20 to 30 percent of cases. Although the level of pain may lessen with everyday activities, some patients experience persistent pain that interferes with daily activities.
Placing weight on the foot, while standing causes the plantar fascia to become more tense or stressed. Moreover, pushing off with the ball of the foot as well as the toes increases the stress. Both of these movements occur during typical walking or running. Overuse or over time, the fascia lacks some of its elasticity or resilience, causing irritation in ordinary daily tasks.
What Are the Causes of Plantar Fasciitis?
Plantar fasciitis is caused by overuse injuries and microtears in the plantar fascia as a result of repetitive strain. However, plantar fasciitis can be caused by trauma or some other circumstances. Plantar fasciitis risk factors include restricted ankle dorsiflexion, prolonged standing or jumping, and severe pronation or supination. Heel spurs (bony growths in the heel bone) affect approximately 50 percent of persons with plantar fasciitis. However, they are not the primary cause. Plantar fasciitis is frequently related to runners and elderly individuals. Obesity, foot pad atrophy, aging, employment requiring prolonged standing, and weight-bearing are other risk factors for plantar fasciitis.
How Is Plantar Fasciitis Managed?
Although there are both surgical and non-surgical therapy options for plantar fasciitis, their efficacy has not been fully understood. Standard plantar fascia-releasing methods can effectively cure plantar fascia pain. However, these are linked to problems such as infection of the wound, postoperatively lateral foot pain syndrome, deep vein thrombosis, and metatarsal stress fractures.
To treat plantar fasciitis, non-surgical methods such as stretching exercises, braces and orthoses, steroidal injections, botulinum toxin injections, non-steroidal anti-inflammatory drugs, transcutaneous electrical nerve stimulation, injections of platelet-rich plasma (PRP), radiofrequency nerve ablation (RFNA), and extracorporeal shockwave therapy are more frequently utilized. Despite the current treatments, not all patients recover. RFNA, a non-surgical therapy method, has a high success rate for treating chronic plantar heel pain.
What Is Radiofrequency Ablation?
Plantar heel pain is treated with radiofrequency nerve ablation. It is a minimally invasive technique that destroys the damaged sensory nerves using high-frequency radio waves. It usually happens at a temperature of 90 degrees Celsius. At this temperature, the nerve is denervated. After that, it will no longer be capable of transmitting pain impulses. Radiofrequency nerve ablation is a well-established procedure that has been utilized by medicine for many years, primarily for persistent back pain and cardiac conditions.
The treatment process is minimally invasive and uses a local anesthetic to numb the area into which the radiofrequency probe is inserted. To correctly position the electrode during the surgery, most surgeons employ ultrasonography (USG) or fluoroscopy. However, additional research has documented successful outcomes without the use of ultrasonography or fluoroscopy.
A nerve stimulator correctly identifies the sensory nerves causing heel discomfort. Once identified, further anesthetic is injected to numb the sensory nerve, which will be ablated with heat. The probe tip directs heat to a specific spot, reducing injury to other structures near the nerve. The region treated is around the size of a tiny garden pea. As a result, the creation of heat in a limited area disrupts the nerves' myelin coating. High temperatures cause myelin sheath gaps, which affects nerve conduction.
As the technique is minimally invasive, the recovery is quick. After the treatment, a mild dressing is administered. Patients can resume weight-bearing in conventional footwear. It is recommended to limit the activity levels for some time (nearly 48 hours) following the treatment and take a brief course of simple pain medication, such as Paracetamol and Ibuprofen, to ease post-operative discomfort. Furthermore, there is no need for wound healing, surgical shoes, or heavy post-operative bandages, and the treatment is simple and quick.
What Are the Side Effects of Radiofrequency Ablation?
Radiofrequency ablation carries minimal risks. However, there are a few possibilities, including:
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One of the most serious side effects of radiofrequency ablation is motor nerve ablation. When using motor and sensory nerve stimulators that are discriminatory, the chances are less likely to damage a motor nerve while trying to ablate a sensory nerve. If the proper precautions are performed before nerve stimulation, motor nerve injury is unlikely.
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An infection or formation of abscess at the puncture site. It is usually rare.
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Bruising and swelling that results in pain.
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Numbness surrounding the region that was treated is an unusual adverse effect.
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Weakness of the smaller muscles in the foot.
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Persistent pain.
Conclusion
When conventional treatments have failed to relieve resistant cases of plantar heel pain, radiofrequency nerve ablation is a great alternative for treatment. It is a safe and effective alternative to standard treatments for plantar fasciitis. The main benefits of radiofrequency ablation are the maintenance of the plantar fascia, the ability to resume full activity within one to two weeks of the surgery, and long-term pain relief. Complications from surgical treatments are avoided through radiofrequency ablation. The advantages of radiofrequency nerve ablation include the ability for patients to swiftly return to work and begin weight-bearing activities easily.
