Ultrasound-Guided Injection of Dextrose Versus Corticosteroid in Chronic Plantar Fasciitis Management: A Randomized, Double-Blind Clinical Trial

2021 ◽  
pp. 193864002098092
Author(s):  
Gholamreza Raissi ◽  
Amin Arbabi ◽  
Maryam Rafiei ◽  
Bijan Forogh ◽  
Arash Babaei-Ghazani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Plantar Fasciitis ◽  
Rating Scale ◽  
Corticosteroid Injection ◽  
Treatment Options ◽  
Plantar Fascia ◽  
Numeric Rating Scale ◽  
Therapeutic Effects ◽  
Ultrasound Guided ◽  
Double Blind

Design Chronic plantar fasciitis (PF) is a common cause of chronic heel pain, with different conventional treatment options. In this randomized clinical trial, the effect of ultrasound-guided injection of dextrose versus corticosteroid in chronic PF was evaluated and compared. Methods A total of 44 patients suffering from chronic PF who visited the physical medicine and rehabilitation clinic were enrolled in the study. Two table-randomized groups were formed. They received an ultrasonography-guided, single injection of either 40 mg methylprednisolone or 20% dextrose. Numeric Rating Scale (NRS), Foot and Ankle Ability Measure questionnaire with 2 subscales, Activities of Daily Living (FAAM-A) and Sports (FAAM-S), along with ultrasonographic parameters were evaluated before and at 2 and 12 weeks after the injection. Results. A total of 40 participants completed the study. Both interventions significantly improved pain and function at 2 and 12 weeks postinjection. After 2 weeks, compared with the dextrose prolotherapy, the corticosteroid group had significantly lower daytime and morning NRS scores (2.55 vs 4.1, P = .012, and 2.75 vs 4.65, P = .004), higher FAAM-S (66.84 vs 54.19; P = .047), and lower plantar fascia thickness at insertion and 1 cm distal to the insertion zone (3.89 vs 4.29 mm, P = .004, and 3.13 vs 3.48 mm, P = .002), whereas FAAM-A was similar in both groups ( P = .219). After 12 weeks, all study variables were statistically similar between corticosteroid and dextrose prolotherapy groups. No injection-related side effects were recorded in either group. Conclusion Both methods are effective. Compared with dextrose prolotherapy, our results show that corticosteroid injection may have superior therapeutic effects early after injection, accompanied by a similar outcome at 12 weeks postinjection. Levels of Evidence: Level II

scholarly journals Full-length silicone insoles versus ultrasound-guided corticosteroid injection in the management of plantar fasciitis: A randomized clinical trial

2013 ◽  
Vol 37 (6) ◽  
pp. 471-476 ◽  
Author(s):  
Ufuk Yucel ◽  
Sami Kucuksen ◽  
Havva T Cingoz ◽  
Emel Anlıacik ◽  
Orhan Ozbek ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Plantar Fasciitis ◽  
Analogue Scale ◽  
Corticosteroid Injection ◽  
Plantar Fascia ◽  
Full Length ◽  
Foot And Ankle ◽  
Ultrasound Guided ◽  
First Line ◽  
Outcome Score

Background: Plantar fasciitis often leads to disability. Optimal treatment for this clinical condition is still unknown. Objective: To compare the effectiveness of wearing a full-length silicone insole with ultrasound-guided corticosteroid injection in the management of plantar fasciitis. Study design: Randomized clinical trial. Methods: Forty-two patients with chronic unilateral plantar fasciitis were allocated randomly to have an ultrasound-guided corticosteroid injection or wear a full-length silicone insole. Data were collected before the procedure and 1 month after. The primary outcome measures included first-step heel pain via Visual Analogue Scale and Heel Tenderness Index. Other outcome measures were the Foot and Ankle Outcome Score and ultrasonographic thickness of the plantar fascia. Results: After 1 month, a significant improvement was shown in Visual Analogue Scale, Heel Tenderness Index, Foot and Ankle Outcome Score, and ultrasonographic thickness of plantar fascia in both groups. Visual Analogue Scale scores, Foot and Ankle Outcome Score pain, Foot and Ankle Outcome Score for activities of daily living, Foot and Ankle Outcome Score for sport and recreation function, and plantar fascia thickness were better in injection group than in insole group (p < 0.05). Conclusions: Although both ultrasound-guided corticosteroid injection and wearing a full-length silicone insole were effective in the conservative treatment of plantar fasciitis, we recommend the use of silicone insoles as a first line of treatment for persons with plantar fasciitis. Clinical relevance Silicone insole may be considered as a first-line treatment option in patients with plantar fasciitis.

