Treatment Of Plantar Fasciitis Research Articles

Comparison of the therapeutic outcomes between open plantar fascia release and percutaneous radiofrequency ablation in the treatment of intractable plantar fasciitis

BackgroundHeel pain is one of the most common complaints in foot and ankle clinic, and one of the leading causes of heel pain is plantar fasciitis.MethodsA retrospective analysis was carried out in 31 cases (39 feet) of patients with intractable plantar fasciitis. In the enrolled 26 cases, 16 patients (19 feet) received open plantar fascia release, and the other 15 patients (20 feet) received percutaneous radiofrequency ablation. The surgical results were assessed by visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AH) before and after surgery in all patients.ResultsAll 31 patients were followed up successfully, with a mean follow-up time of 58.77 months. There were no differences of patient’s demographics and characteristics information between the two groups. The average operative time of the feet in the open plantar fascia release is longer than that in the percutaneous radiofrequency ablation. Furthermore, the percutaneous radiofrequency ablation group had a shorter recovery time to normal activity than the open plantar fascia release group. There were no differences of postoperative VAS scores and the AOFAS-AH scores between the two groups. All patients reported satisfaction after either operation.ConclusionThe symptoms of pain and limb function were significantly improved in patients both of the partial plantar fascia release treated group and the percutaneous radiofrequency ablation treated group. The two types of surgical procedures shared the same long-term curative effects. However, percutaneous radiofrequency ablation was a better technique from the point of shorter operative time and postoperative recovery time.Trial registrationRetrospectively registered.

Endoscopic fasciotomy for plantar fasciitis provides superior results when compared to a controlled non-operative treatment protocol: a randomized controlled trial.

Plantar fasciitis is a frequent and painful condition with a lifetime incidence of 10%. Good results have been reported for operative treatment of plantar fasciitis refractory to non-surgical interventions in uncontrolled studies. The aim of this study was to compare the results of operative treatment (endoscopic debridement, removal of the heel spur and partial resection of the plantar fascia) with those of a controlled and supervised non-operative rehabilitation program. Thirty consecutive patients with plantar fasciitis during more than 3months were randomized to either (1) non-operative treatment with corticosteroid injections and a controlled strength training program or (2) an endoscopic 2-incision operation with partial fasciotomy and heel spur removal followed by the same strength training program. Patients were evaluated at entry and 3, 6, 12 and 24months post-operatively with the foot function index (FFI) and pain score during activity on a 100mm VAS scale (VAS activity). FFI at 6 and 12months was defined a priori as primary endpoint. Both groups improved significantly over time. The FFI score was significantly better in the operated group compared to the non-surgically treated group 12months post-operatively (p = 0.033), at 24months this was, however, not significant (p = 0.06). VAS activity at 24months was significantly (p = 0.001) in favor of the operative group. More patients returned to running and jumping in the operative group (p = 0.04). This randomized controlled trial found significant and clinically relevant superior results for the operative treatment of plantar fasciitis as measured by Foot Function Index at 1year and by VAS activity at 2-year follow-up when compared to the results of a supervised rehabilitation program. I.

Effectiveness of single injection of platelet-rich plasma over corticosteroid in the treatment of plantar fasciitis – A randomized, comparative study

Objectives: Plantar fasciitis (PF) is not an uncommon cause of heel pain whose treatment is not yet standardized. Although platelet-rich plasma (PRP) and corticosteroid (CS) injections are the two commonly used modalities, yet not much importance has been given to the comparison of their roles in sustained functional improvement. We aimed to study the effect of PRP and CS injections in PF and compare their effectiveness with respect to pain relief and improvement of functional and patient satisfaction. Methods: Seventy-three cases were randomized into two groups: 39 patients (Group A) received a single injection of autologous PRP and 34 in Group B received a single injection of CS (40 mg of methylprednisolone) by the random selection. A structured home exercise program was demonstrated to both the groups, as baseline management. The effectiveness was assessed and compared in preinjection and postinjection at 3- and 6-months follow-up. Visual Analog Scale (VAS), Roles and Maudsley (RM), and Foot Function Index (FFI) scoring systems were used as outcome measures. Results: CSs had an early effect, reducing pain to a moderate level in 82.4% of patients compared to PRP (P = 0.000). However, the effect was not sustainable over a long period. On the other hand, PRP was found to have better pain relief over 3 months and 6 months follow-up with a mean VAS score of 2.0 ± 0.9 and 0.8 ± 0.8, respectively (P = 0.000). There was a significant improvement of FFI and RM score as well as at 6 months follow-up (P = 0.000). Conclusion: Injection of CS had an early effect, which is not sustainable, whereas PRP was found to have a prolonged impact on pain relief and better patient satisfaction with treatment outcomes. Therefore, PRP can be advised for sustained and prolonged improvement in PF.

