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anatomy question

Posted by BrianJ on 3/14/04 at 19:12 (147004)

Which is further from the surface of one's skin (i.e., which is 'deeper'), the lateral epicondyle or the origin (at the heel) of the plantar fascia? I'm asking this question because I'm trying to determine whether the successful use of nitric oxide patches to treat tennis elbow suggests they could treat PF as well. I would also assume that tissue density, not just tissue thickness, determines how well the topical medicine would reach the fascia.

Re: anatomy question

Dr. Z on 3/14/04 at 19:29 (147010)

Brian

Good question. I though about this and here is my thinking. There is alot more fat in and around the plantar fascia so the penetration may be different. If I had pf I might try this with other treatments. I am not sure of this but I could use an ultrasound and try to determine deep in both areas.. The question is do you apply from the side or the bottom of the foot. How can you keep the patch on the foot 24 hours? See everytime I think about this more questions pop up. It does sound interesting.

Re: anatomy question

Dr. David S. Wander on 3/15/04 at 12:55 (147054)

Brian

The patches cause vasodilation/increased blood flow to the area. The patch can not selectively dilate some vessels and not other vessels. Any vessels in the depth penetration of the medication will vasodilate. The plantar fascia itself is not vascular, but increasing the blood flow around the fascia may enhance the healing process. In addition to the possibility of causing a headache, the medication should be used with caution with patients that have low blood pressure and all medications that a patient must also be considered for potential interactions.

Re: anatomy question

Robert J on 3/15/04 at 17:53 (147073)

Brian--

Just curious, where are you planning on getting the NO patches?

Re: anatomy question

BrianJ on 3/15/04 at 21:02 (147090)

I think the patches are only available by prescription, so I'll have to find a doctor to prescribe them. I assume this is an 'off label' use, so that may be difficult.