Treatment Of Plantar Fasciitis Research Articles

Investigation of The Effectiveness of Extracorporeal Shock Wave Therapy in Patients Diagnosed with Plantar Fasciitis: Comparison of Radial and Focus Applications

The aim of the study was to investigate the effectiveness of radial and focus ESWT treatment on pain, function and size of the calcaneal spur in patients with clinical and radiological diagnosis of plantar fasciitis. A total of 112 patients aged between 18 and 95 years, were divided into two groups; group 1, rESWT (2.4 bar 12 hz 2000 beats), group 2 received fESWT (0.14 bar 14 hz 1000 beats) three times a week for three weeks. All patients were evaluated using the Visual Analog Scale (VAS)-pain and Foot Function Index (FFI) before and after the treatment, at 4 week and 12 weeks. Calcaneal spur size was measured radiographically in the patients before and after the treatment at the 12 th week follow-up. According to our records, VAS scores were found to be similar between the groups before treatment and at follow-ups (all p>0.05). In both groups, a significant decrease in VAS scores was found in the follow-ups compared to before treatment (p<0.001). FFI total, pain, activity and disability scores were found to be similar between the groups before treatment and at follow-up (all p>0.05). In both groups, a significant decrease in FFI scores was found in the follow-ups compared to before treatment (p<0.001). Both of rESWT and fESWT were effective in plantar fasciitis treatment there were no significiant difference between two modalities in long term. Level of Clinical EvidenceIII

Prevalence, causes, and treatment of plantar fasciitis in young females of a medical college

BackgroundPlantar fasciitis, a common musculoskeletal disorder, is characterized by inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes. The plantar fascia plays a crucial role in supporting the arch of the foot and absorbing shock during movement. Factors such as excessive physical activity, improper footwear, and biomechanical abnormalities are recognized contributors to the development of plantar fasciitis. However, the prevalence and underlying causes may vary across different demographic groups, necessitating targeted investigations.ObjectiveThis study aims to investigate the prevalence, causes and treatment of plantar fasciitis in young female students (18–30) of a medical college in Pakistan and explore potential associations with high-heel footwear.MethodologyIn this study, a cross-sectional survey was carried out, engaging 100 young females from a medical college. Employing a structured questionnaire, we assessed a spectrum of parameters, including heel pain symptoms, footwear habits, and available treatment options. The diagnostic precision of the Windlass test, specific to plantar fasciitis, was incorporated. Rigorous data analysis, utilizing SPSS, centered on discerning associations between the nuances of high-heel wear (considering types and duration) and the reported symptoms. This methodological framework ensures a comprehensive and precise exploration of the prevalence, causes, and treatment of plantar fasciitis in our targeted demographic.ResultsAll the participants were female, and the total number was 100, of which 66% felt pain in the heel when they wore high heels. Out of this 66%, only 6% are diagnosed with plantar fasciitis. The rest of the 60% have pain in the heel due to different causes such as heel spurs, stress fractures, etc. 2% of people receive treatment with steroid injections, and 12% are treated with ice.ConclusionWe conclude that the prevalence of plantar fasciitis is high in females wearing high heels. This study reveals that an increase in the total duration of wearing high heels with hard soles increases the symptoms of plantar fasciitis. Plantar fasciitis can be prevented by education and applying ergonomics and could be treated by steroids and the ice method, according to medical practitioners.