The Effect of Foot Orthosis Use in Reducing Pain in Patients with Plantar Fasciitis: A Meta-Analysis

Background: Plantar fasciitis is an inflammatory problem that occurs in the foot area that causes pain. Its prevalence rates range from 4% to 7% in the elderly population, 8% in athletes and up to 25% in runners. One of the treatments used to reduce the degree of pain is the use of foot orthosis. A number of related articles stated that the use of foot orthosis can reduce the degree of pain in plantar fasciitis patients. The purpose of this study was to estimate the magnitude of the effect of using foot orthosis on pain reduction in plantar fasciitis patients by conducting a meta-analysis on the same number of articles. Subjects and Method: The meta-analysis was carried out by systematically reviewing the same number of articles from PubMed, Science Direct, and Google Scholar. By using the search keywords "foot orthosis" OR "FO" AND "custom foot orthosis" AND "foot pain" AND "plantar fasciitis" AND "plantar fasciopathy" AND "effect foot orthosis for plantar fasciitis" AND "treatment for plantar fasciitis" A "randomized controlled trial". The intervention given was the use of a foot orthosis with a comparison without using a foot orthosis with the study subject of plantar fasciitis patients. The study outcome was pain reduction. The article used is a full text article with a randomized controlled trial design that reports the value of the effect size (mean and standard deviations). Articles were collected using the PRISMA flow chart and analyzed using the Review Manager 5.3 application with random effect models. Results: A meta-analysis of 7 randomized controlled trial studies from Brazil, Virginia, Turkey, Germany, China, and Australia suggested that the use of foot orthosis was -0.54 times better at reducing pain in plantar fasciitis patients compared to those without foot orthosis (ES= -0.54; 95% CI -1.11 to 0.03; p= 0.06). Heterogeneity I2= 82%. Conclusion: Foot orthosis reduces pain in plantar fasciitis patients compared to those without foot orthosis Keywords: Plantar fasciitis, pain, foot orthosis Correspondence: Atika Febri Anggriani, Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: atikaanggriani07@gmail.com. Mobile : 085728794960

Autologous Platelet Rich Plasma (PRP) in the treatment of elbow epicondylitis and plantar fasciitis: medium to long term clinical outcome.

Background and aim:Platelet-Rich-Plasma(PRP) is a popular biological therapy especially used to regenerate different musculoskeletal tissues by releasing growth-factors and cytokines promoting cell proliferation, chemotaxis, differentiation, and angiogenesis. Theaimwas to evaluate the clinical effectiveness and safety of PRP for Lateral-Epicondylitis (LE) of the elbow and Plantar-Fasciitis (PF).Methods:A retrospective study was conducted including patients treated with a single topic autologous-PRP-injection between 1-1-2009 and 7-18-2019 for LE or PF at our institution; patients operated for the same problem, patients refusing the study or not traceable were excluded. Patients were assessed with VAS for pain and clinical scales.Results:33 patients were treated with PRP and 13 (8F, 5M) included: 4LE and 9PF for a total of 16 cases. The average pain level was 0.61±0.63: 1±1.41 for LE and 0,44±0 for PF. No significant side effect was reported. 4 PRP-treatments failed: 2LE and 2PF. OES and PRTEE gave excellent results for elbow. Average foot scores were AOFAS 98.2±5 and FADI 91.3±1. Patients were stratified and compared according to plantar arch conformation, follow-up length, healing time, time from diagnosis to PRP-treatment, therapies before PRP (physiotherapy, steroid infiltration or shock-waves), risk factors (standing work, sport, age, sex).Conclusions:As in other studies, our results do not allow to draw sufficiently valid conclusions regarding the effectiveness and safety of PRP in the treatment of LE and PF: in particular the statistical significance is limited by the small sample size. PRP can be chosen as a non-first-line treatment for LE and PF.

Effectiveness of shockwave therapy in the treatment of plantar fasciitis.

