From the Research
Calcaneal enthesopathy is a condition characterized by degeneration and inflammation at the attachment site of tendons or ligaments to the heel bone (calcaneus), most commonly affecting the Achilles tendon insertion or the plantar fascia attachment, and is typically treated with conservative measures such as rest, NSAIDs, and physical therapy exercises. The condition typically causes pain, tenderness, and sometimes swelling at the affected area, and can be caused by repetitive microtrauma, overuse, improper footwear, biomechanical abnormalities, or systemic conditions such as rheumatoid arthritis or seronegative spondyloarthropathies 1. Some key points to consider in the treatment of calcaneal enthesopathy include:
- The use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to reduce pain and inflammation 2
- The importance of physical therapy exercises to stretch and strengthen the affected structures, with eccentric stretching exercises achieving a 40% reduction in pain 2
- The potential benefits of extracorporeal shock wave therapy, which has been shown to reduce pain by 60% with a patient satisfaction of 80% 2
- The consideration of surgical intervention in cases where conservative treatment has failed, with open debridement allowing all pathologies to be addressed, including osseous abnormalities and intratendinous necrosis 2 It is also important to note that the condition can be associated with impaired quality of life, particularly in patients with axial spondyloarthritis, where ultrasonographic enthesitis is associated with impaired quality of life 3. Overall, the treatment of calcaneal enthesopathy should be individualized and based on the specific needs and circumstances of each patient, with a focus on reducing pain and inflammation, promoting healing, and improving function and quality of life.