A NEW TREND IN ORTHOPEDICS: RADIOFREQUENCY ABLATION FOR THE TREATMENT OF INTRACTABLE PLANTAR FASCIITIS

BACKGROUND: One of the most common causes of pain in the plantar region of the foot is plantar fasciitis (PF), for which there are numerous treatment options. Several invasive and non-invasive treatment modalities have been developed for this condition. One of these options for patients who do not respond to conservative treatment is radiofrequency ablation (RFA). Due to its early functional benefits and minimally invasive nature, RFA is believed to achieve successful clinical outcomes in patients with persistent early-stage PF. This study aims to evaluate the efficacy and clinical outcomes of RFA in the treatment of PF. METHODS: A total of 35 patients (46 feet), aged 31-50 years, who were treated with RFA from December 2018 to December 2019 were included in the study. AOFAS (American Orthopaedic Foot &amp; Ankle Society) and Visual Analog Scale (VAS) of patients who received conservative treatment for 3 months or longer and whose complaints persisted were pre-treatment (PrT) of RFA. These scores were re-evaluated after 3 months. RESULTS: Among the patients in the study, 10 (28.57%) were male and 25 (71.43%) were female. The mean age of the patients was 40.43±5.37 years. The PrT and post-treatment (PsT) VAS scores were 8.97±1.36 and 5.89±3.66, respectively. The PrT and PsT AOFAS scores were 48.51±10.67 and 65.86±22.74, respectively. Statistical analyses showed that the clinical outcomes of RFA were significantly improved after treatment for both scores (p

Treating Plantar Fasciitis: Platelet-Rich Plasma or Corticosteroids? A Single-Center Clinical Trial

Background: Plantar fasciitis (PF) is one of the leading causes of heel discomfort worldwide. There is no definitive treatment available for PF; however, two primary therapies are under investigation: Local injection of either corticosteroids or platelet-rich plasma (PRP). There are disagreements regarding the precise and effective dosage of these therapeutic approaches and their superiority over each other. Objectives: This study was conducted to compare the effects of corticosteroids and PRP in the treatment of PF. Methods: In this single-center clinical trial, 30 patients were divided into two groups (PRP vs. corticosteroids), with 15 patients in each group. In addition to receiving medication treatment, participants were given daily exercise regimens. The PRP group had a mean age of 44.07 ± 8.21 years, while the corticosteroid group had a mean age of 44 ± 9.85 years. The efficacy of these interventions was assessed primarily using the Numeric Pain Rating Scale (NPRS), the Roles and Maudsley score (RM), and the Foot and Ankle Disability Index (FADI). Results: Over a 3-month period, the NPRS decreased in the corticosteroid group from 7.07 ± 0.95 to 3.69 ± 1.43, and in the PRP group from 7.76 ± 0.92 to 3 ± 1.68 (P &lt; 0.001). The FADI improved in the corticosteroid group from 54.84 ± 8.33 to 75.76 ± 11.96, and in the PRP group from 49.3 ± 10.11 to 78.15 ± 16.76 (P &lt; 0.001). Plantar fascia thickness decreased in the corticosteroid group from 5.03 ± 0.62 to 4.51 ± 0.59, and in the PRP group from 5.43 ± 0.91 to 4.38 ± 1.04 (P &lt; 0.001). The results indicated that both groups demonstrated significant improvement in the first three months. Although the PRP group showed greater improvement than the corticosteroid group after three months, the differences between the two groups were not statistically significant. Conclusions: Our results showed that the effects of corticosteroid injections subside after one month, whereas PRP has more stable effects over time.

Innovative approaches in the treatment of chronic plantar fasciitis: comparison of pulsed radiofrequency ablation and surgical intervention.

This study aimed to compare the effectiveness of Pulsed Radiofrequency Ablation (PRFA) and surgery for treating chronic plantar fasciitis, focusing on pain relief and functional outcomes. A prospective study involved 30 patients with chronic plantar fasciitis unresponsive to 12 months of conservative treatment. Patients were divided into PRFA (n = 17) and surgical (n = 13) groups. Clinical evaluations were conducted preoperatively and at three, six and 12 months postoperatively using VAS, AOFAS, FFI, and RMS scores. Radiological measurements assessed foot structure impact. Both PRFA and surgery significantly reduced pain and improved function. PRFA had a shorter operative time and quicker return to activities (p < 0.001). At 3 months, PRFA showed superior VAS, FFI, and RMS scores (p < 0.05). Long-term outcomes were similar. No major complications occurred, but minor complications were higher in the surgical group (p < 0.01). PRFA is a minimally invasive, effective treatment for chronic plantar fasciitis with quicker recovery and lower complication rates compared to surgery. Both treatments offer comparable long-term benefits. Further studies are needed to confirm these findings.

