251 Japour

251 Acetic acid iontophoresis has been considered an effective treatment modality for the relief of heel pain1 and has become a standard approach to the treatment of calcific bursitis and tendinitis of the shoulder.2 Iontophoresis introduces ionizable substances into the body for therapeutic purposes by means of a direct current (Table 1).1 In this case, the acetate radical is introduced under the cathode and deposited subcutaneously, permeating the area around the calcific deposit (Fig. 1). Potential areas of inflammation and subsequent calcium deposition leading to retrocalcaneal spurs are the tendo Achillis insertion on the calcaneus, retrocalcaneal bursae, and superficial Achilles bursae (Fig. 2). Infracalcaneal spurs are formed in the same manner in areas of inflammation and subsequent calcium deposition at the insertion of the plantar fascia on the calcaneus (Fig. 2). The acetate radical is more chemically active than the carbonate radical in the calcific area, replacing the carbonate radical and forming calcium acetate, which is blood-soluble. The presumed chemical reaction is as follows3: