Injection in heel with calcaneal spur: blockade with diprospan

Injections in the heel with a calcaneal spur: reviews about blockade by Diprospan

Blockage of the heel spur is necessary in the event that the symptoms of the disease are too pronounced.

In this case, injections are placed in the area of ​​the heel spur, and the most common drugs are hormonal drugs.

The effectiveness of such injections is explained by the fact that they have an almost instantaneous analgesic effect and removal of the inflammatory process.

How is the treatment

Blockade is a rather complicated injection, which is performed exclusively by an experienced surgeon. In this case, the result depends entirely on his actions.

It is necessary to make an injection in the most painful point on the heel.

The meaning of the whole procedure is that the most painful point on the heel is injected with an anesthetic or an anti-inflammatory agent. Since we are talking about the heel spur, the place is also chosen over the bone growth.

As a rule, the injection should be put right here, since here the pain syndrome is most pronounced.

Why do we pay so much attention to getting the injection in the most painful area on the heel? The fact is that the calcaneal spur always causes severe pain, and the blockade will not be effective if you put the shot in another area.

If an error occurs in the injection, the drug does not reach the pathological area, spreads around the tissues around the spur and is unable to relieve inflammation or pain.

However, the most dangerous thing in the wrong prick is that it is capable of leading to:

• The onset of sepsis.
• Suppuration.
• To tendon inflammation.

With the correct hit in the desired area, there is a momentary reduction in pain and inflammation.

Most patients note that relief comes immediately after the first procedure. So the blockade is always positive.

When a blockade is appointed

The blockade is appointed if the conservative treatment prescribed earlier did not yield a positive result, or it turned out to be ineffective, and the pains continue to increase.

In other cases, such treatment is not a priority. As we said above, the treatment method has its complications, but in addition to improper administration, there is a possibility of complications due to a violation of the integrity of the plantar fascia.

We note the main complications:

1. Suppuration in the area of ​​injection.
2. Development of osteoporosis.
3. Lack of calcium, which develops due to leaching of the microelement after the administration of glucocorticosteroids.
4. Inflammation of tendons in the gastrocnemius muscle.
5. Necrosis of tissues.
6. Destruction of the plantar fascia.

After the injection was successfully delivered, and the blockade is recognized effective, the patient is recommended to adhere to several basic rules and recommendations.

• For the sick foot, a gentle regimen is necessary.
• Use of special orthopedic insoles.
• Wearing comfortable shoes.
• Regular sessions of special exercise therapy.
• Massage.

Contraindications to the use of blockade

An injection in the heel with a calcaneal spur can not be made with the individual intolerance of the drug or its active ingredients. With caution, the injection is made with the following problems:

1. Osteoporosis.
2. Tuberculosis.
3. Streptococcal infection.
4. Diabetes.
5. Psoriasis in the area of ​​the heel.
6. Psychiatric problems.

Essential preparations

The most common drugs are Diprospan, Hydrocortisone, Genalog, Nimesulide. Most often, an injection in the heel is made with such means.

Among the drugs we will select Diprospan. This drug belongs to glucocorticosteroids, and its active substance is betamethasone.

The injection also contains auxiliary components. Diprospan is presented as an injection solution, and as a suspension.

Diprospan has a long therapeutic effect, which can last for at least 10 days.

In this case, Diprospan leads to complete relief of pain or to its significant reduction.

Like other drugs used in blockade, Diprospan is most effective when injected correctly.

The exact number of injections is not, but we can say that for a complete blockade, from 1 to 3 injections of the drug can suffice.

Hydrocortisone is the hormone of the adrenal cortex. In order to achieve effective anesthesia, several injections are prescribed at once.

Kenalog - a synthetic drug, is an analogue of glucocorticosteroids. The injections of this drug can quickly eliminate pain with a calcaneal spur or increase the periods of remission.

Conclusion

In conclusion, let's say that, despite its high effectiveness, blockade and heel stitches with spurs remain extremely ambiguous treatment.

The high risk of complications and many contraindications can not make the blockade method popular enough and often used.

After blockade, strict observance of all the rules and recommendations of the doctor is necessary, only so the effect will be long and the periods of remission will be months and years.