Randomized placebo controlled trial of phytoterpenes in DMSO for the treatment of plantar fasciitis

Plantar fasciitis is the most common cause of heel pain in adults with an overall prevalence of 0.85% in the adult population of the US, affecting over 2 million adults annually. Most current treatment modalities are not supported by sufficient evidence to recommend one particular strategy over another. Topical application of analgesics for soft tissue pain is well established, however the plantar fascia presents challenges in this regard due to thick skin, fibrotic tissue, and an often thickened fat pad. Sixty-two patients with plantar fasciitis were randomized to a placebo controlled trial testing the efficacy of a topical solution of plant terpenes containing camphor, menthol, eugenol, eucalyptol, and vanillin. Skin permeation of the mixture was enhanced with 15% dimethylsulfoxide (DMSO), 1% limonene, and rosemary oil. One ml of solution was applied topically twice daily, and pain scores evaluated on Day 0, Day 1, Day 3, and Day 10. Using the validated foot function index 78.1% of patients reported an 85% or greater decrease in their total pain score by day 10 while placebo treatment was without effect (One Way ANOVA, P < 0.01). This study adapts the treatment modality of topical analgesia for soft tissue pain to a problematic area of the body and shows therapeutic promise.ClinicalTrials.gov Identifier: NCT05467631

Ultrasound-guided procedures for plantar fasciitis: a randomized clinical study

BackgroundCorticosteroid injections are commonly used for the treatment of plantar fasciitis. In recent years, ultrasound-guided multipuncture treatment of the fascia has been described in the literature. Our study aimed to compare the effectiveness of these two techniques in the treatment of plantar fasciitis.MethodsThe outcomes achieved over 120 days following the use of these techniques to treat plantar fasciitis were examined. A total of 81 patients were randomly selected for the study; 41 were treated with ultrasound-guided multipuncture and 40 with ultrasound-guided corticosteroid injection. Clinical examinations and ultrasound assessments were performed before treatment and at 30, 60 and 120 days post-treatment. Clinical assessments included the use of a visual analog scale (VAS) to record pain and the Foot Function Index (FFI) to evaluate function. Ultrasound was used to measure the thickness of the plantar fascia.ResultsBoth the ultrasound-guided multipuncture and corticosteroid injection techniques were associated with significant functional and echographic improvements at 4 months post-treatment (P < 0.001). Pain did not improve significantly after 120 days with ultrasound-guided corticosteroid injection, whereas significant pain reduction was observed with ultrasound-guided multipuncture.ConclusionCorticosteroid injection provides better short-term results in terms of VAS pain and FFI scores. However, ultrasound-guided multipuncture shows superior outcomes in VAS pain and FFI scores at 120 days.

A Novel Combination Strategy of Ultrasound-Guided Percutaneous Radiofrequency Ablation and Corticosteroid Injection for Treating Recalcitrant Plantar Fasciitis: A Retrospective Comparison Study.

The best treatment yielding clinical benefits was still equivocal and controversial for the treatment of recalcitrant plantar fasciitis (PF). This study aimed to propose a novel combination strategy of ultrasound-guided percutaneous radiofrequency ablation (RFA) and corticosteroid injection (CI) for recalcitrant PF, and to compare its therapeutic effects with CI alone and continued conservative management. We retrospectively reviewed consecutive patients with recalcitrant PF who underwent combined strategy (RFA + CI), CI alone, and continue conservative treatment at our institution between October 2021 and February 2023. The technical pearls were described elaborately. A comparison of demographic data and clinical outcomes, including visual analog scale (VAS), Ankle-Hindfoot Scale (AOFAS-AHS), and plantar fascia thickness, were conducted among the three groups. Seventy-one eligible patients were enrolled in this study, with 17 in the combined strategy group, 25 in the CI group, and 29 in the continued conservative treatment group. Both the combined strategy group and the CI group showed significant improvements in VAS scores, AOFAS-AHS scores, and significant reductions in plantar fascia thickness during the 12-month follow-up period compared to those preoperatively (P < 0.05). The combined strategy group achieved comparable immediate pain relief to the CI group after the intervention ([25.7 ± 15.7] vs. [20.6 ± 17.6], P = 0.850). However, the combined strategy group demonstrated superior improvement in symptom and function compared to the CI group at the 3-month (VAS: [21.9 ± 13.5] vs. [39.6 ± 20.4]; AOFAS-AHS: [77.9 ± 12.4] vs. [60.5 ± 17.4], P < 0.05) and 12-month follow-up (VAS: [15.7 ± 12.0] vs. [56.8 ± 17.5]; AOFAS-AHS: [84.5 ± 10.7] vs. [53.8 ± 12.4], P < 0.05). Obvious adverse effects or complications were not identified in either group, while two cases (11.8%) in the combined strategy group and five cases (20.0%) in the CI group experienced unsatisfactory symptom remission. We introduced and detailed a novel combination strategy involving ultrasound-guided percutaneous RFA and CI for treating recalcitrant PF. The strategy is both effective and safe in alleviating pain and enhancing function throughout the entire treatment course.

