AB1419-HPR EFFICIENCY OF INDIVIDUAL STEEL ORTHESIS IN HEAVEN SPRAY
Authors: Dmitry Baryshov, Evgenia Guryanova
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The most common cause of heel pain is the heel spur, which is 75% of patients with heel pain. The intensity of the pain does not depend on the size of the spur, as determined on the radiograph. Often sharp in shape and large in size, the spurs are a random X-ray finding. At the same time, severe pains in the heel region are possible with a normal radiograph [1].. <h3>Objectives</h3> The purpose of this study is to establish the effectiveness of the treatment of patients with pain syndrome in the heel spur, by affecting the main components of the pathogenesis of individually manufactured orthopedic insoles. <h3>Methods</h3> During the year, under our supervision there were 156 patients aged from 32 to 67 years. Gender composition - 123 (79%) - women, and 32 (21%) - men. The average time between the onset of clinical symptoms and the first day of treatment was 134 days. The average spur size was 4.3 mm. In 80% of patients, a history of pain lasted for more than 3 months. Patients were divided into 2 groups. The experimental group (G1) used individually manufactured insoles (78 people: 61 - women, 17 - men). The control group (G2) used factory insoles (78 people: 58 - women, 20 - men). 152 patients (98%) completed the protocol: 78 (100%) in G1 and 74 (96%) in G2. The criterion for inclusion in the study was the diagnosis of the heel spur. The diagnosis was made based on anamnesis, ultrasound of the plantar aponeurosis, and radiography of the heel region. The exclusion criteria were patients with heel spurs without heel pain, as well as systemic diseases: rheumatoid arthritis, diabetes mellitus, and severe vascular pathology. The degree of longitudinal flat-footedness, stability of the foot, individual deformities of the feet were clinically evaluated using clinical and functional methods and the method of vacuum trace modeling [2]. Individual insoles were made based on frame materials in the projection of the arches of the foot. Dense materials maintain a constant tension of the plantar aponeurosis. G1 patients were made full contact insoles with a correction of the transverse arch, without adding relief elements under the heel. The control group used factory-made insoles from different manufacturers, with soft elements under the heel. Measurement parameters: average pain intensity on a VAS scale; duration of pain throughout the day; distance traveled; subjective comfort when using insoles. The observation period is 12 calendar months. <h3>Results</h3> The average VAS score in G1 decreased from 5.4 0.3 at the beginning of the study to 1.01 in 62 patients (81%). 15 patients reported pain reduction, the average VAS score was 2.1 0.3. Complete relief of G1 pain has been reported in patients with an osteophyte size of less than 5 mm. G1 patients regained their usual movement distance of 3.9 km per day. Cases of recurrence of heel pain is not recorded. No patients experienced discomfort from the use of insoles throughout the entire period of adaptation. In G2, the average VAS score decreased from 5.6 0.3 at the beginning of the study to 2.9 0.3. Patients of the G2 group were able to increase the distance of movement to 1.2 km per day. <h3>Conclusion</h3> When using individual insoles, 93% of patients reported complete relief of pain. 7% of patients noted a significant reduction in pain. The use of individual insoles in the treatment of plantar fasciitis made it possible to reduce pain in a shorter time. <h3>References</h3> [1] Kotelnikov G.G. Traumatology and Orthopedics. M.: GEOTAR-Med, 2018. 776 p. [2] Joint pain/K. V. Kotenko (and others). M.: GEOTAR - Med, - 2018. 560 p. <h3>Disclosure of Interests</h3> None declared