ABSTRACTObjective:To evaluate the effectiveness of single-dose focal shockwave therapy in plantar fasciitis treatment.Methods:a primary, prospective study of a series of cases, conducted in the city of São Paulo, Brazil, by the Department of Orthopedics and Traumatology of the Universidade Federal de São Paulo, in Hospital São Paulo. All outcomes were measured at the time of inclusion of the patient in the study and at the post-intervention moments as it follows: three, six and twelve weeks. The VAS, AOFAS and SF-36 scales were applied by teams other than those who performed the SWT.Results:Data from 56 patients were collected during 2017 and 2018. There was improvement of the parameter evaluated (p < 0.005 and 95%CI) in all the periods in which the patients were reevaluated (3, 6 and 12 weeks), progressive improvement were observed in the three outcomes evaluated.Conclusion:Shock wave therapy was effective for plantar fasciitis treatment according to the proposed protocol considering pain, function and quality of life. Level of Evidence Ic, Case-series Study.

Open vs Percutaneous TOPAZ Coblation for the Management of Plantar Fasciitis: Comparison of the Two Techniques in Obese Patients

Plantar fasciopathy is known to be the most common cause of heel pain. Obese patients are known to have an increased probability of suffering from this condition. The technique of radiofrequency (RF) coblation, comparing open vs percutaneous methods, and its outcomes, has not been studied in the subgroup of patients. Patients treated operatively by RF coblation in our institution for plantar fasciitis between 2007 and 2015 were grouped into whether they received the open or percutaneous microtenotomy. The patients were interviewed at baseline and 3 months, 6 months, and 12 months postoperatively using the American Orthopedic Foot and Ankle Society (AOFAS) and 36-item Medical Outcomes Short Form (SF-36) questionnaires. Patients in both arms had an overall improvement in the visual analog scale (VAS) pain score and AOFAS ankle–hindfoot scores. The SF-36 scores also showed improvement across all areas postoperatively. There was also a significant improvement in expectation and satisfaction scores. However, those who had open RF microtenotomy fared better at 3 months, with regard to the visual analog score and both at 3 months and 6 months for the AOFAS hindfoot scores. There were no difference comparing both techniques with regard to the SF-36 scores. Radiofrequency microtenotomy is a safe and effective procedure for the treatment of plantar fasciitis even in the obese group of patients. Both open and percutaneous methods have achieved good patient outcomes and expectation, although the open group showed superior pain and functional outcomes at early follow-up. Wenxian PNG, Thien KKO. Open vs Percutaneous TOPAZ Coblation for the Management of Plantar Fasciitis: Comparison of the Two Techniques in Obese Patients. J Foot Ankle Surg (Asia Pacific) 2020;7(1):14–20.

Lyftogt perineural injection therapy® as a primary treatment for plantar fasciitis: a randomized, controlled pilot with crossover

Abstract Background: Plantar fasciitis is a common condition that interferes with patient function and activity level. This study compared usual care to Lyftogt perineural injection therapy® as a primary treatment for plantar fasciitis. Methods: Subjects with foot pain associated with plantar fasciitis were recruited in to the study. They were randomized into the usual care protocol or treatment with Lyftogt perineural injection therapy®. Subjects in the injection group were injected weekly for 8 weeks. Five milliliters of 5% dextrose in water were injected perineural to the saphenous nerve at the adductor canal and the deep tibial nerve at the bifurcation of the gastrocnemius muscles of the affected side. Subjects who completed the 8 week usual care protocol, crossed over into the injection therapy arm. Subject assessed Roles and Maudsley Scores on a 1–4 scale, physician assessed pain with palpation on a 1–4 scale, and MSKUS measured plantar fasciitis thickness were tracked. Results: Complete information for 9 control and 9 intervention subjects was compiled. MSKUS measured plantar fasciitis thickness was significantly reduced in the intervention group (p = 0.019). Physician assessed pain with palpation was also significantly reduced for the compiled intervention group (p = 0.006). Conclusion: Lyftogt perineural injection therapy® may be a viable treatment option for plantar fasciitis.