Comparison of the Short-Term Effect between Iontophoresis and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Randomized Controlled Trial.

A double-blinded randomized clinical trial was designed to evaluate the short-term efficacy of a physical treatment in chronic plantar fasciitis, namely iontophoresis, compared with radial shockwave therapy. Heel pain, health status using the EuroQol-5D questionnaire, and fascia thickness measured with ultrasound were evaluated. In total, 127 patients were randomly selected for group A and treated with iontophoresis therapy (lidocaine 0.4% and dexamethasone 0.5%), or for group B, in which they were treated with radial shockwave therapy (EWST). Measurements were taken at baseline and at follow-up during the 5 weeks of the study. Statistically significant differences were observed to the shockwave therapy group in respect to the final fascia thickness, and the VAS scale (p = 0.001). The differences between groups A and B showed that the shockwave group follow-up after 3 weeks experienced complete pain remission (1.0 ± 0.9; 95%CI 0.8-1.2) and after the 6-week follow-up, complete pain remission of plantar fasciitis was observed for both therapies. Patients had a better perception of the use of EWST at the end of the treatment, although in both groups it was satisfactory (p = 0.001). The results of this study showed a shorter-term effectiveness of shockwave treatment compared with the use of iontophoresis. However, both techniques were effective in satisfactorily reducing pain in this short period.

Views about the clinical, diagnostic and comprehensive treatment of plantar fasciitis: a review

INTRODUCTION. One of the problems in modern podiatry is plantar fasciitis. According to population studies, more than two million patients are treated for plantar fasciitis each year in the United States, 1 in 10 people will develop heel pain during their lifetime, and 1 % of visits to podiatrists are related to heel pain. Plantar fasciitis occurs in approximately 10 % of the general population, with 83 % of these patients being active working adults between the ages of 25 and 65. The high prevalence of plantar fasciitis in the population necessitates the search and development of new and effective methods for its recognition and treatment. AIM. Generalization of literature data on the mechanisms of development of plantar fasciitis, methods of diagnosis and treatment. MATERIALS AND METHODS. The databases PubMed, Scopus and the electronic scientific library eLIBRARY were searched for articles using the keywords: “plantar fasciitis”, “plantar fasciosis”, “heel pain”, “heel spur”. Search depth — 10 years. Publications related to the diagnosis and treatment of PF were selected. During the study, 40 publications were selected, the content of which, to one degree or another, corresponded to the purpose of this study. RESULTS AND DISCUSSION. Pain syndrome in the area of the heel bone is the main reason for seeking medical care in patients with plantar fasciitis. Currently, there are several approaches to the treatment of plantar fasciitis: conservative and surgical treatment. Conservative treatment is represented by methods of manual therapy, physical therapy, and physical therapy. Surgical methods include various variants of resection of the bony outgrowth of the calcaneal region and other interventions. CONCLUSION. Treatment of plantar fasciitis requires a multidisciplinary approach to treatment, as no single treatment method is universal. Conservative treatment of patients with plantar fasciitis should be comprehensive. Due to the high prevalence of plantar fasciitis in the population, the introduction of new treatment techniques and the development and use of a unified patient management tactic can improve patient outcomes and quality of life. Among other surgical methods, the use of RFD has a positive effect in patients with PF refractory to conservative therapy and is the least invasive method among surgical methods.

