scholarly journals Effectiveness of Massage Including Proximal Trigger Point Release for Plantar Fasciitis: a Case Report

2021 ◽  
Vol 14 (2) ◽  
pp. 22-29
Author(s):  
Lydia Juchli, RMT
Keyword(s):  
Treatment Option ◽  
Plantar Fasciitis ◽  
Rating Scale ◽  
Trigger Point ◽  
Numerical Rating Scale ◽  
Functional Limitations ◽  
Plantar Fascia ◽  
Functional Impairments ◽  
Massage Therapist ◽  
Plantar Surface

Background: Plantar fasciitis (PF) is a common degenerative condition of the plantar fascia. Symptoms include tenderness on the plantar surface of the foot, pain on walking after inactivity, and difficulty with daily activities. Rest, non-steroidal anti-inflammatories, and manual therapies are frequently used treatments for PF. Trigger point release (TrPR) for PF has been found as a viable treatment option. Objective: To determine the effects of massage, including proximal TrPR, for pain and functional limitations in a patient with PF. Method: A student massage therapist from MacEwan University administered five massages, one initial and one final assessment over five weeks to a 46-yearold female with diagnosed PF. She complained of unilateral plantar heel pain (PHP) and deep pulling from mid-glutes to the distal lower limb bilaterally. Evaluation involved active and passive range of motion, myotomes, dermatomes, reflexes, and orthopedic tests. The treatment aim was to decrease PHP by releasing active trigger points (TrPs) along the posterior lower extremity to the plantar surface of the foot, lengthening the associated muscles and plantar fascia. Hydrotherapy, Swedish massage, TrPR, myofascial release, and stretches were implemented. Pain was measured using the numerical rating scale pre- and post-treatments, and the Foot Function Index was used to assess function at the first, middle, and last appointments to assess the effectiveness of massage including proximal TrPR for PF. Results: PHP and functional impairments decreased throughout the fiveweek period. Conclusion: The results indicate massage, including proximal TrPR, may decrease pain and functional impairments in patients with PF. Further research is necessary to measure its efficacy and confirm TrPR as a treatment option.

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 Peripheral EphrinB1/EphB1 signalling attenuates muscle hyperalgesia in MPS patients and a rat model of taut band-associated persistent muscle pain

2020 ◽  
Vol 16 ◽  
pp. 174480692098407
Author(s):  
Feihong Jin ◽  
Lianying Zhao ◽  
Qiya Hu ◽  
Feng Qi
Keyword(s):  
Muscle Pain ◽  
Rating Scale ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Numerical Rating Scale ◽  
Protein Microarray ◽  
Trapezius Muscle ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Peripheral Sensitization

Background Myofascial pain syndrome (MPS) is an important clinical condition that is characterized by chronic muscle pain and a myofascial trigger point (MTrP) located in a taut band (TB). Previous studies showed that EphrinB1 was involved in the regulation of pathological pain via EphB1 signalling, but whether EphrinB1-EphB1 plays a role in MTrP is not clear. Methods The present study analysed the levels of p-EphB1/p-EphB2/p-EphB3 in biopsies of MTrPs in the trapezius muscle of 11 MPS patients and seven healthy controls using a protein microarray kit. EphrinB1-Fc was injected intramuscularly to detect EphrinB1s/EphB1s signalling in peripheral sensitization. We applied a blunt strike to the left gastrocnemius muscles (GM) and eccentric exercise for 8 weeks with 4 weeks of recovery to analyse the function of EphrinB1/EphB1 in the muscle pain model. Results P-EphB1, p-EphB2, and p-EphB3 expression was highly increased in human muscles with MTrPs compared to healthy muscle. EphB1 (r = 0.723, n = 11, P < 0.05), EphB2 (r = 0.610, n = 11, P < 0.05), and EphB3 levels (r = 0.670, n = 11, P < 0.05) in the MPS group were significantly correlated with the numerical rating scale (NRS) in the MTrPs. Intramuscular injection of EphrinB1-Fc produces hyperalgesia, which can be partially prevented by pre-treatment with EphB1-Fc. The p-EphB1 contents in MTrPs of MPS animals were significantly higher than that among control animals (P < 0.01). Intramuscular administration of the EphB1 inhibitor EphB1-Fr significantly suppressed mechanical hyperalgesia. Conclusions The present study showed that the increased expression of p-EphB1/p-EphB2/p-EphB3 was related to MTrPs in patients with MPS. This report is the first study to examine the function of EphrinB1-EphB1 signalling in primary muscle afferent neurons in MPS patients and a rat animal model. This pathway may be one of the most important and promising targets for MPS.