A source: http://sustav.info/bolezni/drugie/ukol-v-pyatku-pri-pyatochnoj-shpore.html

Treatment of calcaneal spur with a heel in the heel hormonal preparations

> Treating the calcaneal spur

To treat the heel spur in modern medicine, effective methods are used - medicamentous, orthopedic and physiotherapy.

But even these methods are not always able to cope with the heel spur.

When all means are tested, and the pain in the heel does not recede, one must resort to ambiguous methods of therapy, which include the drug blockage of the heel spur hormonal preparations.

What is this method of treatment? When do blockade with a calcaneal spur and how long is the therapeutic effect? Is it dangerous to make an injection in the heel and what side effects and consequences are there in this method of treating the heel spur?

Indications for blockage of calcaneal spur

Hormonal drugs in the treatment of calcaneal spurs are used according to strict indications of the doctor in the absence of effect from other methods of treatment. Blockade of calcaneal spur with corticosteroids is used only in case of severe pain.

In this case, the drug is injected into the soft tissues of the sole in the region of the osteophyte. The exact ingestion of a drug substance into the area of ​​inflammation is reflected in the blockade.

Therefore, an experienced surgeon or orthopedist should make an injection in the heel with a calcaneal spur, and better under the supervision of ultrasound.

Benefits of blockade in a fast analgesic effect. This is because the drug is injected directly into the focus of inflammation in the right concentration.

However, the blockade does not eliminate the disease and the cause of the appearance of the heel spur.

It only removes inflammation and the pain associated with it, and is not an option for first-line therapy.

Contraindications for blockade with corticosteroids

Do not apply this method to children under 3 years. With care apply hormones to women after menopause. Contraindications for blockade by hormonal agents, the following:

• mental illness;
• osteoporosis of bones;
• valvular heart disease;
• diabetes mellitus; tuberculosis infection;
• diabetes;
• stomach and stomach ulcer;
• the period after vaccination is less than 2 months;
• heart failure;
• Itenko-Cushing's disease;
• obesity;
• thyrotoxicosis and hypothyroidism;
• pregnancy and lactation;
• heart failure;
• recently suffered myocardial infarction.

Women receiving contraceptives or hormone replacement therapy, the use of the blockade is discussed with the attending physician. In fact, the contraindications for the blockade are much greater than in this list.

What drugs are used to blockade

To treat the calcaneal spur with a prick in the heel, hormonal means are used. Corticosteroids have strong anti-inflammatory, anti-allergic and anti-shock properties.

For blockade, the following medicines are usually used:

1. "Diprospan
2. "Kenalog
3. Hydrocortisone.

These drugs belong to the pharmacological group of corticosteroids. They are artificially created analogues of hormones of the adrenal cortex.

"Hydrocortisone" is a short-acting hormone, therefore, to create an effective storage dose, several injections are required after a short time. Only in this case, "Hydrocortisone" will have an anti-inflammatory effect.

"Kenalog" is also included in the group of short-acting corticosteroids.

The active substance of the drug - triamcinolone, with topical application has anti-inflammatory, antiexudative and anti-allergic effect.

"Kenalog" quickly eliminates pain and increases the period of remission. On the course of treatment of one injection is not enough, it is required to do 2-3 blockades.

To block the calcaneal spur, "Diprospan" is most often used. This drug from the group of corticosteroids differs from Kenalog and Hydrocortisone by prolonged action.

Its advantage in the rapid and long-term therapeutic effect is due to the double effect of the incoming components. "Diprospan" consists of betamethasone sodium phosphate, which has a short action.

It is quickly absorbed and has an anti-inflammatory effect, after which it is completely excreted by the kidneys. Another component of Diprospan - betamethasone dipropionate, has a long-lasting effect.

After blockage of the calcaneal spur by Diprospan, this component is slowly absorbed and remains in the tissues for at least 10 hours. During this time, it has a continuous anti-inflammatory and anti-edema action at the injection site.

"Diprospan" after the first injection relieves pain and eliminates inflammation of the fascia. But with severe edema and pain, 2-3 procedures are required.

Technique for completing the blockade procedure

The therapeutic effect of blockade directly depends on the accuracy of the drug in the focus of inflammation.

The correct place and depth of administration, the dose of the substance - all these important factors are reflected in the result of the therapeutic effect. If mistakenly administered, the drug is distributed along the aponeurosis and causes complications.