PROSPECTIVE STUDY ON THE EFFECTIVENESS OF PLATELET-RICH PLASMA IN MANAGING CHRONIC PLANTAR FASCIITIS

Objectives: The objectives of this study were as follows: (1) Assess the impact of a single dose of platelet-rich plasma (PRP) injection on visual analog scale (VAS) scores for heel pain. (2) Evaluate the functional outcome scores following PRP treatment for chronic plantar fasciitis. (3) Measure and confirm the restoration of plantar fascia thickness through ultrasound (USG) assessments. (4) Determine the safety and viability of local PRP injection as a treatment option for individuals with chronic plantar fasciitis. Methods: This hospital-based prospective case series, spanning January 2019 to January 2020, enrolled 40 participants aged 25–65 with unilateral, persistent plantar fasciitis resistant to conservative treatment. Exclusion criteria included BMI ≥30, various pathologies, and recent injections. Ethical clearance was obtained, and participants received autologous PRP injections, with ultrasound measuring plantar fascia thickness. Post-injection, patients were monitored for adverse reactions, initiated stretching exercises, and progressed to weight-bearing activities after 6 weeks. Results: The study cohort, averaging 45 years (standard deviation [SD] 7.7), primarily comprised females with the right-foot prevalence. Symptom duration averaged 20 weeks (SD 4.5). Pre-injection VAS scores (6.7±1.2) significantly improved at 6 weeks (2.9±0.6) and 12 weeks (2.0±0.9) post-PRP injection (p&lt;0.001). Plantar fascia thickness reduced from 5.1 mm (SD 0.6) to 4.1 mm (SD 0.5) at 12 weeks (p&lt;0.001) and regular foot thickness: 3.7 mm (SD 0.5). Conclusion: The study reveals that a singular PRP injection brings about substantial and clinically meaningful enhancements in heel pain, functional outcomes, and the restoration of plantar fascia thickness, supported by ultrasound measurements. This underscores local PRP injection as a viable and safe therapeutic choice for those grappling with chronic plantar fasciitis.

Dose Escalation Can Enhance the Therapeutic Potential of Radial Extracorporeal Shock-Wave Therapy in the Treatment of Plantar Fasciitis in Runners.

Background and Objectives: Treatment of chronic plantar fasciitis is challenging given that there are various of available treatment options with no clear gold standard. The aim of the study was to examine the dose-escalation effect of rESWT on the biomechanical parameters of the plantar fascia and pain ailments. Materials and Methods: In the experimental group (n = 30), the intensity of the shock wave was increased every two subsequent treatment sessions. In the control group (n = 32), the treatment parameters were not changed. In both groups, six treatments were performed, with two treatment sessions a week. In order to assess the biomechanical parameters of the plantar fascia, myotonometric measurements were performed. The pain intensity was assessed using the Visual Analog Scale (VAS). Results: The tension of the plantar fascia attachment in the experimental group decreased from 27.69 ± 2.06 [Hz] before treatment to 26.29 ± 1.69 [Hz] after treatment (p = 0.009) and to 26.03 ± 2.15 [Hz] 1 month after the beginning of treatment (p = 0.003). In the control group, the frequency results did not change significantly (p > 0.05). Flexibility increased in both groups. The test results before treatment and 1 month after the beginning of the treatment showed statistical significance in the experimental group (p = 0.001) vs. (p = 0.002) in the control group. The differences were not statistically significant between groups (p > 0.05). The assessment of pain intensity carried out 1 month after the end of treatment in the experimental group amounted to 3.14 ± 2.28 points, which was statistically significantly lower compared to that in the control group, where it amounted to 5.14 ± 1.92 points. (p < 0.001). Conclusions: The use of rESWT performed with an increasing intensity of impact during subsequent treatment procedures demonstrated greater effectiveness in improving the biomechanical parameters of the plantar fascia and was also more effective in reducing the pain ailments. Our results are encouraging. The dose escalation in the treatment cycle is worth considering. To prove that this method of treatment is more effective, a randomized controlled trial should be carried out on a representative sample.

Clinical Efficacy of Application-Linked Stretching Ball as Digital Therapeutics in Plantar Fasciitis.

