Chronic plantar heel pain modifies associations of ankle plantarflexor strength and body mass index with calcaneal bone density and microarchitecture

Effects of insoles adapted in flip-flop sandals in patients with persistent plantar heel pain: A sham-controlled randomised trial

OBJECTIVE

To evaluate the use of custom-made insoles adapted to flip-flops on pain intensity, foot function, and functional walking ability in individuals with persistent plantar heel pain in the short and medium term.

DESIGN

Randomised controlled trial.

SETTING

Flip-flop sandals in patients with persistent plantar heel pain.

MAIN MEASURES

Participants (n = 80) were assessed at baseline, six and 12 weeks after the intervention, and 4 weeks post-intervention.

RESULTS

For the primary outcomes, after 6 weeks of intervention, no between-group difference was observed in the intensity of morning pain or pain with walking, mean difference = -0.4 (95% confidence intervals = -1.5 to 0.8). Similarly, after 12 weeks of intervention, no between-group difference was observed in the intensity of morning pain or pain with walking, mean difference = -0.7 (95% confidence intervals = -1.9 to 0.6). Finally, at 4 weeks after the end of the intervention, there was no between-group difference in morning pain or pain on walking, mean difference = 0.01 (95% confidence intervals = -1.4 to 1.4). All differences and confidence intervals were smaller than the minimum clinically important difference for pain (2 points). There were no differences between the groups for the secondary outcomes. In addition, the mean differences were smaller than the minimum clinically important differences for pain intensity, foot function and functional walking ability.

CONCLUSION

Custom-made insoles fitted to flip-flops did not differ from flip-flops with sham insoles in improving pain intensity, foot function and functional walking ability in people with persistent heel pain.Trial registration: ClinicalTrials.gov (Identifier: NCT04784598). Data of registration: 2023-01-20.

Calcaneal Spurs: A Potentially Debilitating Disorder

Feet are often the most neglected part of the body, all the while being the highly dependent part of daily work and mobility. The lack of attention to them can lead to painful conditions such as calcaneal spurs and associated conditions. Calcaneal spurs are bony projections that form around the calcaneal bone, the strongest, most significant, and posterior-most bone in the feet. The classic symptom of the calcaneal spur is talalgia, commonly known as heel pain. There are many causes of heel pain, which are usually associated with calcaneal spurs. Hence it becomes imperative to diagnose and treat them effectively. The development of calcaneal spur is shrouded in mystery, and why a few individuals are more prone to developing the condition than others depends on their gender, age, occupation, and lifestyle. Calcaneal spurs are seen in association with many diseases. It is also regarded as the etiological factor in plantar fasciitis and increasing body weight and as a complication in arthropathies, Gout, pes cavus, and pes planus. This review article aims to highlight a relationship between those factors while also summarizing the treatment modalities present today. Hence, it promotes the usage of a model for administering treatment based on a tier-wise follow-up procedure, where the response to a particular treatment is recorded. If it does not resolve the spur, the treatment progresses to the next tier. This review article hopes to shed light on the understanding and treatment of calcaneal spurs.