Comparison of Ultrasound-Guided Local Ozone (O2-O3) Injection vs Corticosteroid Injection in the Treatment of Chronic Plantar Fasciitis: A Randomized Clinical Trial

Pain Medicine ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 314-322 ◽  
Author(s):  
Arash Babaei-Ghazani ◽  
Neda Karimi ◽  
Bijan Forogh ◽  
Seyed Pezhman Madani ◽  
Safoora Ebadi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Plantar Fasciitis ◽  
Corticosteroid Injection ◽  
Ultrasound Guided

scholarly journals Effectiveness and tolerability of focal versus radial extracorporeal shock wave therapy in patients affected by plantar fascia enthesopathy

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Edoardo Pisani ◽  
Claudio Curci ◽  
Antimo Moretti ◽  
Anna Mazzola ◽  
Marco Paoletta ◽  
...  
Keyword(s):  
Shock Wave ◽  
Plantar Fasciitis ◽  
Rating Scale ◽  
Plantar Fascia ◽  
Extracorporeal Shock Wave Therapy ◽  
Brief Pain Inventory ◽  
Severity Index ◽  
Numeric Rating Scale ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

Plantar fascia enthesopathy is the most common cause of heel pain. Extracorporeal shock wave therapy (ESWT) is widely used in patients affected by this condition. The aim of this study was to compare efficacy and tolerability of ESWT modalities in the treatment of plantar fasciitis. We included 42 patients receiving 1 session of focused ESWT (f-ESWT group) or radial ESWT (r-ESWT group) per week for 3 weeks. Pain assessment was performed at baseline, before each session, and 1 month after the last session using brief pain inventory (BPI) severity index, and interference index (II). Tolerability was defined in terms of patient discomfort after treatment assessed by numeric rating scale at baseline and after each session. Plantar fascia changes in ultrasonography were further investigated. A significant reduction of BPI-II (P<0.001) was reported in both groups, although no between-group differences were found. Plantar fascia thickness showed significant reduction only in the f- ESWT group (P=0.028). Patient’s tolerability was significantly better in the r-ESWT group (P<0.05). Our study confirms that ESWT is effective for reducing pain and disability in patients affected by plantar fasciitis, although r- ESWT seems to be better tolerated.

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

2017 ◽  
Vol 107 (3) ◽  
pp. 192-199 ◽  
Author(s):  
Sehriban Hocaoglu ◽  
Umit Erkan Vurdem ◽  
Mehtap Aykac Cebicci ◽  
Serap Tomruk Sutbeyaz ◽  
Zuhal Guldeste ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Plantar Fasciitis ◽  
Corticosteroid Injection ◽  
Plantar Fascia ◽  
Injection Therapy ◽  
Ultrasound Guided ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Injection Treatment

Background: We compared the long-term clinical and ultrasonographic effects of radial extracorporeal shockwave therapy (rESWT) versus ultrasound-guided corticosteroid injection treatment in patients with plantar fasciitis unresponsive to conservative therapy. Methods: Seventy-two patients with unilateral plantar fasciitis were randomized to receive either rESWT (three times once per week) (n = 36) or corticosteroid treatment (a single 1-mL dose of betamethasone sodium plus 0.5 mL of prilocaine under ultrasound guidance by injection into the plantar fascia) (n = 36). The primary outcome measures were visual analog scale (VAS) and Foot Function Index (FFI) scores. Secondary outcome measures included the heel tenderness index (HTI) score and plantar fascia thickness (PFT) as obtained by ultrasound examination. All of the assessments were performed at baseline and 1, 3, and 6 months after treatment. Results: Significant improvements were observed in the rESWT group in VAS, HTI, and FFI scores and PFT at the end of treatment and were maintained during follow-up. Posttreatment improvements in VAS, HTI, and FFI scores and PFT were also seen in the corticosteroid group but were not maintained for VAS and FFI scores after the completion of therapy and were lost at 1 and 6 months, respectively. No serious treatment-related complications occurred. Conclusions: Both rESWT and corticosteroid injection therapy are effective modalities for treatment of chronic plantar fasciitis. However, rESWT seems to be superior to corticosteroid injection therapy due to its longer duration of action.

Comparing Intradermal Sterile Water with Intravenous Morphine in Reducing Pain in Patients with Renal Colic: A Double-Blind Randomized Clinical Trial

2020 ◽  
Vol 15 (1) ◽  
pp. 76-82
Author(s):  
Javad Mozafari ◽  
Mohammadreza Maleki Verki ◽  
Fatemeh Tirandaz ◽  
Reza Mahjouri
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Renal Colic ◽  
Therapeutic Effects ◽  
Sterile Water ◽  
Morphine Group ◽  
Double Blind ◽  
Water Group ◽  
Intravenous Morphine ◽  
Painful Area