Therefore, the injection is made by a qualified surgeon or orthopedist. Before the blockade, the doctor warns the patient about possible complications.

Anesthetic is often not used for blockade of the calcaneal spur, and if used, then a syringe is first collected, ml Diprospan, Kenalog or Hydrocortisone, then add a solution of 1% Lidocaine and mix shaking. The place of administration of the drug is treated with an antiseptic.

The needle is injected under ultrasound control into the most painful point - above the site of attachment of the plantar fascia to the calcaneus.

The thickness of the skin and increased density of tissues slow down the time of manipulation. Pain in the foot is removed immediately after the injection.

In the same field of application, the prick is repeated at intervals of 2-3 months. In different legs, the drug can be administered after 10-14 days.

Consequences of blockage of calcaneal spurs with hormonal medications

The consequences of blockade of the heel spur with steroid means are associated with the dose of the drug substance. The more often the use and the greater the dose of the drug, the more serious the negative consequences.

rupture of plantar fascia

After the blockage of the calcaneal spur Kenalog, the following complications are possible:

• atrophy of the skin and necrosis of the muscles at the injection site;
• a sterile abscess;
• local osteoporosis - calcium washing;
• infection of the injection site;
• rupture of plantar fascia.

The most dangerous complication of the blockade of the calcaneal spur by Kenalog is the rupture of the plantar fascia.

"Kenalog" also has side effects:

1. joint use with non-steroidal anti-inflammatory drugs (Ibuprofen, Voltaren) increases the risk of gastric bleeding;
2. due to increased production of hydrochloric acid, the risk of steroid stomach ulceration increases;
3. lowering of immunity causes an exacerbation of an infectious disease.

Even with local application, "Kenalog" has a negative impact on all body systems due to oppression of the pituitary gland.

It lowers the function of the ovaries, which causes disruption of the menstrual cycle and the development of osteoporosis.

Kenalog increases the level of the hormone of the adrenal cortex, which is the cause of obesity, increased blood pressure and blood glucose.

adrenal glands

The most destructive property is possessed by "Diprospan". Betamethasone dipropionate has a long-lasting effect and is retained in the body for up to 10 days.

If the blockade is repeated within this time interval, a cumulative dose is created, which destroys the nervous and endocrine system.

Even the injection of Diprospan once in 3 months disrupts the secretory function of glands, negatively affects the exchange of proteins, fats and carbohydrates.

Under the influence of Diprospan, the body's control system of the hypothalamus-pituitary-adrenal gland is disrupted. The fact is that corticosteroids depress the main gland of our body - the pituitary gland, which controls neurohumoral processes. As a result of its weakening, all systems suffer:

• the production of female and male sex hormones decreases, which is the cause of osteoporosis;
• the production of hormones of the adrenal cortex increases, which causes the development of Isenko-Cushing syndrome;
• develops steroid diabetes mellitus;
• manifest latent (latent) form of diabetes mellitus;
• due to increased production of the hormone cortisone by the adrenals, blood pressure rises;
• suppressed immunity;
• there is muscle weakness and atrophy;
• The impact on the nervous system is manifested by convulsions and the development of depression.

calcium washing out

Hormonal drugs give side effects and long-term negative consequences. After the blockade, Diprospan often develops complications:

1. rupture of the plantar fascia;
2. inflammation of the Achilles tendon of the foot;
3. development of soft tissue necrosis;
4. an abscess at the injection site;
5. allergic reaction;
6. leaching of calcium from the junction of the aponeurosis with calcaneus;
7. hematoma in the area of ​​drug administration;
8. reduction of subcutaneous fat.

The most dangerous complication after blocking the calcaneal spur with corticosteroids is the rupture of the plantar fascia, after which the patient will not be able to step on the leg.

The duration of action of corticosteroids does not have an advantage over other methods of conservative treatment. The effect of the injection is temporary, but the risk is high. This method is applicable 1-2 times only to stop the pain syndrome.

To prevent complications before blockade, X-rays of the foot are performed to determine the size of the spur. And the manipulation itself is carried out under the supervision of ultrasound.

Isenko-Cushing syndrome

Note! - Such consequences can develop a few months after the blockade.The negative influence and temporary effect of the injection does not justify its use for the removal of pain in the foot.

