[The relationship between the thickness and elasticity of the heel pad and heel pain].
OBJECTIVE
We investigated the factors affecting the thickness and elasticity of the heel pad and sought relationship between the heel pad thickness and elasticity and heel pain.


METHODS
Of 182 patients who presented with a complaint of heel pain over a three year period, 50 patients (38 females, 12 males; mean age 46 years; range 23 to 73 years) met specific criteria for the study. A combined treatment modality was conducted throughout a year which consisted of non-steroidal anti-inflammatory drugs, contrast baths, stretching exercises, and changes in footwear design. At the end of a year, the results were assessed according to the criteria proposed by Wolgin et al. Measurements of heel pad thickness were performed according to the technique described by Jorgensen: compressibility index of the heel pad was calculated on anteroposterior and lateral radiographs of the heel, loaded and unloaded by body weight.


RESULTS
The results were good in 35 patients (70%), fair in 12 patients (35%), and poor in three patients (6%). Four patients (8%) developed recurrences. Increased heel pad thickness, decreased elasticity, and delayed healing were observed in males, in patients above 40 years of age, in obese patients, in those with a pretreatment symptom duration exceeding 12 months, and in those with a greater subcalcaneal spur.


CONCLUSIONS
The thickness of heel pad increases in relation to age and weight, resulting in decreased elasticity. In addition, subcalcaneal spur may be involved in heel pain induction through decreasing heel pad elasticity.
Ozdemir
Hakan
H
Akdeniz Universitesi Tip Fakültesi Ortopedi ve Travmatoloji Anabilim Dali, Antalya, Turkey. drhakanozdemir@ixir.com
Urgüden
Mustafa
M
Ozgörgen
Mete
M
Gür
Semih
S
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004548:Elasticity; D015444:Exercise; D005260:Female; D006365:Heel / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D059408:Pain Management; D011312:Pressure; D011859:Radiography; D012775:Shoes; D016474:Weight-Bearing
D000894:Anti-Inflammatory Agents, Non-Steroidal