From the Alpert Medical School, Brown University, Providence, RI (Dr. Lareau, Dr. Sawyer, and Ms. Wang), the Rhode Island Hospital, Providence (Dr. Lareau and Dr. Sawyer), and Harvard Medical School and the Massachusetts General Hospital, Boston, MA (Dr. DiGiovanni).
J Am Acad Orthop Surg. 2014 Jun;22(6):372-80. doi: 10.5435/JAAOS-22-06-372.
Heel pain is commonly encountered in orthopaedic practice. Establishing an accurate diagnosis is critical, but it can be challenging due to the complex regional anatomy. Subacute and chronic plantar and medial heel pain are most frequently the result of repetitive microtrauma or compression of neurologic structures, such as plantar fasciitis, heel pad atrophy, Baxter nerve entrapment, calcaneal stress fracture, and tarsal tunnel syndrome. Most causes of inferior heel pain can be successfully managed nonsurgically. Surgical intervention is reserved for patients who do not respond to nonsurgical measures. Although corticosteroid injections have a role in the management of select diagnoses, they should be used with caution.
足跟痛在矫形外科中很常见。准确的诊断至关重要,但由于区域解剖结构复杂,这可能具有挑战性。亚急性和慢性足底和足跟内侧疼痛最常是由于重复的微创伤或神经结构受压引起的,如足底筋膜炎、足跟垫萎缩、Baxter 神经卡压、跟骨应力性骨折和跗管综合征。大多数足跟下疼痛的原因可以通过非手术方法成功治疗。手术干预仅保留给对非手术措施无反应的患者。虽然皮质类固醇注射在某些诊断的治疗中有一定作用,但应谨慎使用。