After all, the consequence of hormones is the systemic destruction of the organism in the form of Itenko-Cushing syndrome and osteoporosis, the risk of rupture of the plantar fascia.

For these reasons, blockage of the calcaneal spur is not a treatment for the first line and is used only in extreme cases with severe pain.

Within a month after the injection, there is no difference in pain between persons who have applied hormones and those who have been treated in other ways. But the injection of a corticosteroid is dangerous by a formidable complication-the rupture of the plantar fascia.

So serious risk does not justify the use of hormonal drugs. In addition, the injection only removes the inflammation of the fascia, but the cause of its appearance does not eliminate.

How to maintain the therapeutic effect after the blockade

The injection of the hormonal drug does not solve the problem of the disease, it only removes the inflammation of the fascia and the pain.

After all, there remain risk factors - flat feet, overweight, leg work or the underlying disease.

Therefore, for the prevention of recurrence and consolidation of the effect, the doctor recommends that the patient constantly maintain a sparing regimen. For this you need:

Compliance with these measures will prevent the need to treat the heel spur with a heel.It is important to understand that blockade with hormones does not eliminate the disease itself, but only relieves inflammation and relieves pain.

Summing up, we will recall. Blockade with corticosteroids is used to relieve pain with a calcaneal spur, but it is dangerous by a number of side effects and the risk of rupturing the plantar fascia.

The injection of corticosteroids is done only with severe pain in the foot. The most dangerous negative consequences are caused by "Diprospan" - a hormone of systemic importance.

Blockade with corticosteroids is not a first-line therapy, that is, it is not worth it to begin treatment of the heel spur.

A source: http://shporynet.ru/lechenie/blokada-pyatochnoj-shpory.html

Correct blockage of the heel spur. Injection (prick) in the heel with a calcaneal spur - reviews, technique of implementation, consequences

An injection from the calcaneal spur (name - blockade) is an effective way to treat the inflammation of the calcaneus fascia by injecting the drug on the basis of artificial hormones directly into the heel spine. The peculiarity of this method is that the active substance is injected into the affected fascia and begins to act instantaneously. Steroid injections have many contraindications, they can only be prescribed and done by a doctor.

When is a blockade in the heel with a calcaneal spur?

This method of getting rid of the spur is prescribed under the following conditions:

1. Other methods of treatment were tried, but they did not give the desired effect.
2. The patient experiences severe pain, which worsens the quality of his life and requires constant anesthesia.
3. There are no contraindications to the blockade.

If you have an unbearable pain in the heel spur, what kind of doctor should you go to have a blockade? The surgeon or orthopedist appoints and conducts the blockade. Before the procedure, the doctor will prescribe the necessary tests.

Women in childbearing age should definitely consult a gynecologist, as well as visit a female doctor after carrying out steroid injections.

Treating the calcaneal spur with a prick in the heel

The meaning of the procedure is to introduce a steroid drug into the very center of the bone spine. Given that the spine has an osseous-salt nature to make an injection correctly is quite difficult.

It is important to make an injection in the bone growth, and not in the surrounding tissue. After the introduction of a hormonal drug inflammation is significantly reduced. Steroids provoke an acceleration of metabolism and bone build-up dissolves.

The main advantage of the blockade is the rapid alleviation of the pain syndrome. Within 2-5 minutes after the injection, the patient feels considerable relief.

However, do not forget that steroid drugs, although they have a prolonged effect, but the therapeutic effect of them is not higher than other conservative methods of treatment.

For example, treatment of calcaneal spurs medically with the use of nonsteroidal drugs with anti-inflammatory effect gives an excellent result, and the use of an instep support for the foot with spurs or heels adds to the process recovery.

Medication for blockage of calcaneal spur

The drugs used to block the inflamed fascia have the following action:

• inhibit the formation of leukocytes in the area of ​​inflammation;
• block the absorbing function of macrophages;
• inhibit the development of inflammatory mediators;
• stabilize cell membranes of healthy cells;
• reduce the permeability of the blood capillaries;
• decreased activity and the formation of antibodies.

