足部和踝部病症:足底筋膜炎
Foot and Ankle Conditions: Plantar Fasciitis.
作者信息
Carek Peter J, Edenfield Katherine M, Michaudet Charlie, Nicolette Guy W
机构信息
University of Florida College of Medicine, PO Box 100237, Gainesville, FL 32610-0237.
出版信息
FP Essent. 2018 Feb;465:11-17.
Plantar fasciitis is the most common cause of heel pain in adults. It involves painful symptoms occurring along the plantar fascia with or without the presence of a bony heel spur. Heel pain that occurs on standing after a prolonged non-weight-bearing period is a prominent symptom of plantar fasciitis. On physical examination, palpation along the medial plantar calcaneal region reproduces the painful symptoms. Routine imaging studies usually are not necessary but can be used to rule out pathologies or confirm chronic or recalcitrant plantar fasciitis. The presence of a heel spur on x-ray is not thought to be an underlying cause of symptoms and indicates the condition has been present for at least 6 to 12 months. Conservative therapies such as rest, ice massage, nonsteroidal anti-inflammatory drugs, specific plantar fascia stretching exercises, and orthoses are the preferred initial treatments. Injection therapies using a corticosteroid or platelet-rich plasma typically provide short-term relief. If conservative treatment is ineffective, extracorporeal shock wave therapy and surgery may be considered.
足底筋膜炎是成人足跟疼痛最常见的原因。它包括沿足底筋膜出现的疼痛症状,无论是否伴有足跟骨刺。长时间非负重后站立时出现的足跟疼痛是足底筋膜炎的突出症状。体格检查时,沿内侧跟骨区域触诊会再现疼痛症状。常规影像学检查通常没有必要,但可用于排除病变或确诊慢性或顽固性足底筋膜炎。X 光片上出现足跟骨刺不被认为是症状的根本原因,表明该病症已存在至少 6 至 12 个月。保守治疗如休息、冰敷按摩、非甾体类抗炎药、特定的足底筋膜伸展运动和矫形器是首选的初始治疗方法。使用皮质类固醇或富血小板血浆的注射疗法通常能提供短期缓解。如果保守治疗无效,可考虑体外冲击波疗法和手术。