Platelet rich plasma injection versus extracorporeal shock-wave therapy in treatment of plantar fasciitis

Objective The aim of this study was to determine the efficacy of local platelet-rich plasma (PRP) injection compared with extracorporeal shock-wave therapy (ESWT) for treatment of plantar fasciitis. Background Plantar fasciitis is an important cause of heel pain. ESWT and PRP have emerged as new management options, alternative for surgery. Patients and methods This comparative study included 60 patients, comprising 48 female and 12 male patients with plantar fasciitis diagnosed clinically and by ultrasound. The patients were divided into two groups: 30 patients received single local PRP injection and 30 patients received three sessions of ESWT weekly. All patients were assessed using pain visual analog scale (VAS) score, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot scale, and plantar fascia thickness by ultrasound before treatment and at 1 and 3 months after treatment. Results VAS, AOFAS ankle-hind foot score, and plantar fascia thickness improved significantly in both groups. The AOFAS ankle-hind foot scale shows more improvement in the ESWT group at 1 month after treatment (P = 0.009). Significant improvement in plantar fascia thickness was seen clearly in PRP group at 1 and 3 months after treatment (P Conclusion Local PRP injection and ESWT improve pain and function in patients with plantar fasciitis. ESWT showed early improvement if plantar fasciitis is associated with calcaneal spur.

A comparative prospective study of platelet rich plasma vs. corticosteroid injection in plantar fasciitis

Objective: To compare the relative effectiveness of intralesional Steroid versus Platelet- Rich Plasma injection among 80 patients in plantar fasciitis.Methods: A total number of 80 patients with plantar fasciitis were divided into 2 groups (Group A and B). Group A with 30 patients received intralesional Platelet Rich Plasma (PRP) and Group B received intralesional methyl prednisolone acetate injection. Pre and post intervention Visual Analogue Score (VAS), Foot and Ankle Ability Measure (FAAM) score and PF (plantar fascia) thickness for assessment of pain relief in two groups were recorded at 6 months.Results: The mean VAS scores for heel pain measured after 6 months of treatment were 1.460+0.6911in PRP group and 3.024+0.9572in steroid group. The decrease in mean VAS score in both the groups was statistically significant when compared with pre-treatment values (8.38+0.6820in PRP group and 8.44+0.6021in steroid group). The mean FAAM score measured after 6 months of treatment increased in both the groups (83.43±5.661in PRP group and 69.12±5.795 in steroid group)when compared with pre-treatment value (29.97±5.997in PRP group and 31.68±6.297 in steroid group)and it was statistically significant.There was 35.90% reduction in mean plantar fascia thickness in PRP group and 28.67% reduction in Steroid groupas compared to baseline values after 6 month of injection.Conclusion: Intralesional injection of both the PRP and steroid are effective and safe modalities of treatment for plantar fasciitis. Steroid is better for short term treatment of plantar fasciitis but in long term follow up platelet rich plasma therapy is better than steroid. Both the treatment methods have caused significant reduction in PF(Plantar fascia) thickness.

The effectiveness of extracorporeal focused shockwave therapy in the treatment of plantar fasciitis

Plantar fasciitis is a common pathological condition affecting hind foot. The etiology of this disorder is not fully known, but is most probable multi-factorial in nature. Extracorporeal shock wave therapy (ESWT) is a non-invasive procedure that includes delivering shock waves to the traumatic region with the goal of decreasing pain and encouraging soft tissue healing. Extracorporeal shock wave therapy of pain syndrome on the background of plantar fasciitis allows to get a good result in 50% of cases with full restoration of the foot function, professional and daily activity of the patient.

Platelet-Rich Plasma Versus Corticosteroid Injections in the Management of Elbow Epicondylitis and Plantar Fasciitis: An Updated Systematic Review and Meta-analysis

Background: Platelet-rich plasma (PRP), as a promising alternative to traditional corticosteroid (CS), is now increasingly used in the treatment of elbow epicondylitis (EE) and plantar fasciitis (PF). To date, however, the synthesis of information on the clinical efficacy of PRP versus CS is limited with divergent conclusions. Purpose: To compare the clinical efficacy of PRP and CS injections in reducing pain and improving function in EE and PF. Study Design: Systematic review and meta-analysis. Methods: Online databases were searched from inception to October 2018 for prospective studies evaluating PRP versus CS injections for EE or PF. Independent reviewers undertook searches, screening, and risk-of-bias appraisals. The primary outcomes of interest were pain and function in both the short term (1-3 months) and the long term (≥6 months). Results: Twenty trials with 1268 participants were included. For EE, PRP provides a statistically and clinically meaningful long-term improvement in pain, with a very large effect size of −1.3 (95% CI, −1.9 to −0.7) when compared with CS, but the evidence level was low. For EE, there was moderate evidence that CS provides a statistically meaningful improvement in pain in the short term, with a medium effect size of 0.56 (95% CI, 0.08-1.03) as compared with PRP; this improvement might not be clinically significant. For PF, there was low evidence that PRP provides a statistically and clinically meaningful long-term improvement in function (American Orthopedic Foot & Ankle Society score), with a very large effect size of 1.94 (95% CI, 0.61-3.28). There were no significant differences between the groups in improvement in function in EE and pain and short-term function in PF, but the quality of the evidence was low. Conclusion: The use of PRP yields statistically and clinically better improvement in long-term pain than does CS in the treatment of EE. The use of PRP yields statistically and clinically better long-term functional improvement than that of CS in the treatment of PF.