Background/Objectives: This study aimed to evaluate the efficacy of application-linked stretching ball instruments that record the rolling time and force of patients compared with a traditional simple stretching ball. Methods: Fourteen participants with plantar fasciitis were divided into a simple massage ball group (group A, n = 8) and an application-linked massage ball group (group B, n = 6). The application-linked massage ball sends information regarding the massages, such as the frequency and force of the massage on the foot, to the application on the patient's smartphone. All clinical outcomes were evaluated at the beginning of the study and 1-, 2-, and 3-month follow-up. The primary outcome measure was the Manchester-Oxford Foot Questionnaire (MOXFQ) score. Results: At the beginning of the study, the initial MOXFQ score was not significantly different between the two groups (p = 0.948). At each time point, the MOXFQ score of the whole population did not improve significantly compared to that of the initial state (p = 0.131). Generalized estimating equation modeling demonstrated that there was no significant difference in the improvement of the MOXFQ score between groups A and B during follow-up (p = 0.826). In addition, no group-by-time interactions were observed (p = 0.457). Conclusions: The efficacy of an application-linked massage ball for the treatment of plantar fasciitis was not as definite as that of a traditional simple stretching ball in patients whose symptoms persisted for at least six months. Future studies that include patients with acute plantar fasciitis are required.

Clinical Study of a Four-Step Program for the Treatment of Plantar Fasciitis with Bone Spurs.

The most common causes of plantar and heel pain are plantar fasciitis and calcaneal spurs, and they often co-exist. Surgery is a recognized treatment for refractory plantar fasciitis. However, few studies have proposed treatment options for patients with metatarsophalangeal fasciitis with bone spurs. Accordingly, this study's purpose was to propose a four-step surgical regimen, and to improve the surgical outcome of plantar fasciitis with osteophytes and to establish a procedure for surgical treatment. Retrospective analysis of 45 patients suffering from plantar fasciitis with bone spurs from 2020 to 2023. All patients underwent a four-step procedure, including plantar fascia release, calcaneal spur grinding, inflammatory tissue removal, and calcaneal burr decompression. The imaging parameters and functional scores were recorded before and after the operation. The objective evaluation included the measurement of calcaneal spur length on radiographs. Clinical evaluation included the American Orthopaedic Foot and Ankle Society (AOFAS), the Visual Analog Scale (VAS), and the Foot and Ankle Outcome Scale (FAOS). Measurement data that conformed to normal distribution were expressed as (x2 ± s), and pre-and postoperative AOFAS, FAOS, and VAS scores were compared using repeated-measures ANOVA, and preoperative and postoperative spur lengths were compared using paired t-tests. The 45 patients were followed up for 3 to 30 months, (17.72 ± 8.53) months, at final follow-up, the patient's AOFAS score improved from preoperative (74.93 ± 5.56) to (94.78 ± 3.98), FAOS score increased from preoperative (76.42 ± 3.37) to (96.16 ± 2.74), the VAS score decreased from (3.18 ± 0.54) to (1.07 ± 1.20) (p < 0.05), the length of spur decreased from (0.72 ± 1.81) cm to (0.23 ± 1.19) cm, and there were significant differences before and after operation (p < 0.05). The four-step surgical regimen is an appropriate and effective surgical procedure to treat plantar fasciitis with bone spurs.

Comparison of Radiofrequency Ablation and Steroid Injection in the Treatment of Plantar Fasciitis; Short and Medium Term Results