What are the injections done with the heel spur? The most commonly used drugs are the group of corticosteroids:

Blockade of calcaneal spur by Diprospan

The active substance is betamethasone, which has a long effect up to 10 days. Treating the calcaneal spur with diprospan allows you to quickly get rid of the pain and stop inflammation. Also, the drug has an anti-inflammatory and anti-allergic effect.

The number of injections and dosage is determined by the doctor. Usually, 1-2 injections are enough to completely remove the spur. Patients should be aware that Diprospan has a devastating effect on the pituitary-adrenal system and has an impressive list of contraindications.

Hydrocortisone Injection

The drug contains artificial hormones, similar to those that produce the adrenal glands. To get rid of the spur you need a course of 3-5 injections.

Injections are done with a minimal break, while the active substance accumulates in the tissues of the heel and reduces inflammation.

It should be said that in comparison with Diprospan this drug is slightly less effective, but its cost is much lower.

Anesthesia with the help of Kenalog

The drug is based on synthetic corticosteroids. After the introduction, instantly relieves pain and promotes the onset of persistent remission.

You can use Kenalog not more than once every 6-9 months.

Before deciding how to anesthetize the heel spur and prescribe the drug, the doctor should ask the patient about the presence of allergies and the experience of taking hormonal drugs.

When choosing a steroid for a prick, the specialist takes into account the age, sex, weight, the presence of a history of the disease, as well as the results of tests, ultrasound and radiographs.

Blockade with calcaneal spur: technique of performing

Independently to make the blockade impossible for several reasons:

• It is necessary to determine precisely the site of the injection, and this can be done only by palpation on a relaxed foot or with ultrasound;
• During the injection, the foot should be in a straight line, and the heel should remain in place.
• To reduce the risk of infection, the procedure is carried out in conditions as close as possible to sterile (clean dressing or manipulation in the department of surgery).

The effectiveness of blockade by 90% depends on the correctness of the hormonal drug. Also of great importance is the depth of the injection and the speed of injection of the drug. If improperly administered, the risk of complications increases significantly, so surgeons prefer to perform this procedure under the supervision of an ultrasound machine. It does not matter which drug was chosen by the doctor for the blockade: Hydrocortisone, Kenalog or Diprospan, with the heel spur technique of injection is the same for all medicines:

1. By the method of palpation, the doctor determines the most painful point on the fascia.
2. A special syringe with a trocar needle is prepared. The anesthetic is injected, ml, and then the selected steroid for the blockade is typed.
3. The heel is treated with an antiseptic.
4. Under the control of the ultrasound machine, the doctor introduces the trocar needle to the desired depth and slowly injects the medicine.

Anesthetic is used because of the extreme painfulness of the procedure. As an anesthetic, novocaine, ultracaine and other pain relievers can be used.

After blockade, the patient should not step on the heel for 30-60 minutes. Subsequently, to reduce pressure on the fascia of the heel, it is necessary to use insoles with spurs and comfortable shoes.

Blockade of calcaneal spur: consequences and complications

Complications after blockade are manifested in 15-20% of people.

In most cases, they are associated with the incorrect administration of steroids and because of the individual characteristics of the organism.

By the way, the pharmacological and physiotherapy procedures for treating the heel spur practically do not cause negative consequences.

The most common complications are:

• suppuration of the injection site and / or adjacent tissues;
• appearance of signs of osteoporosis;
• death of tissues;
• heel fascia rupture.

After the procedure, a person should examine the heel daily for any complications. The first signs that the blockade caused complications are redness, blackening, pain or numbness of the heel, etc.

If you find these or other atypical symptoms you should immediately contact a surgeon.

How to strengthen the effect of injection in the heel with a calcaneal spur?

To strengthen the therapeutic effect of blockade doctors recommend following the advice:

1. Do not load the foot

Motor activity should be restored gradually. Be sure to use heel spurs to wear heel pads or Strutz insteps, fixing the arch of the foot in a natural position and reducing the dynamic load on the fascia of the heel.

2. Do gymnastics and foot massage

This is necessary to restore normal circulation and metabolism.

3. Use special cream and ointments

Apply a cream that softens the bone spur and has a resorptive effect.

The means of the "Pjatkoshpor" series with medical bile are excellent for the treatment and prevention of inflammation of the fascia.

After blockade with spurs, apply these creams, and you will reduce the negative effect of corticoids, soften and moisten the skin of the heels.