COMPARATIVE STUDY OF PLATELET-RICH PLASMA AND CORTICOSTEROID INJECTION IN THE TREATMENT OF PLANTAR FASCIITIS

Background: Plantar fasciitis is defined as localized inflammation due to chronic repeated microinjury to the substance of plantar aponeuroses and the patients present to the clinic for pain in heel. In this study, autologous platelet-rich plasma (PRP), a concentrated bioactive blood component rich in growth factors, was compared to traditional steroid injection usually methylprednisolone in the treatment of plantar fasciitis resistant to traditional nonoperative management.&#x0D; Methods: Eighty patients with plantar fasciitis were included in the study and randomly categorised into group A (steroid inj) and Group B (prp inj). 3 cc PRP or 40 mg DepoMedrol injected into plantar aponeurosis at maximum point of tenderness, in both groups separately. Results of both groups comparedand Score of both the groups tellied by using vas score.&#x0D; Study Design and Time: Prospective cohort study of 6 months duration.&#x0D; Inclusion criteria: All cases of plantar fasciitis except cases of metabolic disorder&#x0D; Exclusion criteria: other plantar pathologies and deformities. calcaneum fractures Old treated with injections.&#x0D; Results: The instillation of PRP found to be more effective than Steroids injection in terms of pain and functional results in the treatment of plantar fasciitis. Clinical evaluation was performed before treatment and at the 6th week, 12th week and 24th weeks from instillation of PRP/steroid in follow up visits. Visual analog scale were used in the clinical evaluation.&#x0D; Keywords: Platelet-Rich, Plasma, Corticosteroid, Plantar &amp; Fasciitis.

Effect of Dextrose Prolotherapy on Pain Intensity, Disability, and Plantar Fascia Thickness in Unilateral Plantar Fasciitis: A Randomized, Controlled, Double-Blind Study.

The aim of the study was to evaluate the efficacy of dextrose prolotherapy in the treatment of chronic resistant plantar fasciitis through comparison with a control group. In this double-blind, randomized, controlled study, the patients were divided into two groups. The prolotherapy group (n = 30) was administered 5 ml of 30% dextrose, 4 ml of saline, and 1 ml of 2% lidocaine mixture (15% dextrose solution) and the control group was given 9 ml of saline and 1 ml of 2% lidocaine mixture twice at a 3-wk interval. During the 15-wk follow-up period, pain intensity was measured using the visual analog scale during activity and at rest. The foot function index was used to measure pain and disability. The plantar fascia thickness was measured by ultrasonography. The measurements were undertaken before treatment and at posttreatment weeks 7 and 15. Improvements in visual analog scale during activity, at rest, foot function index (all subgroups), and plantar fascia thickness measured at the 7th and 15th weeks were significantly higher in the prolotherapy group compared with the control group (P < 0.001). Dextrose prolotherapy has efficacy up to 15 wks and can be used as an alternative method in the treatment of chronic resistant plantar fasciitis.

Analysis of the effect of two medial portals for the all-inside endoscopic treatment of recalcitrant plantar fasciitis

