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March 20, 1978

Management of Heel Pain

Author Affiliations

Fort Lauderdale, Fla

JAMA. 1978;239(12):1131. doi:10.1001/jama.1978.03280390027006

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To the Editor.—  I would take some exception to the advice of N. J. Giannestras, MD, to the physician from New York with regard to the use of a heating pad applied to the foot in a patient described as having mild diabetes with probable arteriolar disease (238:2419, 1977). Should this patient indeed have compromise in his arterial circulation in the lower extremity, as may well be the case in a man 77 years of age with diabetes and coronary heart disease and possibly some degree of peripheral neuropathy, such treatment may well be the precursor of more serious lesions of the foot, eg, burn that in turn could lead to disastrous complications.If the patient's only complaint is a brief period of sharp pain, which he relates stops on ambulation, in the plantar surface of the foot, that in itself may well be the only treatment required.