Zhiji Chen

Objective: To evaluate the effectiveness of ultrasound‐guided tibial nerve block (TNB) with extracorporeal shock wave therapy (ESWT) versus ESWT alone or ESWT with fascial injection (FI) in plantar fasciitis (PF) of various courses. Methods: This retrospective cohort study enrolled 209 PF patients (101 acute, 108 chronic), categorized into three groups: ESWT alone (Group A), ESWT‐FI (Group B), and ESWT‐TNB (Group C). Pain intensity and foot function were assessed via visual analogue scale (VAS) and American Orthopaedic Foot‐Ankle Society (AOFAS) scores at baseline and 1‐, 3‐, and 6‐month follow‐ups. Subgroup analysis was performed stratified by calcaneal spur size. Multiple linear regression was applied to identify independent predictors of pain relief, and subgroup analysis stratified by calcaneal spur size was further performed to characterize treatment response across spur‐length strata. Results: For acute PF, Groups B/C yielded lower 1‐month VAS vs A (mean difference = 1.094, 95% CI 0.759–1.429, p < 0.001; mean difference = 1.414, 95% CI 1.088–1.739, p < 0.001), with no intergroup differences at 6 months (all p > 0.05). In chronic PF, Groups B/C maintained superior VAS/AOFAS improvements at all timepoints; and Group C showed the largest 1‐month VAS reduction vs A (mean difference = 2.998, 95% CI 2.662–3.333, p < 0.001). Regression identified calcaneal spur length as an independent negative predictor of pain relief (standardized β = −0.166, 95%CI −0.090−0.031, p < 0.001). Subgroup analysis revealed Group C optimal for spurs < 2.5 mm, comparable efficacy of B/C for 2.5–5 mm spurs, and superior ΔVAS in Group B for spurs > 5 mm. Only two transient heel numbness and five transient post‐ESWT pain flares occurred, without severe adverse events. Conclusion: For chronic PF, ESWT combined with interventional therapy (especially TNB) provides greater clinical benefit. Heel spur length can serve as a predictor to guide individualized combination therapy (fascial injection or nerve block).

Objective: Compare the clinical efficacy of CT‐guided blunt versus sharp needles for dorsal root ganglion‐pulsed radiofrequency (DRG‐PRF) in treating zoster‐associated pain (ZAP). Method: This retrospective study analyzed 70 ZAP patients receiving CT‐guided DRG‐PRF between January 2021 and December 2024. Participants were divided into the blunt needle group (BNG, n = 30) and the sharp needle group (SNG, n = 40). Evaluated endpoints encompassed SF‐MPQ scores, postoperative analgesia use, intraprocedural trajectory pain (NRS), operative time, number of CT scan slices, and incidence of complications. Result: The BN group showed lower puncture NRS scores, shorter operative time, and fewer CT scan layers than the SN group ( p < 0.05). SF‐MPQ scores (PRI, VAS, and PPI) decreased in both groups postoperatively ( p < 0.05), with lower PRI and PPI in the BN group at Day 1, Week 1, and Months 1 and 3 ( p < 0.05). Pregabalin use was lower in the BN group at Months 3 and 6, and tramadol use was lower at Week 1 and Month 1 ( p < 0.05). Conclusion: CT‐guided DRG‐PRF demonstrates good analgesic efficacy in the treatment of ZAP. Compared with sharp needles, blunt needles show superior performance in terms of intraoperative puncture pain, procedure duration, radiation exposure, and postoperative medication use. As an optimized puncture instrument for DRG‐PRF, the blunt needle holds promise for broader clinical application and warrants further promotion. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2500102560