Introduction to achalasia II

  Heel pain has many causes and a high incidence, and there is no specific treatment for it. At present, the clinical treatment for achalasia generally follows the principle of conservative first and then surgery.  Non-surgical treatment is effective in more than 90% of patients, but since it is not possible to determine which treatment has a definite effect, it is often necessary to combine several methods for comprehensive treatment. In some patients, even if they are not treated, the pain can eventually be relieved by itself. However, some patients have pain that can last for years.  (1) Prevent wearing hard-soled shoes and prolonged standing. Reduce weight in obese patients.  (2) Wear heel pads or insoles for heel pain.  (3) Plantar transthermal physiotherapy. Such as ultrasound, myoelectric stimulation, hot and cold therapy, etc.  (4) Soak in blood-vitalizing herbs.  (5) Take anti-inflammatory and pain-relieving drugs.  (6) Local closure with prednisolone acetate.  (7) Extracorporeal shock wave therapy Current research suggests that the mechanism of extracorporeal shock wave treatment for achalasia is that shock waves do not damage soft tissues, but have an impact on hard tissues such as stones and bone. Therefore, when the shock wave acts on the heel attachment point of the plantar fascia, it is equivalent to deep micro-motion massage, which can soften the local hardened tissues due to chronic inflammation, reduce local congestion, and improve microcirculation, thus reducing the local accumulation of tissue metabolites. In addition, the shock wave overstimulates the nerve receptors and therefore has a closing effect, which can make the local pain reduced.  2.Surgical treatment Very few patients can be treated surgically after more than 6 months of non-surgical treatment is ineffective.