Objective: The present study was conducted to investigate the effect of intradermal administration of sterile water compared to intravenous morphine on patients with renal colic. Methods: This double-blind, randomized clinical trial study was conducted in 2017 to compare the therapeutic effects of intradermal sterile water with those of intravenous morphine on patients with renal colic presenting to the emergency departments (ED) of Imam Khomeini and Golestan Hospitals in Ahvaz, Iran. The first group received 0.5 ml of intradermal sterile water, and the second group 0.1mg/kg of intravenous morphine plus 0.5 ml of intradermal sterile water in the most painful area or the center of the painful area in the flank. The pain severity was measured using a visual analogue scale (VAS), and the medication side-effects were recorded at the beginning of the study and minutes 15, 30,45 and 60. Result: A total of 94 patients were studied in two groups. The mean severity of pain was 2.97 ± 1.51 in the sterile water group and 2.34 ± 1.89 in the morphine group at minute 30 (P=0.042), 2.58 ± 1.43 in the sterile water group and 1 ± 1.23 in the morphine group at minute 45 (p<0.001), and 1.89 ± 1.7 in the sterile water group and 0.52 ± 0.79 in the morphine group at minute 60 (p<0.001). Conclusion: Morphine reduces pain faster and more effectively than intradermal sterile water; nevertheless, treatment with intradermal sterile water can be used as an appropriate surrogate or adjunct therapy for pain control, particularly in special patients or in case of medication scarcity.

Adjunctive Therapy to Manage Neuropsychiatric Symptoms in Moderate and Severe Dementia: Randomized Clinical Trial Using an Outpatient Version of Tailored Activity Program

2021 ◽  
pp. 1-12
Author(s):  
Alexandra Martini Oliveira ◽  
Marcia Radanovic ◽  
Patricia Cotting Homem de Mello ◽  
Patricia Cardoso Buchain ◽  
Adriana Dias Barbosa Vizzotto ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Sleep Disturbances ◽  
Rating Scale ◽  
Neuropsychiatric Symptoms ◽  
Caregiver Training ◽  
Controlled Clinical Trial ◽  
Post Intervention ◽  
Double Blind ◽  
Activity Program ◽  
Experimental Group

Background: Neuropsychiatric symptoms (NPS) such as aggression, apathy, agitation, and wandering may occur in up to 90%of dementia cases. International guidelines have suggested that non-pharmacological interventions are as effective as pharmacological treatments, however without the side effects and risks of medications. An occupational therapy method, called Tailored Activity Program (TAP), was developed with the objective to treat NPS in the elderly with dementia and has been shown to be effective. Objective: Evaluate the efficacy of the TAP method (outpatient version) in the treatment of NPS in individuals with dementia and in the burden reduction of their caregivers. Methods: This is a randomized, double-blind, controlled clinical trial for the treatment of NPS in dementia. Outcome measures consisted of assessing the NPS of individuals with dementia, through the Neuropsychiatric Inventory-Clinician rating scale (NPI-C), and assessing the burden on their caregivers, using the Zarit Scale. All the participants were evaluated pre-and post-intervention. Results: 54 individuals with dementia and caregivers were allocated to the experimental (n = 28) and control (n = 26) groups. There was improvement of the following NPS in the experimental group: delusions, agitation, aggressiveness, depression, anxiety, euphoria, apathy, disinhibition, irritability, motor disturbance, and aberrant vocalization. No improvement was observed in hallucinations, sleep disturbances, and appetite disorders. The TAP method for outpatient settings was also clinically effective in reducing burden between caregivers of the experimental group. Conclusion: The use of personalized prescribed activities, coupled with the caregiver training, may be a clinically effective approach to reduce NPS and caregiver burden of individuals with dementia.

scholarly journals Responsiveness of the Scripps Neurologic Rating Scale During a Multiple Sclerosis Clinical Trial

1999 ◽  
Vol 26 (4) ◽  
pp. 283-289 ◽  
Author(s):  
James A. Koziol ◽  
Adriana Lucero ◽  
Jack C. Sipe ◽  
John S. Romine ◽  
Ernest Beutler
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trial ◽  
Rating Scale ◽  
Effect Sizes ◽  
Active Therapy ◽  
Double Blind ◽  
Treatment Groups ◽  
Negative Effect ◽  
The Individual ◽  
Positive Effect

Objective:The Scripps neurologic rating scale (SNRS) is a summary measure of individual components comprising a neurological examination, designed for use in multiple sclerosis (MS). Our objective is to evaluate the responsiveness of the SNRS, within the context of a 2-year, randomized, double-blind crossover study of the efficacy of cladribine for treatment of secondary progressive MS.Methods:Effect sizes were determined for the SNRS and its components, separately for each treatment group (initial placebo, and initial cladribine) over both years of the clinical trial, using a standard random effects model.Results:Individual components tended to show positive effect sizes (improvement) during periods of active therapy in both treatment groups, and negative effect sizes (deterioration) during periods of no active therapy. Summation indices derived from the individual components of the SNRS seemed somewhat more stable than the individual components. The two components mentation and mood, and bladder, bowel, or sexual dysfunction, were rather unresponsive in our clinical trial.Conclusion:Changes in the components of the SNRS over the course of our clinical trial were consistent between the two treatment groups. Most components were moderately responsive; and, the summary SNRS score appropriately summarized the moderate magnitudes of change evinced in the individual components.

