A 62 old white Caucasian female attended my clinic complaining of left sided heel pain. The onset was sudden and thought by the patient to be caused by an ill fitting pair of narrow slip on shoes, which were quickly discarded. The pain was severe on the first few steps and eased during the day.
As she attends my clinic for regular foot care the patient requested that I investigate the problem.
She is a keen lawn bowler; if the condition became chronic this would hinder her enjoyment and participation of the bowling.
She additionally reported a problem with cramping in the lower leg.
The patient is in good general health, with the exception of being 1 ½ stone overweight. The VAS score was taken as 3 when rising and eased to a 1 throughout the day. The patient had a history of plantar fasciitis which was diagnosed by ultrasound at the Lister Hospital in Stevenage during June 2007. It was then treated over a number of weeks by the Hospital’s Physiotherapy Department. The patient had been symptom free for a number of months.
The toes were passively dorsiflexed and the area around the medial tuberosity was palpated, which proved to be maximally painful for the patient. No swelling was noted around the site.
The nature and cause of the injury was clear and a diagnosis of recurring plantar fasciitis was made.
As this was a relatively recent injury although a recurrence of an old problem it was thought that acupuncture would be an ideal treatment. The patient was happy for me to use this mode of treatment and had no problem with needles. The condition was sub acute and dry needling with manual stimulation every 5 minutes was suggested.
Treatment Administered and outcome
Treatment: Acupuncture for 20 minutes UB61, UB57, GB34, GB41, Ki1 and ST44. The needles were manually stimulated every 5 minutes.
The patient reported feeling energised after needling.
She was given new exercises to be done in the morning before rising and again in the evening. Also, she was instructed to rub a golf ball into the painful area and ice for 5 minutes.
Review: 1 week
Outcome: The VAS had changed from a 3 to 2 and the cramping was greatly improved. No side effects were reported.
Treatment: Acupuncture for 30 minutes UB61, UB57, GB34, GB41, Ki1 and ST44. I forgot to manually stimulate the needles.
Review: 1 Week
Outcome: The VAS had moved back to a 3. The patient had been on holiday and done a lot more walking than normal, but she did wear sensible walking shoes. She was re-instructed to continue with her home treatment plan. The lower leg cramping had gone.
Treatment: Acupuncture for 30 minutes UB61, UB57, GB34, GB41, Ki1 and ST44. The needles were manually stimulated every 5 minutes.
Review: Next Chiropody appointment in 2 weeks
Outcome: The VAS has changed from a 3 to a 0. To date no further acupuncture treatments have been required.
This patient had no problem with acupuncture needles and responded very well to the treatment. She reported no adverse side effects, only feeling more energized after the treatment.
The VAS score increased back to a ‘3’ on the second treatment, but the patient had been on a walking holiday and did not do any home treatment during this period. Also, the needles were not manually stimulated on the second treatment; it is not known how much of a difference this would have made?
The patient was extremely pleased with the outcome of the treatment with the VAS moving to a ‘0’ after only the third treatment. No further treatments have been necessary.
Local and distal points chosen on their therapeutic effects
UB61- Heel pain, cramp
UB57 – Spasms of the calf muscles, plantar fasciitis. Heat sensation sole of the feet with inability to stand for long, flaccidity and weakness of leg cramp.
GB34 – Pain and swelling of the leg, heat in sole of feet
GB41 – Foot pain, swelling, and pain of the lower leg and all disorders of the feet.
ST44 – Very important analgesic point for the lower limb.
Ki1- Very important analgesic point for the lower limb. It is the foot chakra, for pain relief of the leg.
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