Plantar Fasciitis Treated with TAME — Case Report

(Photo taken with the patient's consent)

Ms. K, 76 years old, had been experiencing pain in her right heel for more than 2 years. After seeking medical help, she was diagnosed with "plantar fasciitis".

Despite long-term use of painkillers and pain patches, and despite rehabilitation therapy, several local injections, nerve blocks, and proliferative therapy, the pain persists, reaching a pain index of the highest level of 10. The pain is so severe that walking is impossible, requiring a wheelchair, and the patient cannot sleep without medication.

After various treatments proved ineffective, the patient sought treatment at National Cheng Kung University Hospital Orthopedics Clinic and was subsequently referred to the Interventional Medicine Center for further discussion.

After discussion, Bow Wang, M.D. ultimately chose to perform "transarterial embolization treatment" for Ms. K. Guided by X-ray fluoroscopy, under local anesthesia, a microcatheter was inserted through a puncture in the inguinal artery to the painful area. Under arterial angiography, contrast agent was injected to identify newly formed capillary-like vessels. Embolizing medication was then injected through the microcatheter to remove these abnormal capillary-like vessels.

Normal Foot Plantar Fasciitis Angiography Comparison

After the embolization procedure,Ms. K's pain was significantly reduced that eveningAfter two weeks of treatment, her pain index dropped from 10 to 5, and she can now walk short distances.

           (Photo taken with patient's consent)

However, Bow Wang, M.D. reminds that the application of transarterial embolization (TACE) for plantar fasciitis has limitations:

The main indication is a pain index exceeding 5, and patients who have not shown significant improvement after more than three months of various treatments.

This treatment is not suitable in the following situations:

1. Severe tendon damage or rupture

2. Pain accompanied by other nerve compression symptoms, such as numbness

3. Poor kidney function (eGFR < 30 mL/min/1.73m2)

4. Low platelet count, abnormal coagulation function

5. The patient is unable to lie flat for two hours

6. Pregnancy

Treatment side effects may include local hematoma and bruising at the puncture site; temporary local discoloration at the embolization site may occur, which will improve and disappear within a few days to a month.

It is recommended that patients undergo a detailed evaluation by a physician to confirm the true source of pain, and have a thorough discussion with their doctor and family to understand the treatment process and related precautions before receiving treatment for better assurance.