**Low-Dose Radiotherapy of Painful Heel Spur/Plantar Fasciitis as an Example of Treatment Effects in Benign Diseases**

Robert Michael Hermann, Frank Bruns and Mirko Nitsche

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/67058

#### **Abstract**

Degenerative changes in the plantar fascia may cause the so‐called "painful heel" with typical projections of tenderness. This condition is often associated with a plantar heel spur. Radiotherapy with low doses (LD‐EBRT) has been well known for its anti‐inflam‐ matory potential. In the recent years, several microbiological mechanisms were eluci‐ dated to explain immunomodulation by LD‐EBRT. Furthermore, a randomized study proved the clinical efficacy of this therapy in plantar fasciitis. Two other trials defined a fractionation schedule of 6 × 0.5 Gy twice weekly as the new standard therapy. Taken together, LD‐EBRT is an effective and safe therapeutic option for patients over 30 years of age and after exclusion of pregnancy. In case of an insufficient response, a second course can be offered to the patient. There are still open questions concerning target volume definition and fractionation of LD‐EBRT. Furthermore, studies randomizing LD‐EBRT with other conservative therapeutic approaches are missing.

**Keywords:** low dose radiotherapy, heel spur, plantar fasciitis, *reizbestrahlung*, target volume definition