Objective: To examine the clinical effect of all-inside endoscopic treatment of recalcitrant plantar fasciitis through two medial portals. Methods: The recalcitrant plantar fasciitis data of 67 cases (79 feet) that underwent two medial portals all-inside endoscopic treatment at Department of Hand and Foot Microsurgery, Xuzhou Central Hospital from October 2016 to June 2018 were retrospectively analyzed.There were 24 males (30 feet) and 43 females (49 feet) aged 44.3 years old(range:24-76 years).The mean disease duration from the specialist doctor intervention to operation was (23.7±11.0) months (range: 12-60 months). All the patients were treated with the two medial portals all-inside endoscopic procedure when the 6 months conservative treatment had failed.The endoscopic procedure including debridement and partial plantar fasciotomy.The clinical results,including pain,activity,gait and foot health quality,were scored using visual analogue pain scale (VAS),American Orthopaedic Foot & Ankle Society Ankle Hindfoot Scale (AOFAS) and SF-36. Results: All the patients were followed up for (15.2±6.7) months (range: 12-24 months). All cases achieved primarily healing of the wound without postoperative complications of nerve,vessel and tendon.At the last follow-up,the VAS decreased from (5.3±2.0) preoperative to 0 prooperative (t=21.60, P=0.000), AOFAS increased from (72.6±9.4) to (97.3±4.6)(t=19.43,P=0.000),SF-36 increased from (93.6±8.4) to (119.1±7.3) (t=18.78, P=0.000), non-recurrent calcaneal spur, normal foot and ankle activity was recorded. Conclusion: The two medial portals all-inside endoscopic procedure is effective for the treatment of recalcitrant plantar fasciitis.

Is Platelet-rich Plasma Injection more Effective than Steroid Injection in the Treatment of Chronic Plantar Fasciitis in Achieving Long-term Relief?

Introduction: Plantar fasciitis is characterised by pain in the heel, which is aggravated on weight bearing after prolonged rest. Many modalities of treatment are commonly used in the management of plantar fasciitis including steroid injection. Many studies show that steroid injection provides pain relief in the short term but not long lasting. Recent reports show autologous platelet-rich plasma (PRP) injection promotes healing, resulting in better pain relief in the short as well as long term. The present study was undertaken to compare the effects of local injection of platelet-rich plasma and Corticosteroid in the treatment of chronic plantar fasciitis.Materials and methods: Patients with the clinical diagnosis of chronic plantar fasciitis (heel pain of more than six weeks) after failed conservative treatment and plantar fascia thickness more than 4mm were included in the study. Patients with previous surgery for plantar fasciitis, active bilateral plantar fasciitis, vascular insufficiency or neuropathy related to heel pain, hypothyroidism and diabetes mellitus were excluded from the study. In this prospective double-blind study, 60 patients who fulfilled the criteria were divided randomly into two groups. Patients in Group A received PRP injection and those in Group B received steroid injection. Patients were assessed with visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) score. Assessment was done before injection, at six weeks, three months and six months follow-up after injection. Plantar fascia thickness was assessed before the intervention and six months after treatment using sonography.Results: Mean VAS in Group A decreased from 7.14 before injection to 1.41 after injection and in Group B decreased from 7.21 before injection to 1.93 after injection, at final follow-up. Mean AOFAS score in Group A improved from 54 to 90.03 and in Group B from 55.63 to 74.67 at six months’ follow-up. The improvements observed in VAS and AOFAS were statistically significant. At the end of six months’ follow-up, plantar fascia thickness had reduced in both groups (5.78mm to 3.35mm in Group A and 5.6 to 3.75 in Group B) and the difference was statistically significant.Conclusion: Local injection of platelet-rich plasma is an effective treatment option for chronic plantar fasciitis when compared with steroid injection with long lasting beneficial effect.

Comparison Effect of Corticosteroid Injection with Low Level Laser Therapy in Plantar Fasciitis Patients in Dr. Bratanata Hospital, Jambi

Objectives:Plantar fasciitis is a common pain disorder that affects the heel and soles of the feet. These are abnormalities at the location of tendon insertions in the bone and are characterized by scarring, inflammation, or damage to the plantar fascia. Treatment options for patients with plantar fasciitis vary with little consensus on the clinical approach. Physical therapy procedures including LLLT (Low-Level Laser Therapy) are most often applied in conservative treatment of plantar fasciitis. While steroid injection is a treatment that has been proven effective in the management of short-term symptoms. The aim of this study was to compare the effects of LLLT and steroid injection on pain and functional conditions in patients with plantar fasciitis.Methods:This is a prospective study conducted in 30 patients. 15 patients were treated with local injection steroids (single Group A) and 15 patients were treated with LLLT (Group B), 8 J / cm2 per day, 3 days per week for 2 weeks. VAS scores and FFI (Foot Function Index) are measured.Results:Pain intensity was reduced in both groups after 2 weeks. VAS scores decreased to 3.47 in Group A and 3.82 in Group B in 2 weeks (p <0.05). In Group A, FFI decreased to 22.03 ± 4.45 while in Group B it decreased to 26.40 ± 2.52 in the same interval. But generally, patients who suffer from plantar fasciitis prefer LLLT compared to more invasive steroid injection therapy.Conclusion:LLLT therapy and steroid injection are effective methods for reducing pain and improving foot function in plantar fasciitis. It appears that steroid injection is superior to LLLT therapy. But fear of invasive action, patients have LLLT.

