Objective To document the outcome of the conservative treatment in plantar heel pain patients. Specific objectives included the evaluation the difference of outcome between patients, who revealed the different clinical menifestation, and the evaluation of prognostic factors. Method We devided the plantar heel pain patients to two groups by the location of maximal tenderness on the heel(Group A - localized severe tenderness over the medial calcaneal tuberosity, Group B - diffuse tenderness over the central heel) and performed the conservative treatment according to a standard protocol(relative rest,nonsteroidal anti-inflammatory medications and stretching exercise during initial 2 weeks. And then viscoelastic polymer heel cushion, functional custom-made insole for all patients. Steroid injections were used for the patients of Group A who suffer from pain despite of standard treatment. In order to evaluate the results, we reviewed all charts and conducted the follow-up survey by questionnairs. 21 patients(8 males, 13 females; 26 heels; average age, 47.9 years; 15 group A, 6 group B) were available for review. Results The average follow-up was 9 months. Clinical results were classified as good(resolution of symptoms) for 3 patients, fair(continued symptoms but no limitation of activity) for 13 patients, poor(continued symptoms limiting activity) for 5 patients. The overall successful improvement(including good and fair) were 76.2% within 2.6 months. There were no significant difference of the successful improvement between two groups, which were 73.3% in group A, 83.3% in group B. The overweight was the only predictive factor of poor result. Conclusion The outcome of a conservative treatment in patients with plantar heel pain is successful. But it is not different in spite of difference of clinical menifestation. |