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[足底筋膜炎——病理生理学、诊断与治疗——临床指南]

[Plantar Fasciopathy - Pathophysiology Diagnostics and Therapy - A Clinical Guideline].

作者信息

Hirschmüller Anja, Weidermann Frances

机构信息

ALTIUS Swiss Sportmed Center, Rheinfelden, Schweiz.

Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität Freiburg, Deutschland.

出版信息

Ther Umsch. 2022 Sep;79(7):325-332. doi: 10.1024/0040-5930/a001369.

DOI:10.1024/0040-5930/a001369
PMID:35983940
Abstract

Plantar Fasciopathy - Pathophysiology Diagnostics and Therapy - A Clinical Guideline Plantar fasciitis (often referred to as "heel spurs") is a common problem in daily practice. Approximately 4-10% of the general population is affected, in athletes the prevalence is even higher with an estimated prevalence of 5-18%. Heel pain is one of the most common running injuries. Besides runners, overweight individuals exposed to several hours of standing or walking daily are also at risk. The reduction in quality of life can be considerably high. The diagnosis can usually be secured by means of a targeted anamnesis and clinical examination, backed up by ultrasound examination or MRI. The most common differential diagnoses are irritation of the Baxter's nerve, tarsal tunnel syndrome, and insertional tendinopathy of the Achilles tendon. Plantar heel pain is a domain of conservative therapy, surgical procedures are very rarely required. The basic therapy consists of patient education and stretching exercises, it can be expanded by low dye taping, insoles, and extracorporeal shock wave therapy. If this does not lead to a significant improvement in symptoms, night splints and infiltrations can be useful.

摘要

足底筋膜炎——病理生理学、诊断与治疗——临床指南 足底筋膜炎(通常称为“足跟骨刺”)是日常临床实践中的常见问题。普通人群中约4-10%受其影响,运动员中的患病率更高,估计为5-18%。足跟痛是最常见的跑步损伤之一。除跑步者外,每天站立或行走数小时的超重个体也有患病风险。生活质量的下降可能相当严重。通常通过有针对性的病史采集和临床检查,并辅以超声检查或磁共振成像来确诊。最常见的鉴别诊断包括巴克斯特神经激惹、跗管综合征和跟腱止点腱病。足底足跟痛属于保守治疗范畴,很少需要手术治疗。基础治疗包括患者教育和伸展运动,可通过低染料贴扎、鞋垫和体外冲击波治疗加以扩展。如果这不能使症状得到显著改善,夜间夹板和局部注射可能会有帮助。

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