Chronic Plantar Fasciitis
Conditions
Keywords
extracorporeal shock wave therapy (ESWT), radiofrequency thermal lesioning (RTL), Chronic plantar fasciitis, corticosteroid injection (CSI)
Brief summary
Chronic plantar fasciitis is a prevalent condition causing persistent heel pain, often refractory to conservative treatments. This prospective randomized controlled trial aimed to compare the effectiveness of corticosteroid injection (CSI) , extracorporeal shock wave therapy (ESWT), and radiofrequency thermal lesioning (RTL) in the management of chronic plantar fasciitis.
Detailed description
Based on the investigators' understanding of the literature there are no randomized, controlled, prospective studies comparing the therapeutic effects of CSI, ESWT and RTL for recalcitrant plantar fasciitis. In this study, the investigators investigated and compared the outcomes of three treatment techniques in participants who had exhausted conservative treatment options over the past six months.
Interventions
PROCEDURERadiofrequency ablation alone
RTL was performed as a single session using the radiofrequency ablation device (NeuroTherm JK4A; NeuroTherm Ltd, Croydon, London, England).
PROCEDURECortisone Injection
An injection of 1 ml of betamethasone 40 mg/ml and 2 ml of bupivacaine 5 mg/ml was performed.
OTHERExtracorporeal shock wave therapy
Patients underwent 3 ESWT sessions applied to the plantar heel area, once a week with the same ESWT dose (15 Hz, 2000 pulse, 4.0 bar energy density) using a BTL-5000 SWT device (BTL Industries, USA).
Sponsors
Kars Harakani State Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Persistant heel pain for ≥ 6 months * No response to at least 6 weeks of conservative treatment (including at least two of the following: NSAIDs, stretching exercises, ice, heel pads, physical therapy, or night splints) * Age ≥ 18 * BMI ≤ 35 * VAS ≥ 5 following the first step in the morning or after periods of prolonged inactivity * Willingness to participate in the study
Exclusion criteria
* Previous foot or ankle surgery, major trauma * Tumor, osteomyelitis, or complex regional pain syndrome in the affected limb * Allergy to local anesthesia or NSAIDs * Pregnancy or breastfeeding * History of calcaneal fracture * Previous cortisone injection, ESWT, or RTL for similar complaints * BMI \>35 * Age \< 18 * Use of medications for neuropathic pain (Pregabalin, Gabapentin) * Proximal nerve lesion (e.g., spinal stenosis, sciatica, tarsal tunnel syndrome) * Regional skin or subcutaneous infections, fat pad atrophy * History of rheumatic disease, or hematologic conditions * History of peripheral vascular disease * Seronegative arthropathies, heart failure, hepatic or metabolic disorders * Pacemaker * History of clubfoot, pes cavus, or calcaneovalgus * Diabetic neuropathy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS) scores | 1st month. 3rd month, 6th month | Pain score (1 to 10 points) |
| Foot Function Index (FFI) | 1st month. 3rd month, 6th month, | Function score (The FFI is a self-administered index consisting of 23 items divided into 3 sub-scales.) |
| Roles and Maudsley Score | 1st month. 3rd month, 6th month, | The Roles and Maudsley score is an established subjective 4-point patient assessment of pain and limitations of activity (1 = excellent result with no symptoms following treatment; 2 = significant improvement from pretreatment; 3 = patient somewhat improved; 4 = poor, symptoms identical or worse than pretreatment) |
Countries
Turkey (Türkiye)
Outcome results
None listed