scholarly journals Comparison of the effect of hyaluronic acid injection versus extracorporeal shockwave therapy on chronic plantar fasciitis: Protocol for a randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0250768
Author(s):  
Gabriel Ferraz Ferreira ◽  
Davy Sevilla ◽  
Carolinne Nascimento Oliveira ◽  
Luiz Carlos Nogueira Junior ◽  
Gustavo Gonçalves Arliani ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Statistical Analysis ◽  
Repeated Measures ◽  
Plantar Fasciitis ◽  
Foot And Ankle ◽  
Ultrasound Guided ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Significant Difference

Background Plantar fasciitis is the most common cause of pain in the plantar region of the heel, and extracorporeal shockwave therapy (ESWT) is an option used in cases where conservative treatment fails. Hyaluronic acid (HA), initially used for osteoarthrosis, is a treatment option because it has been applied to extra-articular regions, such as tendons, ligaments, and fascia. The aim of the present study will be to evaluate the outcomes of pain, function, and personal satisfaction after a single injection of HA and to compare the results with those of ESWT in patients with chronic plantar fasciitis. Methods The study will include 80 patients who will be randomized to receive three sessions of ESWT (n = 40) or a single ultrasound-guided HA injection in the plantar fascia (n = 40). The outcomes will include the visual analog pain scale score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Outcome Score (FAOS). All of the assessments will be performed at baseline and 3, 6, and 12 months after treatment. Statistical analysis will be performed using the repeated measures ANOVA (analysis of variance test) for primary and secondary outcomes and also Fisher’s Least Significant Difference, a Post-Hoc test. We will use R software for statistical analysis, randomization, and sample size calculation. Results Recruitment and data collection will begin in November 2020, with completion scheduled for November 2022 and final publication available in March 2023. Conclusion This trial will evaluate the effects of a single ultrasound-guided HA injection for the treatment of chronic plantar fasciitis. Trial registration Brazilian Clinical Trials Registry (Register Number: RBR-97vkx4) http://www.ensaiosclinicos.gov.br/rg/RBR-97vkx4/.

Radiofrequency Thermal Lesioning and Extracorporeal Shockwave Therapy: A Comparison of Two Methods in the Treatment of Plantar Fasciitis

2016 ◽  
Vol 10 (3) ◽  
pp. 204-209 ◽  
Author(s):  
Fırat Ozan ◽  
Şemmi Koyuncu ◽  
Kaan Gürbüz ◽  
Eyyüp Sabri Öncel ◽  
Taşkın Altay
Keyword(s):  
Plantar Fasciitis ◽  
Radiographic Evaluation ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Study Results ◽  
Significant Difference ◽  
Group 2 ◽  
Therapeutic Study ◽  
Group 1

We compared the results of radiofrequency thermal lesioning (RTL) and extracorporeal shockwave therapy (ESWT) in patients with chronic plantar fasciitis. This prospective study included 56 patients diagnosed with plantar fasciitis who had complaints for ≥6 months: 40 (group 1) underwent ESWT and 16 (group 2) underwent RTL. The presence of calcaneal spurs was investigated with imaging studies. All patients were followed up clinically at baseline and 1, 3, and 6 months after treatment. Clinical evaluations were performed by the visual analog scale (VAS) and the modified Roles-Maudsley (RM) scoring system. There was no significant difference in the age, sex, body mass index, and side of involvement between the groups (all P > .05). Radiographic evaluation showed calcaneal spurs in 22 patients (55%) in group 1 and 7 patients (43%) in group 2. There was no significant difference in the baseline and posttreatment values between the groups; however, group 2 had significantly different RM values at 1 month than group 1 ( P < .05). In both groups, the VAS scores significantly decreased at 1, 3, and 6 months after treatment ( P < .05). The RM scores at 1, 3, and 6 months after treatment significantly decreased in both groups, except for the RM values at 1 month after treatment in group 1 ( P < .05). Our study results suggest that RTL and ESWT are safe and effective treatments in patients with chronic plantar fasciitis. Levels of Evidence: Level II: Therapeutic study

Assessment of the Efficacy of Extracorporeal Shockwave Therapy for Plantar Fasciitis with Magnetic Resonance Imaging Findings

2018 ◽  
Vol 108 (2) ◽  
pp. 100-105 ◽  
Author(s):  
Mualla Bicer ◽  
Elif Hocaoglu ◽  
Sema Aksoy ◽  
Ercan İnci ◽  
İlknur Aktaş
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Plantar Fasciitis ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Analog Scale ◽  
Mri Findings ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy

Background:Extracorporeal shockwave therapy (ESWT) has recently been used as a new treatment modality for plantar fasciitis. We aimed to determine the efficacy of ESWT by magnetic resonance imaging (MRI) findings.Methods:Thirty patients with plantar fasciitis who had received no treatment for 6 months were included. Extracorporeal shockwave therapy was applied once a week for a total of three sessions (frequency of 12–15 Hz, 2–3 bars, and 2,500 pulses). All of the patients were assessed with the visual analog scale, a 6-point evaluation scale, the Foot and Ankle Outcome Score (FAOS), and MRI findings before and 3 months after ESWT. Visual analog scale scores were used in determining the pain level of patients in the morning, during activity, and at rest. Foot and ankle–related problems were evaluated with the FAOS.Results:The duration of painless walking according to the 6-point rating scale, the FAOS, and pain showed significant improvements after ESWT (P &lt; .05). Significant decreases in MRI findings, including thickening of the plantar fascia, soft-tissue edema, and bone marrow edema, were observed after treatment (P &lt; .05).Conclusions:Extracorporeal shockwave therapy is a safe and effective treatment that yields favorable results in improvement of pain and function for plantar fasciitis. An MRI is useful for determining response to ESWT for these patients.

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.

Comparison of High-Dose Extracorporeal Shockwave Therapy and Intralesional Corticosteroid Injection in the Treatment of Plantar Fasciitis

2010 ◽  
Vol 100 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Istemi Yucel ◽  
Kutay Engin Ozturan ◽  
Yavuz Demiraran ◽  
Erdem Degirmenci ◽  
Gursel Kaynak
Keyword(s):  
Visual Analog Scale ◽  
Plantar Fasciitis ◽  
Therapeutic Response ◽  
Corticosteroid Injection ◽  
High Dose ◽  
Analog Scale ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Significant Difference

Background: The aim of this study was to evaluate the results of high-dose extracorporeal shockwave therapy applied with an ankle block and corticosteroid injection in patients with plantar fasciitis whose symptoms persisted for more than 6 months. Methods: Sixty patients were assessed clinically at presentation and at 3-month follow-up with a patient-assessed 100-mm visual analog scale of pain and a physician-assessed heel tenderness index. A therapeutic response rate was evaluated. A decrease of at least 50% from baseline to 3 months in visual analog scale or heel tenderness index scores was accepted as a successful result. Results: Extracorporeal shockwave therapy and corticosteroid injection provided significant improvements in visual analog scale and heel tenderness index scores, but between the two groups there was no significant difference in the visual analog scale score change 3 months after treatment (P &gt; .05). Twenty-seven of 33 patients (82%) in the extracorporeal shockwave therapy group and 23 of 27 (85%) in the corticosteroid injection group had a successful therapeutic response after 3 months. Conclusions: Corticosteroid injection and extracorporeal shockwave therapy are successful treatment modalities for plantar fasciitis. Corticosteroid injection treatment is cost effective compared with extracorporeal shockwave therapy, and corticosteroid injection may be the first treatment choice according to these results. (J Am Podiatr Med Assoc 100(2): 105–110, 2010)

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