Does Targeting the Sural Nerve in Addition to the Posterior Tibial Nerve Increase the Effectiveness of Pulsed Radiofrequency Treatment in Chronic Plantar Heel Pain?
Does Targeting the Sural Nerve in Addition to the Posterior Tibial Nerve Increase the Effectiveness of Pulsed Radiofrequency Treatment in Chronic Plantar Heel Pain?
This observational study aims to compare the effectiveness of pulsed radiofrequency (PRF) treatment applied to the posterior tibial nerve alone versus PRF applied to both the posterior tibial and sural nerves in patients with chronic plantar heel pain. Outcomes will be assessed using the Visual Analog Scale (VAS) and the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score at baseline, 1 month, and 3 months after treatment.
This prospective observational cohort study evaluates whether the addition of sural nerve pulsed radiofrequency (PRF) to posterior tibial nerve PRF is associated with greater clinical improvement in patients with chronic plantar heel pain. In routine clinical practice, ultrasound-guided PRF is applied to the posterior tibial nerve, and in selected patients, additional PRF of the sural nerve is performed based on clinical judgment.
Patients are prospectively followed in two groups according to the treatment received: posterior tibial nerve PRF alone and posterior tibial nerve PRF combined with sural nerve PRF. Clinical outcomes are assessed at baseline and at 1 and 3 months after the procedure. Pain intensity is evaluated using the Visual Analog Scale (VAS), and functional outcome is assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. Changes in these outcomes are compared between the two groups during the follow-up period.
Inclusion Criteria:
Age between 18 and 65 years
Presence of chronic plantar heel pain
Baseline VAS score >5
Exclusion Criteria:
History of foot fracture or tumor
Pregnancy
Coagulopathy or use of antiplatelet therapy
Cognitive impairment preventing informed consent