- X-ray stimulation
- Orthovolt therapy
Cause and development of a heel spur
The cause of heel spur development is based on increased pressure and tensile stress on the tendon attachments on the heel bone body. This stimulus triggers conversion processes in the tendon fibers, which ultimately leads to a spur-like, footward-facing new bone formation. The heel spur can lead to an inflammatory reaction of the surrounding tissue due to its pressure load. Triggering factors for the development of a heel spur are
- Age
- Overweight (Adiposity)
- Bad footwear
- Overloads (job and sport)
- Foot malformations with elongation of the longitudinal arch of the foot (frequently: buckling and flat foot, sometimes also splayfoot).
X-ray irradiation
A further measure for the treatment of a heel spur is X-ray stimulation radiation. Often used in orthopedics after hip replacement (to prevent excessive bone formation), X-ray radiation can also be used to treat heel spurs. X-rays are radioactive radiation with accelerated particles that can penetrate tissue depending on their strength.
Especially less dense tissue, such as skin and fatty tissue, can be penetrated unhindered. On denser tissues, X-rays are usually reflected or absorbed. Such structures are then shown as a bright area in the X-ray image.
X-rays per se are cell-damaging. The more intensive the X-rays are chosen, the greater the damage the radiation can cause to the irradiated tissue. In the case of heel spur treatment, the X-rays are selected so that the surrounding tissue can be penetrated without any problems, but when they hit the tissue of the heel spur they carry so much energy that the bony tissue and the cells are irreversibly damaged.
This ultimately leads to the fact that the bony tissue of the calcaneal spur is increasingly degraded and becomes smaller. Sometimes repeated applications are necessary until the desired effect can be achieved. It is important to ensure that the energy of the X-rays is chosen accordingly so that the amount is not too damaging.
Furthermore, in contrast to shock wave irradiation, even more care must be taken with X-ray irradiation to ensure that the radiation is directed directly at the area to be irradiated, in this case the heel spur. If the area is too large, surrounding, unaffected tissue, such as nerves and blood vessels, may be irreversibly damaged by the X-rays. The possible side effects would be bleeding, sensitivity disorders and possibly nerve pain.
Occasionally, irritation of the skin in the area of the irradiated area may also occur. This is because the X-rays must first penetrate a corresponding area of skin before they reach the bone. This can lead to the described irritation of the skin and corresponding irritation.
In order to minimize the side effects, cooling gels can be applied to the skin after X-ray irradiation. The skin usually regenerates within a few days. After several weeks, there is usually no longer any sign of the irradiation.
In both shock wave therapy and X-ray radiation, it is not the case that the bony structures have suddenly all disappeared; in most cases, a slow reduction of the heel spur signals a good response to the therapy. At the first appointment, the patient receives a detailed consultation in which the attending physician also looks at all the diagnostic tests (such as X-rays) again. In addition, the patient is informed about side effects and risks and his or her questions are answered.
The irradiation of the calcaneal spur is individually adapted to the patient by computer programs so that only the region of the calcaneal spur is irradiated. The next appointment will be the actual irradiation, which usually only takes a few seconds to minutes. The irradiation is then performed approximately twice a week for three to eight weeks, depending on the radiation dose used.
After the irradiation cycle, follow-up appointments will be arranged to discuss the success of the therapy and the further procedure. Irradiation of the calcaneal spur usually takes five weeks.During this time, the heel is irradiated with low-dose radiation, usually twice a week. The majority of patients are free of pain and discomfort after this five-week treatment.
In some cases, the irradiation of heel spurs shows effects after only three weeks. However, it is also possible that the pain does not disappear after the first five weeks. In this case, the therapy period is extended to up to eight weeks.
If complete freedom from pain is not achieved after this treatment period, the cycle can be repeated after two to three months. Pain relief after radiation of the calcaneal spur varies from patient to patient. Thus, it is possible that already after the first or second irradiation the pain will improve.
After a radiation cycle of three to five weeks, most patients are free of pain. However, the pain can also become stronger in the short term during irradiation. However, this should not cause concern, as this is a known side effect.
Rarely, no pain relief of the heel spur can be achieved after the first irradiation cycle, so that a further treatment sequence can be connected after a few months. The prognosis for pain irradiation of heel spurs is generally very good. About 80-90% of patients are pain-free after the first treatment cycle.
In about 60% of the patients the pain relief is permanent after the heel spur irradiation. If the irradiation in the first cycle did not achieve a sufficient effect, a further treatment cycle has to be discussed and if necessary, the treatment has to be continued after a few weeks or months break. Since the irradiation does not cause any changes in bones or joints, but only serves to relieve pain, pain can occur again in rare cases due to a recurring inflammation of the calcaneal spur.
Since the irradiation is a therapy with ionizing radiation, side effects may occur occasionally during treatment. However, the radiation exposure of the heel spur is very low (about 6 Grey) and limited to a small region of the body. Side effects are therefore rare.
In very rare cases and in the case of pre-damaged skin, skin irritation, rashes or redness may occur at the site of irradiation. In addition, a temporary increase in pain is possible during irradiation. In general, the sensitive genitals are particularly at risk during irradiation, as the genetic material can change.
Therefore, one should consider whether radiation is really necessary for men or women who still want to have children. However, since nowadays radiation can be targeted very locally and because of the low doses, a negative influence on the sexual organs is very rare. Before irradiation of the calcaneal spur in women, pregnancy should definitely be ruled out, as the therapy can lead to abortion or malformations in the unborn child. In principle, the risk of causing a tumor by irradiation of the calcaneal spur cannot be excluded, although this is very unlikely with the low dosage.
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