Objective: Plantar fasciitis, commonly found in orthopaedic practice, may restrict daily life activities and lead to loss of workforce. We aimed to evaluate the short- and medium-term outcomes of radiofrequency ablation (RFA) and steroid injection treatments in patients with plantar fasciitis who did not benefit from conservative therapies through pain and function scores. Material and Method: Patients studied at the Hakkari State Hospital for at least six months of conservative treatment due to plantar fasciitis between 01.07.2021-01.01.2023. The patients were divided into two groups: those who received RFA and those who were given steroid injections. Demographic information of the patients, the Visual Analog Scale (VAS) and the American Orthopedic Foot Ankle Society (AOFAS) score were studied, and both gups were compared. Results: No significant difference was observed when comparing preop VAS and AOFAS values for both groups (p=0.469 p=0.244). No significant difference was observed when comparing the VAS and AOFAS values of the two groups for the first month (p=0.764 p=0.466 respectively). A significant difference was observed when comparing the VAS and AOFAS values in the post-6 month (p=0,001 p=0.001). Significant differences were observed between VAS and AOFAS values in patients receiving RFA in preop and 6 months (p=0.001 p=0.001). No significant difference was observed in preop and 6 month VAS and AOFAS values in steroid injections (p=0.512 p=0.844 respectively).No complications were observed in both groups during the follow-up period. Conclusion: In patients who have received conservative treatment but have not benefited, radiofrequency ablation has been found to be an effective, safe and minimally invasive method of reducing the severity of pain in the short to medium term and improving daily activities.

Comparison of tibial nerve pulsed radiofrequency and intralesional radiofrequency thermocoagulation in the treatment of painful calcaneal spur and plantar fasciitis: a randomized clinical trial.

Ultrasound-guided tibial nerve pulsed radiofrequency (US-guided TN PRF) and fluoroscopy-guided intralesional radiofrequency thermocoagulation (FL-guided intralesional RFT) adjacent to the painful calcaneal spur are two interventions for pain management in painful calcaneal spur and plantar fasciitis. This study aimed to compare the effectiveness of the two procedures. A prospective, randomized, single-blind study. Single-center pain clinic. Forty-nine patients who met the inclusion criteria were randomized into two groups. Group U (25 patients) received US-guided TN PRF at 42°C for 240 s, whereas Group F (24 patients) received FL-guided intralesional RFT at 80°C for 90 s. The most severe numeric rating scale (NRS) score during the first morning steps and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were used to evaluate the effectiveness of the procedures. The study's primary outcome assessed treatment effectiveness via the NRS, whereas the secondary outcomes included changes in the AOFAS score and the incidence of procedure-related mild adverse events. NRS and AOFAS scores significantly improved in Groups U and F at 1 and 3 months compared with baseline (P < .05), and there was no significant difference between the groups. At month 1, 50% or greater pain relief was achieved in 72% of patients in Group U and 75% of patients in Group F. No significant difference was observed in the incidence of mild adverse events between the groups. US-guided TN PRF and FL-guided intralesional RFT have shown significant effectiveness in the treatment of painful calcaneal spur and plantar fasciitis. Larger randomized controlled trials are needed. NCT06240507.

A Multi-centered Retrospective Study on the Efficacy of Pulsed Radiofrequency Nerve Ablation in the Treatment of Recalcitrant Plantar Fasciitis: A Mid-term Outcome.

Background Plantar fasciitis, a condition marked by persistent and often excruciating heel pain, frequently poses a formidable hurdle when conservative treatment approaches fall short. This multi-centered retrospective study embarks on a journey to explore the potential effectiveness of pulsed radiofrequency nerve ablation (RFNA), an innovative and less invasive procedure, as a novel avenue for treating recalcitrant plantar fasciitis. This investigation centers around a group of 24 patients who have faced the persistence of this challenging ailment. By meticulously scrutinizing patient outcomes and conducting a comprehensive analysis of safety aspects, this study aspires to offer enlightening revelations regarding the promise and practicality of pulsed RFNA as a therapeutic solution for tackling this intricate and tenacious condition. Methods This retrospective study included 24 patients who had undergone pulsed RFNA for recalcitrant plantar fasciitis between June 1, 2020, and June 1, 2022, at Hospital Pengajar Universiti Putra Malaysia (HPUPM), Hospital Universiti Teknologi Mara (UiTM), and Hospital Serdang. Patients were selected from the Orthopedic Clinics at HPUPM, Hospital UiTM, and Hospital Serdang and were screened according to the inclusion and exclusion criteria. Patient data was extracted from the hospital information systemand electronic medical records. Pre-procedure and post-procedure assessments were conducted at one, three, and six months on the selected patients using the visual analog scaleand American Orthopaedic Foot and Ankle SocietyAnkle-Hindfoot Scoring systems. All selected patient data was traced and tabulated accordingly. Results This study evaluates the effectiveness of pulsed RFNA in treating recalcitrant plantar fasciitis in 24 participants (39 feet). Results show a significant reduction in pain and improvement in functionality at one, three, and six months post-RFNA. Demographic factors (age, gender, and specific diagnosis) did not significantly impact outcomes. The study supports pulsed RFNA as an effective treatment for recalcitrant plantar fasciitis, emphasizing consistent benefits across various patient characteristics. Conclusion In conclusion, the study demonstrates the notable effectiveness of pulsedRFNAin improving pain reduction and functional outcomes for individuals with recalcitrant plantar fasciitis. The findings, consistent across various demographic factors, support pulsed RFNA as a promising and uniform treatment option for those who do not respond to conservative measures.