JALAUKĀVACARAṆA IN PLANTAR FASCIITIS

2020 ◽  
Vol 8 (10) ◽  
pp. 4724-4731
Author(s):  
Veena K Nambiar ◽  
George M. J
Keyword(s):  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Modern Medicine ◽  
Heel Pain ◽  
Time Saving ◽  
Clinical Assessments ◽  
Plantar Surface ◽  
Non Invasive ◽  
Recent Origin ◽  
Inflammatory Changes

Plantar fasciitis is a disorder that results in pain in the heel and plantar surface. Chronic inflammation of posterior bony attachment of the plantar aponeurosis is known as plantar fasciitis. As per statistics, 1 in 10 people develop heel pain at some point in their life. Out of heel pain from all causes, 80% is due to plantar fasciitis. People are advised to take rest, physiotherapy, orthotics, splinting or steroid injections. Despite proper management in modern medicine, reoccurrence rate is more. Hence it is relevant to find out a meth-od of management of this condition using Ayurveda. The causative and risk factors create a cumulative micro trauma to plantar fascia and it may be considered as Vraṇa and the inflammatory changes in plantar fascia may be considered as Vraṇa Śōpha. For inflammations with recent origin bloodletting should be car-ried out to reduce pain and obviate suppuration. So Jalaukāvacaraṇa was done as it is a non-invasive, pa-tient compliant and time saving procedure. A total number of 20 participants with the symptoms of plantar fasciitis were selected and evaluated, by taking detailed history and clinical examination. The study was conducted at Shalyatantra OPD of VPSV AVC, Kottakkal. Jalaukāvacaraṇa was done on 1st, 8th and 15th days. Clinical assessments were done on 1st, 8th, 15th 22nd and 43rd days. On statistical analysis, it was found that the Jalaukāvacaraṇa shows 67.85 % of effect in the management of plantar fasciitis. Ja-laukāvacaraṇa is having more efficacy in acute cases (duration within 6 months), as Raktaviśrāvaṇa is indicated for recent inflammations.

scholarly journals Pain Predicts Function One Year Later: A Comparison across Pain Measures in a Rheumatoid Arthritis Sample

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Vivian Santiago ◽  
Karen Raphael ◽  
Betty Chewning
Keyword(s):  
Rheumatoid Arthritis ◽  
Pain Intensity ◽  
Severe Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Functional Limitations ◽  
Measurement Scale ◽  
Impact Measurement ◽  
Patient Reported ◽  
One Year

Background. Guidance is limited on best measures and time periods to reference when measuring pain in order to predict future function. Objective. To examine how different measures of pain predict functional limitations a year later in a sample of rheumatoid arthritis patients. Methods. Logistic regression analyses were conducted using baseline and one-year data (n=262). Pain intensity in the last 24 hours was measured on a 0–10 numerical rating scale and in the last month using an item from the Arthritis Impact Measurement Scale 2 (AIMS2). AIMS2 also provided frequency of severe pain, pain composite scores, and patient-reported limitations. Physician-rated function was also examined. Results. Composite AIMS2 pain scale performed best, predicting every functional outcome with the greatest magnitude, a one-point increase in pain score predicting 21% increased odds of limitations (combined patient and physician report). However, its constituent item—frequency of severe pain in the last month—performed nearly as well (19% increased odds). Pain intensity measures in last month and last 24 hours yielded inconsistent findings. Conclusion. Although all measures of pain predicted some functional limitations, predictive consistency varied by measure. Frequency of severe pain in the last month provided a good balance of brevity and predictive power.

