Tendinopathy
Conditions
Keywords
Myofascial pain syndrome
Brief summary
The aim of this randomized controlled study in to investigate if a shock wave treatment extended to the gastrocnemius-soleus trigger points (TrP) is more effective than a standard treatment exclusively targeted at the plantar fascia in a population affected by unilateral plantar fasciitis with concomitant sural myofascial pain syndrome.
Interventions
OTHERShock wave therapy on plantar fascia extended to the gastrocnemius-soleus trigger points
Enrolled subjects were treated with focused shock wave therapy, once a week for three consecutive weeks, by a specialized physician with more than five years of expertise, using a device powered by a piezoelectric generator (PIEZOSON 100PLUS, Richard Wolf®). At each treatment session, with the patients lying in prone decubitus position, the enthesis of the plantar fascia and the gastrocnemius-soleus trigger points were clinically targeted and treated with a perpendicular technique.
OTHERShock wave therapy on plantar fascia only
Enrolled subjects were treated with focused shock wave therapy, once a week for three consecutive weeks, by a specialized physician with more than five years of expertise, using a device powered by a piezoelectric generator (PIEZOSON 100PLUS, Richard Wolf®). At each treatment session, with the patients lying in prone decubitus position, the enthesis of the plantar fascia was clinically targeted and treated with a perpendicular technique.
Sponsors
Fondazione IRCCS Policlinico San Matteo di Pavia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Adult age (18 to 75 years) and written informed consent; * Unilateral heel pain of four weeks or longer duration; * Pain to digital pressure in the insertional area of the plantar fascia at the calcaneum; * Sonographic examination showing a plantar fascia thickness greater than 3.8mm (see procedures for details); * Concomitant presence of a sural myofascial pain syndrome (SMPS), diagnosed on the basis of the finding, at the physical examination, of trigger points of the gastrocnemius-soleus muscle complex, according to Travel and Simons' original description.
Exclusion criteria
* No corticosteroid injections or other physical therapies since the onset of the current pain episode (except pharmacological pain treatments and foot orthoses); * No general contraindication to shock wave therapy (pregnancy, bleeding disorders or anticoagulant drug usage, cancer in the focal area); * No clinical signs of lumbar radiculopathy at physical examination; * No ankle osteoarthritis, diagnosed on the basis of clinical and radiographic findings; * No previous fractures or surgery in the affected ankle and foot; * No rheumatologic diseases, no plantar fibromatosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in FFI-foot function index | FFI was administered at baseline, at two months time point and at three months time point | Foot Function Index is self-administered questionnaire designed to measure foot performances in relation to symptoms. Foot Function Index is structured in two sections of nine items each, investigating foot pain (FFI-A) and function (FFI-B) respectively. The total score of each section ranges from zero (no pain/no functional limitation) to 100 (intolerable pain/complete inability). The two scores were separately analysed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in PPT-pressure pain threshold | PPT was recorded at baseline, at two months time point and at three months time point | Pressure pain threshold (PPT) of the gastrocnemius-soleus trigger points was assessed by means of a digital hand-held algometer (see procedures for details). PPT is the minimal force that induces pain and its measurement is useful to quantitatively evaluate the effect of a treatment on trigger points |
Outcome results
None listed