Bożena Jasiak-Tyrkalska, Jolanta Jaworek, Bogusław Frańczuk

Bożena Jasiak-Tyrkalska, Jolanta Jaworek, Bogusław Frańczuk – Efficacy of two different physiotherapeutic procedures in comprehensive therapy of plantar calcaneal spur. Fizjoterapia Polska 2007; 7(2), 145-154

Abstract

Background. A plantar calcaneal spur causes pain in the area of the medial process of the calcaneal tuber. The pain is caused by localised pressure in the region of the plantar aponeurosis attachment to the calcaneal bone. Plantar calcaneal spurs are principally treated by physiotherapy techniques, with ultrasound as the most popular procedure. At present, phonophoresis is more and more frequently used. Phonophoresis is an ultrasound treatment in which the substance between the transducer and the skin is replaced with a medicine in gel form. The aim of this paper is to assess the efficacy of and compare ultrasound- and phonophoresis-based therapeutic procedures for calcaneal spur. Materials and methods. 40 patients treated for plantar calcaneal spur participated in the study. The patients were randomised into two groups: Group A was treated by phonophoresis and group B received an ultrasound treatment. The patients were between 35 and 80 years of age (mean age 57.3 years). The enrolment criteria for the study were: absence of concomitant systemic disease or generalised inflammatory conditions and no history of recent injuries. The following criteria of physiotherapeutic treatment efficacy were adopted for the study: subjective pain intensity using the VAS scale, the range of plantar flexion and supination as well as the strength of muscle groups of the longitudinal arch of the foot. In order to provide better insight, taking into account the risk factors for the calcaneal spur, the BMl as well as Bogdanov’s ankle bone angle, which determines the length of the longitudinal arch of the foot, were determined in both groups. Results. Plantar calcaneal spur patients are usually overweight and suffer from slight longitudinal flatfootedness. A significant reduction of pain intensity was observed in group A (at p<0.001), and in group B (p<0.01). There was also an improvement in both foot flexion and supinetion at p<0.001. The strength of foot flexors and supinators increased significantly in both groups, at p<0.001 in group A and p<0.05 in group B. Conclusions. The clinical profile of calcaneal spur patients mostly includes overweight and slight longitudinal flatfootedness. Phonophoresis is a significantly more effective physiotherapeutic procedure than ultrasound in the physiotherapeutic management of plantar calcaneal spurs.

Key words:

calcaneal spur, treatment, efficacy

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