4. Use night orthoses

Also, in order to strengthen the action of Diprospan on the heel spur, it is necessary to create a sparing regimen for the healing fascia.

This task is perfectly handled by the night Strasbourg sock, fixing the foot in a position where the fascia undergoes minimal load and is quickly restored.

When an injection against the calcaneal spur is contraindicated?

Even with the most unbearable pain, spur blockade is contraindicated in the presence of the following pathologies:

1. tuberculosis, bronchitis and other infections;
2. cardiovascular diseases;
3. endocrine disorders;
4. impairment of calcium digestibility;
5. skin diseases of the feet;
6. obesity, etc.

Also, contraindication in women is taking COC, pregnancy, gynecological diseases. In each specific case, the doctor decides how to treat the heel spur.

Injection in the heel with a calcaneal spur - feedback and opinion of experts

Reviews on the network on the effectiveness of blockade with steroids with a calcaneal spur divided as follows:

• 55% - injections helped to get rid of the spur without side effects or with minimal damage to health;
• 35% - note high performance against the background of significant side effects;
• 10% - speak about low efficiency of blockade.

The opinion of specialists about the use of steroids in the treatment of the heel spurs is that this method gives an excellent result, but because of its complexity it is rarely used.

First of all, it is necessary to treat the spur with non-steroid medications and physiotherapy and only in the absence of a positive effect can the question of the appropriateness of the blockade be posed.

A source: http://ZdorovyeNogi.ru/blog/pjatochnaja-shpora/blokada-pjatochnoj-shpory-ukol-inektsija-v-pjatku-pri-pjatochnoj-shpore/

Injections in the heel of the spur (blockade): features of the method of treatment

Blockage of the calcaneal spur by pricking is performed with pronounced edema of the foot and severe pain syndrome.

Manipulation involves targeting in soft tissues over the osteophyte (bone marrow) area of ​​the pharmaceutical with analgesic, anti-allergic and anti-inflammatory effect. Usually, steroid hormones are used for this purpose.

Mechanism of introduction of the drug into the heel spur

What medications are used to block pain at the calcaneal spur

Aiming pricks with a calcaneal spur require high qualification of the surgeon. Their effectiveness is maximum when the pharmaceutical product hits the inflammation area.

If the injection is incorrect, the drug is distributed in the area of ​​the sole and has no pronounced effect on the pathological focus.

On the contrary, there may be dangerous complications (inflammation of the tendon, suppuration, necrosis of tissues).

As a result, surgeons use blockades only in case of acute pain, when other treatment is not effective.

If it was possible to eliminate the pain syndrome, then it is necessary to maintain a positive state with physiotherapy and wearing orthopedic insoles.

Hydrocortisone is the hormone of the adrenal cortex. Its strong anti-inflammatory and analgesic effects are achieved only after several administrations in a short time to create an effective dose of accumulation.

Kenalog is a synthetic analogue of glucocorticoid steroids.

Diprospan contains an active substance called "betazon". This drug is used for injections and the manufacture of suspensions.

The drug is able to accumulate at the injection site for a long time, providing a therapeutic effect.

The procedure and complications from healings in the heel

Stops the patients soreness of the procedure. To tolerate the introduction of diprospan or hydrocortisone in the heel for some people is more painful than the pain syndrome in plantar fasciitis.

The pain is similar to the one that a person has to endure when removing a tooth without an anesthetic.

When the blockade is performed, the surgeon injects into the most painful point of the heel.

Because of thick integuments and dense tissues, the needle is inserted more slowly than the prick in the buttock.

To reduce the pain syndrome, the injection of diprospan is combined with the administration of an anesthetic. The classical dose of the drug for insertion into the heel is, ml. It is preferable to add anesthetic (usually lidocaine) in a similar dose. Before injection, shake the syringe thoroughly.

Usually, one procedure for eliminating a strong pain syndrome with a calcaneal spur is not enough. Nevertheless, after blockade, a person feels a significant relief of pain.

What are the advantages of blockade with diprospan:

1. effect up to 6 months;
2. rapid elimination of pain syndrome.

Disadvantages of the procedure:

• allergic reactions;
• painful introduction of a substance;
• serious side effects.