The Effect of Addition of Buffered Dextrose 5% Solution on Pain Occurring During Local Steroid Injection for Treatment of Plantar Fasciitis: A Randomized Controlled Trial

The Effect of Addition of Buffered Dextrose 5% Solution on Pain Occurring During Local Steroid Injection for Treatment of Plantar Fasciitis: A Randomized Controlled Trial

Comparación de la terapia de ondas de choque extracorpóreas focales y presión radiales en la fascitis plantar

ObjectivePlantar fasciitis is a common cause of heel pain. The aetiology of this condition remains unclear. Patients typically have pain upon palpation of the medial plantar calcaneal region. Extracorporeal shockwave therapy has shown favourable outcomes in various studies. The aim of this study was to compare the effect of focused extracorporeal shockwave therapy with radial pressure wave therapy. Patients and methodsSeventy-nine non-randomised patients diagnosed with plantar fasciitis were included between January 2017 and June 2018. Patients from the Arnau de Vilanova Hospital in Valencia were treated with focused extracorporeal shockwave therapy, and patients from Llíria Hospital with radial pressure wave therapy. Measured outcome variables were: visual analog scale; ultrasonographic measurement of plantar fascia thickness; self-reported foot-specific pain and disability using the Foot Function Index; self-reported health-related quality of life using the Euroqol-5D; self-reported pain and limitations of activity using the Roles & Maudsley Scale. ResultsAt inclusion, the 2groups showed no significant differences in demographic or clinical characteristics. Three months after treatment completion, both groups showed improvement in all outcome variables, without statistically significant differences between the 2groups. No adverse effects or complications were observed. ConclusionsBoth extracorporeal shockwave therapy and radial pressure wave therapy are effective treatments for plantar fasciitis.

Positive Effect of Platelet-Rich Plasma on Pain in Plantar Fasciitis: A Double-Blind Multicenter Randomized Controlled Trial

Background: When nonoperative treatment for chronic plantar fasciitis fails, often a corticosteroid injection is given. Corticosteroid injection gives temporary pain reduction but no healing. Platelet-rich plasma (PRP) has proven to be a safe therapeutic option in the treatment of tendon, muscle, bone, and cartilage injuries. Purpose: To determine the effectiveness of PRP as compared with corticosteroid injections for chronic plantar fasciitis. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients with chronic plantar fasciitis were allocated to have steroid injection or PRP. The primary outcome measure was the Foot Function Index (FFI) Pain score. Secondary outcome measures were function, as scored by the FFI Activity, FFI Disability, and American Orthopaedic Foot & Ankle Society, and quality of life, as scored with the short version of the World Health Organization Quality of Life (WHOQOL-BREF). All outcomes were measured at baseline and at 4, 12, and 26 weeks and 1 year after the procedure. Results: Of the 115 patients, 63 were allocated to the PRP group, of which 46 (73%) completed the study, and 52 were allocated to the control group (corticosteroid injection), of which 36 (69%) completed the study. In the control group, FFI Pain scores decreased quickly and then remained stable during follow-up. In the PRP group, FFI Pain reduction was more modest but reached a lower point after 12 months than the control group. After adjusting for baseline differences, the PRP group showed significantly lower pain scores at the 1-year follow-up than the control group (mean difference, 14.4; 95% CI, 3.2-25.6). The number of patients with at least 25% improvement (FFI Pain score) between baseline and 12-month follow-up differed significantly between the groups. Of the 46 patients in the PRP group, 39 (84.4%) improved at least 25%, while only 20 (55.6%) of the 36 in the control group showed such an improvement (P = .003). The PRP group showed significantly lower FFI Disability scores than the control group (mean difference, 12.0; 95% CI, 2.3-21.6). Conclusion: Treatment of patients with chronic plantar fasciitis with PRP seems to reduce pain and increase function more as compared with the effect of corticosteroid injection. Registration: NCT00758641 (ClinicalTrials.gov identifier).