Comparative Effectiveness of Radial Extracorporeal Shockwave Therapy and Ultrasound-Guided Local Corticosteroid Injection Treatment for Plantar Fasciitis

by MASS4D® Prescription Orthotics March 25, 2018

The aim of this study was to compare the long-term clinical and ultrasonographic effects of radial extracorporeal shockwave therapy (rESWT) and ultrasound-guided local corticosteroid injection treatment in patients with plantar fasciitis refractory to conservative treatment.

This study enrolled 92 patients admitted to the outpatient clinic with heel pain and subsequently diagnosed as having plantar fasciitis using an appropriate work-up.

After the baseline assessment and data collection, a computer-generated random number list was used to randomise patients into two equal groups: rESWT and local corticosteroid injection treatment.

Participants in both treatment groups were advised to avoid long periods of standing and any strenuous, pain-provoking activity or high-impact exercise for a week after the treatment. Patients in neither group were given additional medical therapy.

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A visual analog scale (VAS), heel tenderness index (HTI), Foot Function Index (FFI), ultrasonographic measurement of plantar fascia thickness and echogenicity were performed for both groups.

The authors detected an improvement in pain and foot function and reduction in PFT in patients receiving rESWT or ultrasound-guided corticosteroid injection therapy.

In the rESWT group, although the beneficial effect on VAS, FFI, and HTI scores was delayed, it was maintained for a long period.

On the other hand, corticosteroid injection had an early onset of action and rapidly showed its effect on VAS, FFI, and HTI scores, but its benefits were lost in the next months.

Additionally, there was a reduction in PFT at the end of treatment with both modalities, but they did not show a statistically significant difference in that respect.

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References:

1. Hocaoglu, S., Vurdem, U. E., Cebicci, M. A., Sutbeyaz, S. T., Guldeste, Z., Yunsuroglu, S. G. (2017) Comparative Effectiveness of Radial Extracorporeal Shockwave Therapy and Ultrasound-Guided Local Corticosteroid Injection Treatment for Plantar Fasciitis. Journal of the American Podiatric Medical Association: May/June 2017, Vol. 107, No. 3, pp. 192-199.

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