Effect of Acupuncture Treatment on Heel Pain Due to Plantar Fasciitis

1998 ◽  
Vol 16 (2) ◽  
pp. 66-68 ◽  
Author(s):  
A Tillu ◽  
S Gupta
Keyword(s):  
Pain Relief ◽  
Plantar Fasciitis ◽  
Acupuncture Treatment ◽  
Trigger Point ◽  
Plantar Fascia ◽  
Heel Pain ◽  
Poor Responders ◽  
Percentage Improvement ◽  
Significant Difference ◽  
History Of

Eighteen patients attending an orthopaedic outpatient clinic with a year or more's history of heel pain due to plantar fasciitis were studied. All had had conservative treatment of physiotherapy and shoe-support without significant pain relief before acupuncture was offered, and thus acted as their own controls for the purposes of the study. The following traditional points were needled: Taixi (KI.3), Kunlun (BL.60) and Sanyinjiao (SP.6). Pain was assessed by a 100mm visual analogue scale (VAS) before treatment was started and after four, weekly sessions of acupuncture treatment. If complete pain relief was not obtained by the initial four-week treatment, a further two, weekly sessions of the above mentioned acupoints, with the addition of trigger point acupuncture in the gastro-soleus and plantar fascia, was carried out and pain assessed. Patients were also assessed with a verbal rating score to indicate the percentage improvement after acupuncture compared to before treatment. The mean duration of heel pain was 25.11 months (SD 10.68). The VAS data obtained at 4 and 6 weeks of acupuncture treatment showed a statistically highly significant improvement compared to the VAS before acupuncture (p < 0.0009 and p < 0.0001 respectively). Using the Mann-Whitney test, there was a statistically significant difference in VAS obtained at 6 weeks, after trigger point acupuncture had been added for poor responders, compared to that obtained after the first 4 weeks of acupuncture treatment (p < 0.047). Our study demonstrates that acupuncture is effective in treating patients with chronic heel pain due to plantar fasciitis and that the addition of trigger point acupuncture in poor or non-responders may be useful.

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.

Combination Therapy Versus Exercise and Orthotic Support in the Management of Pain in Plantar Fasciitis: A Randomized Controlled Trial

2018 ◽  
Vol 39 (4) ◽  
pp. 406-414 ◽  
Author(s):  
Eda Cinar ◽  
Shikha Saxena ◽  
Fatma Uygur
Keyword(s):  
Usual Care ◽  
Repeated Measures ◽  
Plantar Fasciitis ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Low Level Laser Therapy ◽  
Home Exercise ◽  
Extracorporeal Shock Wave ◽  
Pain Subscale ◽  
And Control

Background: This study aimed at estimating the effectiveness of two commonly used modalities—extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT)—each combined with usual care (exercises and orthotic supports) in comparison to only usual care to relieve pain in patients with plantar fasciitis (PF). Methods: Participants with PF were randomly allocated into 3 groups: ESWT (n = 25), LLLT (n = 24), and control (n = 17). All participants received a home exercise program with orthotic support. The ESWT group received 2000 shock waves with 0.02 mJ/mm2 for 3 sessions, once a week; LLLT group received gallium-aluminum-arsenide laser with 850 nm wavelength for 10 sessions, 3 times a week. Pain was measured by Foot Function Index-pain subscale (FFI-p) and Numerical Rating Scale for pain (NRS-p). The scores were recorded at baseline, third week, and third month after the treatment. Analysis was performed using repeated measures ANOVA. Results: There was a significant improvement in pain over the 3 months in all groups on both FFI-p ( P < .001) and NRS-p ( P < .001). In NRS-p, LLLT group had significantly lower pain than ESWT ( P = .002) at the third week and control ( P = .043) and ESWT ( P = .003) at third month. In FFI-p total score, ESWT group had higher pain than LLLT ( P = .003) and control ( P = .035) groups at third week and LLLT ( P = .010) group at third month. Conclusion: When LLLT and ESWT were combined with usual care, LLLT was found to be more effective than ESWT in reducing pain in PF at short-term follow-up. Level of Evidence: Level II, comparative study.