Modulation of Remifentanil-induced Analgesia and Postinfusion Hyperalgesia by Parecoxib in Humans

2006 ◽  
Vol 105 (5) ◽  
pp. 1016-1023 ◽  
Author(s):  
Andreas Tröster ◽  
Ruth Sittl ◽  
Boris Singler ◽  
Martin Schmelz ◽  
Jürgen Schüttler ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Rating Scale ◽  
Control Level ◽  
Numeric Rating Scale ◽  
Cyclooxygenase 2 ◽  
Controlled Study ◽  
Double Blind ◽  
Antinociceptive Effects ◽  
Current Densities ◽  
Mu Opioids

Background Numerous experimental and clinical studies suggest that brief opioid exposure can enhance pain sensitivity. It is suggested that spinal cyclooxygenase activity may contribute to the development and expression of opioid tolerance. The aim of the investigation was to determine analgesic and antihyperalgesic properties of the cyclooxygenase-2 inhibitor parecoxib on remifentanil-induced hypersensitivity in humans. Methods Fifteen healthy male volunteers were enrolled in this randomized, double-blind, placebo-controlled study in a crossover design. Transcutaneous electrical stimulation at high current densities was used to induce spontaneous acute pain (numeric rating scale 6 of 10) and stable areas of pinprick hyperalgesia. Pain intensities and areas of hyperalgesia were assessed before, during, and after a 30-min intravenous infusion of remifentanil (0.1 microg x kg x min) or placebo (saline). Parecoxib (40 mg) was administered intravenously either with onset of electrical stimulation (preventive) or in parallel to the remifentanil infusion. Results Remifentanil reduced pain and mechanical hyperalgesia during the infusion, but upon withdrawal, pain and hyperalgesia increased significantly above control level. Preventive administration of parecoxib led to an amplification of remifentanil-induced antinociceptive effects during the infusion (71.3 +/- 7 vs. 46.4 +/- 17% of control) and significantly diminished the hyperalgesic response after withdrawal. In contrast, parallel administration of parecoxib did not show any modulatory effects on remifentanil-induced hyperalgesia. Conclusion The results confirm clinically relevant interaction of mu opioids and prostaglandins in humans. Adequate timing seems to be of particular importance for the antihyperalgesic effect of cyclooxygenase-2 inhibitors.

A Comparative Trial of Opipramol and Chlordiazepoxide in the Treatment of Anxiety

1973 ◽  
Vol 1 (3) ◽  
pp. 145-150 ◽  
Author(s):  
K Jepson ◽  
G Beaumont
Keyword(s):  
Clinical Trial ◽  
General Practice ◽  
Side Effects ◽  
Rating Scale ◽  
Comparative Trial ◽  
Anxiety Score ◽  
Double Blind ◽  
Somatic Anxiety ◽  
Daily Dose ◽  
The Difference

A daily dose of 200 mg of opipramol (Insidon, Geigy) and 30 mg of chlordiazepoxide (Librium, Roche) were compared in a clinical trial in general practice. The trial was double blind and a stratified randomisation technique was employed. Twenty four patients received opipramol and twenty six chlordiazepoxide for four weeks. A total anxiety score and separate ‘psychic’ anxiety and ‘somatic’ anxiety scores were recorded, using a rating scale initially and after two and four weeks treatment. No overall difference in efficacy was found between the two drugs—opipramol producing a 76% improvement and chlordiazepoxide 64% by the end of the study. There was no difference in the relief of psychic anxiety. Although opipramol appeared to give more relief of somatic anxiety, the difference was not statistically significant. Again although opipramol relieved more individual symptoms than chlordiazepoxide, none of the differences were significant. 70% of patients on opipramol and 74% of those on chlordiazepoxide were classified ‘better’ globally by both doctor and patient by the end of the trial. The total number of side effects recorded was similar on both drugs although drowsiness occurred twice as frequently on chlordiazepoxide as it did on opipramol.

scholarly journals Plantar fascia calcification a sequelae of corticosteroid injection in the treatment of recalcitrant plantar fasciitis

2013 ◽  
Vol 2013 (aug16 1) ◽  
pp. bcr2013200303-bcr2013200303 ◽  
Author(s):  
T. P. Fox ◽  
G. Oliver ◽  
C. Wek ◽  
T. Hester
Keyword(s):  
Plantar Fasciitis ◽  
Corticosteroid Injection ◽  
Plantar Fascia
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