The radiologists
seem to have invented this illness called 'calcaneal spur’.
In private practice, I have never found this to be the cause of pain
in the heel.
Most of the times, pain in the heel is due to plantar fasciitis. This
pain is maximum in the morning, on getting out of bed and then gradually
reduces on ambulation as the day passes.
Cold compression or hot fomentation, weight reduction (if overweight)
and arch support/scooped heel padding helps this illness to pass off.
Patients with acute pain can be sent for local injection of steroids
(which is also painful, while being given).
Next time, do not blame the calcaneal spur, which is normally seen
in many patients!
HEART
ATTACK PATIENTS NEED BETTER SECONDARY PREVENTION
Even though secondary prevention after acute myocardial infarction
reduces the risk of recurrence and death, its implementation
remains suboptimal. Dalal and colleagues describe drug and other
treatments available after myocardial infarction. Antiplatelet
drugs, statins, angiotensin converting enzyme inhibitors, and
beta blockers are the four main prophylactic drugs. Organisation
of care and nurse led clinics for secondary prevention, cardiac
rehabilitation, and smoking cessation may improve outcome, but
not all patients receive all the treatment they need. Up to
20% of patients are depressed after myocardial infarction, and
this is associated with increased mortality.
BMJ, 2004; 328,693. |
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital,
Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital,
Mumbai 400 008.
|