scholarly journals Efficacy of Stretching Exercises in the Treatment of Chronic Plantar Fasciitis: A Prospective Study in Manipal Teaching Hospital, Pokhara, Nepal

2011 ◽  
Vol 2 (2) ◽  
pp. 97-101 ◽  
Author(s):  
Manoj Kumar Chakraborty ◽  
Pratendra Raj Onta ◽  
Brijesh Sathian
Keyword(s):  
Plantar Fasciitis ◽  
Functional Limitations ◽  
Weight Bearing ◽  
Poor Response ◽  
Plantar Fascia ◽  
High Rate ◽  
Medical Sciences ◽  
Pre Treatment ◽  
Stretching Exercises

Objective: Chronic plantar fasciitis developed in ten percent of cases with poor response. Specific plantar stretching exercises alone improves the patient with better outcome. It is self limited process with resolution of symptoms within one year but five percent cases may require surgical intervention in intractable cases. The purpose of this study was to evaluate the long term outcomes of the plantar fascia specific stretching exercise only for chronic plantar fasciitis. Material & Methods: 50 patients with chronic plantar fasciitis for more than three month duration were enrolled in our study for post treatment follow up with effect from Jan 2010 to Jan 2011 in Department of Orthopedics of Manipal College of Medical Sciences. All patients received plantar specific stretching exercise protocol for twelve months interval of one week, three week, two months, six months and twelve months. Results: Out of 50 patients, 36(72%) were female and 14 (28%) were male. 36(72%) were left sided and 14 (28%) were right. Mean age of patients were 46.12±SD7.11 years. The pre treatment mean visual analogue scale score for all patients is significantly higher than every follow up (p=0.0001). Conclusion: This stretching of the plantar fascia is a modification of the traditional stretch weight bearing to tissue specific plantar fascia stretching protocol to optimize tissue tension through a controlled stretch of plantar fascia by recreation of windlass mechanism with high rate of satisfaction in regards to decrease of pain and functional limitations. Key Words: Chronic plantar fasciitis; stretching; windlass mechanism DOI: http://dx.doi.org/10.3126/ajms.v2i2.4218 Asian Journal of Medical Sciences 2 (2011) 97-101

Atypical Presentation of Plantar Fasciitis Secondary to Soft-Tissue Mass Infiltration

2001 ◽  
Vol 91 (2) ◽  
pp. 89-92 ◽  
Author(s):  
Alan Ng ◽  
Terrance Beegle ◽  
Andrea K. Rockett
Keyword(s):  
Plantar Fasciitis ◽  
Soft Tissue Mass ◽  
Trigger Point ◽  
Signs And Symptoms ◽  
Plantar Fascia ◽  
Surgical Excision ◽  
Resonance Imaging ◽  
Tissue Mass ◽  
Over The Counter ◽  
History Of

This article describes a patient with plantar fascial pain who presented to the office of one of the authors. Physical examination and the patient’s description of the history of symptoms revealed classic signs and symptoms of plantar fasciitis. The patient was treated with numerous conservative modalities, including ultrasound, nonsteroidal anti-inflammatory medications, trigger-point injections, over-the-counter orthoses, and stretching exercises. When the pain was not relieved by these conservative measures, magnetic resonance imaging of the area was performed. Visualization of the insertional area of the plantar fascia revealed a mass inferior to, as well as infiltrated into, the plantar fascia. Surgical excision of the lesion resulted in complete elimination of the patient’s pain. (J Am Podiatr Med Assoc 91(2): 89-92, 2001)

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