Role of insole material in treatment of plantar fasciitis: A randomized clinical trial

BackgroundIn this randomized clinical trial, we compared the early effects of polyethylene (PE), polyurethane (PU), and Carbon Fiber insoles in the treatment of PF using a set of patient-reported outcomes. MethodsPatients were randomly allocated one of the three prefabricated insoles – Carbon Fiber (n = 14), PU (n = 14), or PE (n = 17) for regular use. Their response was recorded using PROMIS 3a (for pain intensity), PROMIS 4a (for pain interference), FAOS (Foot and Ankle Outcome Score), and VAS for pain at baseline, two, six, and twelve weeks. ResultsThe PROMIS pain intensity scores improved in both the Carbon Fiber and the PE groups starting at the 6th week (p = 0.04) and 2nd week (p = 0.002), respectively. PROMIS pain interference scores also showed positive trends in these two groups (p = 0.02, p = 0.004, respectively). ConclusionPrefabricated Carbon Fiber and PE insoles showed significant pain-reducing effects in patients with PF. Levels of evidenceLevel I, Randomized controlled trial.

A Review of Common Interventions and Preventive Options Used in the Treatment of Plantar Fasciitis

Plantar fasciitis is a frequent, chronic ailment that significantly affects day-to-day functioning. This review takes a deep look at the different therapies and preventions used in the treatment of this condition to improve foot function, reduce pain, and improve patient outcomes. The efficacy of common treatment options such as physical therapy, medication, stretching, night splints, therapeutic ultrasound, and extracorporeal shock wave therapy has been mentioned again in this study. Moreover, the importance of injection treatment and surgery also play a significant role in the management of plantar fasciitis. In addition to conventional treatment, the health care professional also needs to pay attention to the prevention of this overuse foot injury. The available approaches involve stretching the particular posterior muscles of the low limbs. Eventually, the impact of interdisciplinary considerations, including physiological factors and strength training methods, on plantar fasciitis was explored in order to provide a certain theoretical basis for clinical practice.

Ultrasound-guided platelet-rich plasma vs. radiofrequency nerve ablation for refractory plantar fasciitis

Objectives: Plantar fasciitis (PF), which accounts for approximately 80% of heel pain, is a common condition affecting adults' quality of life. There are many different treatment modalities used in the treatment of PF. In this study, we compared the clinical and functional outcomes of patients diagnosed with chronic PF in our clinic who underwent USG-guided PRP (platelet-rich plasma) injection and patients who underwent RFNA (radiofrequency nerve ablation) treatment. Methods: Ultrasound-guided PRP injection or RFNA was performed on 95 patients who were diagnosed with chronic PF and met the inclusion criteria. This group of patients was followed for at least one year (October 2021-October 2023), and the clinical and functional results of the patients were compared. Results: The mean pre-treatment Visual Analog Scale (VAS), Foot Function Index (FFI), and American Orthopaedic Foot and Ankle Society (AOFAS) posterior-ankle scores were similar, and no significant difference was found (P&amp;gt;0.05). A significant improvement was observed in the groups' FFI, VAS, and AFOAS scores after treatment (P&amp;lt;0.05). However, no significant difference was found in treatment modalities (P&amp;gt;0.05). Conclusions: As a result of the study, it was concluded that PRP injection and RFNA are effective treatment methods in patients diagnosed with chronic plantar fasciitis without response to other conservative treatment methods, but these two methods are not superior to each other.