Complications from diposipanaxes

The use of glucocorticoid drugs is addictive. With frequent administration, the effective dose does not have a pronounced effect. These hormones are produced in the adrenal cortex. With their artificial introduction, the body reduces the production of its own hydrocortisone.

The danger of heel blockade is a high risk of traumatization of the plantar fascia. If this happens, a person will not be able to fully step on his foot. Other possible complications from pricks in the heel:

1. "Leaching" of calcium from the calcaneus at the site of action of glucocorticoids;
2. inflammation of the tendon of the calf muscle;
3. necrotic tissue changes in the area of ​​administration;
4. purulent lesion of the foot.

To avoid complications, the specialist conducts the blockade only after the heel bone x-ray.

It allows you to determine the location of the spur, its dimensions and calculate the dosage of the drug.

The only contraindication to injections of steroid drugs in the heel is the presence of individual intolerance drugs. Caution should be applied to blockade when:

• diabetes mellitus;
• defeat of valvular heart valves with streptococcus;
• tuberculosis;
• psychiatric illnesses;
• psoriatic plaque on the heel;
• osteoporosis of bones (reduced calcium density).

Summarize. Treating the heel spur with heel blockade with steroid preparations (diprospan, kenalog, hydrocortisone) is an effective method. However, its positive side can be leveled by the wrong choice of the injection site or damage to the plantar fascia.

Treatment of calcaneal spurs with blockades does not belong to the first line of pathology therapy. It is used only for severe pain and swelling of the foot, when other types of treatment do not bring good results.

Even after a successful blockade, the doctor's recommendations should be followed. If the cause of the disease is not eliminated, and the patient does not support the arch with orthopedic insoles, the probability of repeating plantar fasciitis is high.

A source: http://legsgo.ru/ortopediya/fasciit/blokady-ukoly-pri-pyatochnoj-shpore.html

Blockade of calcaneal spur

Among the diseases of the muscular and bone system, one of the most common diseases is heel spurs. It is detected in approximately 28% of patients older than 40 years and 88% of individuals over the age of 70 years.

With a strong puffiness, accompanied by pain in the foot, the doctor appoints a blockade of the calcaneal spur.

The essence of the procedure is the introduction of steroid hormones into the muscles over the bone growth with anti-inflammatory and analgesic effect.

The action of the injection is almost instantaneous, the swelling and pain are quickly removed.

Causes of the disease

The heel spur is formed by a combination of several negative factors, such as:

1. Flat feet,
2. Metabolic disorders,
3. Excessive load on the foot (excess weight, wearing uncomfortable shoes, long stay on legs),
4. Gout,
5. Problems with the spine.

Constant tension of ligaments with time leads to the development of their chronic inflammation and proliferation of bone tissue in the attachment of tendons and ligaments in the heel. Usually, the bony build-up is formed from the plantar side, but sometimes it appears on the back of the heel.

Locations of calcaneal spur formation

The disease is accompanied by severe pain during movement.

Especially strongly it is felt in the morning after waking up or as a result of long stay of a foot in a resting state. Pain with calcaneal spur is characterized by patients, as burning, piercing.

Their feelings are compared with a nail in the heel. One of the methods of treatment is blockade of the calcaneal spur.

Key points of treatment

Blockade is a complicated manipulation, which is possible only by an experienced surgeon, whose professional actions directly affect the final result.

The surgeon needs to make an exact injection in the most painful place on the heel, which is distinguished by a high density of tissue and a fairly thick layer of skin, with the needle being introduced much more slowly than with conventional injections.

The patient at this time is in great pain. Therefore, carrying out the procedure requires the doctor to have a certain skill and effort.

The procedure should be performed by an experienced surgeon

In the event of a violation of the technique of the injection, the injected drug does not reach the inflammatory focus, but spreads along a number of located tissues, which significantly reduces its therapeutic effect. Correctly executed pricks with a calcaneal spur lead to a significant pain relief, which is noted by almost all patients.

Wrong execution technique is fraught with:

• The onset of sepsis (severe inflammatory process);
• Appearance of suppuration;
• Inflammation of the tendon on the leg.

Because of this, if you have a spur on the heel, the blockade is applied only in case of acute pain and when other methods of treatment do not give a positive result.

