Effect of Additional Sural Nerve PRF in Chronic Heel Pain
August 13, 2026 updated by: Damla Yürük, Diskapi Teaching and Research Hospital
Does Targeting the Sural Nerve in Addition to the Posterior Tibial Nerve Increase the Effectiveness of Pulsed Radiofrequency Treatment in Chronic Plantar Heel Pain?
This observational study aims to compare the effectiveness of pulsed radiofrequency (PRF) treatment applied to the posterior tibial nerve alone versus PRF applied to both the posterior tibial and sural nerves in patients with chronic plantar heel pain.
Outcomes will be assessed using the Visual Analog Scale (VAS) and the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score at baseline, 1 month, and 3 months after treatment.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
This prospective observational cohort study evaluates whether the addition of sural nerve pulsed radiofrequency (PRF) to posterior tibial nerve PRF is associated with greater clinical improvement in patients with chronic plantar heel pain. In routine clinical practice, ultrasound-guided PRF is applied to the posterior tibial nerve, and in selected patients, additional PRF of the sural nerve is performed based on clinical judgment.
Patients are prospectively followed in two groups according to the treatment received: posterior tibial nerve PRF alone and posterior tibial nerve PRF combined with sural nerve PRF. Clinical outcomes are assessed at baseline and at 1 and 3 months after the procedure. Pain intensity is evaluated using the Visual Analog Scale (VAS), and functional outcome is assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. Changes in these outcomes are compared between the two groups during the follow-up period.
Study Type
Observational
Enrollment (Estimated)
48
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
-
Ankara, Turkey (Türkiye), 06500
- Recruiting
- Ayse Betul Acar
-
Contact:
- Omer Taylan Akkaya
- Phone Number: 05325569847
- Email: dr.taylanakkaya@gmail.com
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Sampling Method
Non-Probability Sample
Study Population
Patients aged 18 to 65 years with chronic plantar heel pain who are eligible for ultrasound-guided pulsed radiofrequency (PRF) treatment and have a baseline Visual Analog Scale (VAS) pain score greater than 5. Eligible participants are prospectively enrolled and randomized to receive either PRF of the posterior tibial nerve alone or PRF of both the posterior tibial and sural nerves.
Description
Inclusion Criteria:
Age between 18 and 65 years
Presence of chronic plantar heel pain
Baseline VAS score >5
Exclusion Criteria:
History of foot fracture or tumor
Pregnancy
Coagulopathy or use of antiplatelet therapy
Cognitive impairment preventing informed consent
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
|
Posterior tibial nerve PRF
Patients with chronic plantar heel pain who received ultrasound-guided pulsed radiofrequency treatment applied only to the posterior tibial nerve as part of routine clinical care.
|
Ultrasound-guided pulsed radiofrequency applied to the posterior tibial nerve, with or without additional application to the sural nerve.
|
|
Posterior tibial + sural nerve PRF
Patients with chronic plantar heel pain who received ultrasound-guided pulsed radiofrequency treatment applied to both the posterior tibial nerve and the sural nerve as part of routine clinical care.
|
Ultrasound-guided pulsed radiofrequency applied to the posterior tibial nerve, with or without additional application to the sural nerve.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
VAS
Time Frame: Baseline, 1 month, and 3 months post-procedure
|
Visual Analog Scale (VAS) is a simple tool used in clinical trials to measure pain intensity.
Patients rate their pain on a scale, typically from 0 (no pain) to 10 (worst imaginable pain).
It provides a quick, quantitative assessment of subjective pain and is commonly used to evaluate treatment effectiveness before and after intervention.Change in pain intensity assessed by Visual Analog Scale (VAS)
|
Baseline, 1 month, and 3 months post-procedure
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
AOFAS
Time Frame: Baseline, 1 month, and 3 months post-procedure
|
American Orthopaedic Foot and Ankle Society (AOFAS) score is a clinical outcome measure used to assess foot and ankle conditions.
It combines pain (40 points), function (50 points), and alignment (10 points) into a total score out of 100.
Higher scores indicate better clinical status.
It is frequently used in clinical trials to evaluate surgical or conservative treatment outcomes.
|
Baseline, 1 month, and 3 months post-procedure
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Wu YT, Chang CY, Chou YC, Yeh CC, Li TY, Chu HY, Chen LC. Ultrasound-Guided Pulsed Radiofrequency Stimulation of Posterior Tibial Nerve: A Potential Novel Intervention for Recalcitrant Plantar Fasciitis. Arch Phys Med Rehabil. 2017 May;98(5):964-970. doi: 10.1016/j.apmr.2017.01.016. Epub 2017 Feb 14.
- Agyekum EK, Ma K. Heel pain: A systematic review. Chin J Traumatol. 2015;18(3):164-9. doi: 10.1016/j.cjtee.2015.03.002.
- Yildiz G, Perdecioglu GRG, Yuruk D, Can E, Akkaya OT. Comparison of tibial nerve pulsed radiofrequency and intralesional radiofrequency thermocoagulation in the treatment of painful calcaneal spur and plantar fasciitis: a randomized clinical trial. Pain Med. 2024 Aug 1;25(8):493-499. doi: 10.1093/pm/pnae029.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
June 1, 2025
Primary Completion (Actual)
May 1, 2026
Study Completion (Estimated)
September 1, 2026
Study Registration Dates
First Submitted
January 26, 2026
First Submitted That Met QC Criteria
January 26, 2026
First Posted (Actual)
February 3, 2026
Study Record Updates
Last Update Posted (Actual)
August 17, 2026
Last Update Submitted That Met QC Criteria
August 13, 2026
Last Verified
August 1, 2026
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Sural-Posterior Tibial PRF
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.