When a blockade is prescribed for treatment

Blockade with calcaneal spur is performed with a pronounced edema of the foot and severe pain syndrome, as well as in those cases when conservative treatment did not give a positive result.

That is, in the beginning, medications, compresses, therapeutic exercises and massage, ultrasound therapy are prescribed. With age-related changes in the heel, conservative treatment usually does not help and even aggravates the patient's condition.

It is then that blockage of the heel spur is shown.

The doctor makes an injection in the heel

How many injections need to be performed depends on the individual characteristics of the organism and the severity of the course of the disease. A doctor can prescribe a blockade at the request of the patient himself, if he does not want to wait for the results of drug therapy and suffer the pain.

What medications are used to block pain at the calcaneal spur

To date, there are several types of drugs that surgeons inject, making heel prick on the heel spur.

The most commonly prescribed drugs are diprospan, hydrocortisone, Kenalog.

Especially popular is the blockade with diprospan in the heel spur because of its long therapeutic effect, that is, the ability to accumulate in the body.

The drug is produced in the form of a suspension or injection solution. Diprospan contains the substance betamethasone, which is a steroid hormone. This drug has anti-inflammatory, immunosuppressive and anti-allergic action.

Steroid preparations for injections

Some patients are stopped by the high morbidity of the procedure, which seems more painful than the patience of pain from the disease itself.

In order to reduce the pain from a prick, diprospan with a calcaneal spur is usually combined with the introduction a suitable anesthetic (analgesic), for example lidocaine (diprospan and lidocaine are taken in equal relations).

One procedure with a severe neglect of the disease is not enough, but the relief will be significant. So it's worth to endure a couple of minutes to get rid of the terrible everyday pain.

Kenalog and hydrocortisone, which are less effective than diprospan, are also often used for blockade.

The disadvantage of hydrocortisone is that it must be administered several times in a short period of time to achieve an analgesic effect.

Pros of blockade with diprospan:

1. The effect lasts up to six months;
2. Quickly removes pain.

Disadvantages:

• Allergy to the components of the drug;
• Painfulness of manipulation;
• The presence of side effects.

Are you worried about the cost of the blockade and whether it is affordable for everyone? The procedure has an affordable price, which justifies a lasting effect.

Possible consequences of the blockade

If the patient chose to perform this procedure, he should understand the possible consequences of the blockade, among them:

1. The patient develops osteoporosis (a disease that lowers bone density and increases the risk of fractures);
2. Elution of calcium;
3. Necrosis of tissues;
4. Inflammation of tendons in calves;
5. Fracture of the fascia (the membrane covering the tendon, muscle) of the foot.

To avoid possible complications, the surgeon does the injection only after qualitative radiography of the calcaneus. This allows you to more accurately locate the location of the spur, its dimensions and calculate the dosage of the drug.

The procedure of blockade is sometimes done under the control of the ultrasound machine, which ensures a more accurate entry of the drug into the area of ​​inflammation and excludes damage to the nerve and muscle tissue.

The blockade under the control of the ultrasound machine

Contraindications to the implementation of blockade spurs on the heel

Blockade is contraindicated for individual intolerance of the drug or its components. Doctors with extreme caution perform the procedure when:

• Tuberculosis;
• Presence of streptococcal infection in the heart;
• Psoriasis on the heel;
• Diabetes mellitus;
• Any psychiatric problems;
• Osteoporosis.

Apparently, there are not too many contraindications, and even with the above-mentioned diseases it is possible to carry out a blockade, but only by experienced doctors.

Recommendations for the prevention of recurrent heel spurs

When the remedy is successfully introduced and the heel spur blockade is recognized by the doctor as effective, the patient should adhere to the following recommendations:

1. Observe for gentle heel regimen;
2. To apply orthopedic insoles;
3. Wear extremely comfortable shoes;
4. Regularly engage in exercise therapy;
5. To conduct massage.

Preventive actions

Even if the block of the heel spur is successful, the pain and inflammation are gone, it is very important to carefully follow the doctor's recommendations, Until the true cause of the disease is eliminated and preventive measures are taken, there remains a high probability relapse. As prevention it is important to maintain the arch of your foot with orthopedic insoles on a daily basis.

A source: https://NogivNorme.ru/bolezni/pyatochnaya-shpora/blokada-pyatochnoj-shpory.html