Comparison of Injection Modalities in the Treatment of Plantar Heel Pain

In a prospective randomized study of plantar heel pain, 44 patients were treated with injection of 1 mL of 2% prilocaine using the peppering technique, 1 mL of 2% prilocaine combined with 2 mL of autologous blood, or 1 mL of 2% prilocaine mixed with 40 mg of methylprednisolone acetate. At 6-month follow-up, clinical improvement was evaluated by using a 10-cm visual analog scale and the rearfoot score of the American Orthopaedic Foot and Ankle Society. Results were analyzed using sample t-tests within groups and repeated-measures analyses of variance between groups. Mean ± SD visual analog scale scores in the peppering technique, autologous blood injection, and corticosteroid injection groups improved from 6.4 ± 1.1, 7.6 ± 1.3, and 7.28 ± 1.2 to 2.0 ± 2.2 (P < .001), 2.4 ± 1.8 (P < .001), and 2.57 ± 2.9 (P < .001), respectively. Mean ± SD rearfoot scores in the same groups improved from 64.1 ± 15.1, 71.6 ± 1, and 65.7 ± 12.7 to 78.2 ± 12.4 (P = .018), 80.9 ± 13.9 (P = .025), and 80.07 ± 17.5 (P = .030), respectively. There were no statistically significant differences among the groups. Good outcomes have been documented using the peppering technique and autologous blood injection for the treatment of lateral epicondylitis. Although the curative mechanisms of both injection modalities are based on a hypothesis, they seem to be good alternatives to corticosteroid injection for the treatment of plantar heel pain. (J Am Podiatr Med Assoc 96(4): 293–296, 2006)

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A randomised control trial to evaluate the efficacy of autologous blood injection versus local corticosteroid injection for treatment of lateral epicondylitis

Bone and Joint Research ◽

10.1302/2046-3758.18.2000095 ◽

2012 ◽

Vol 1 (8) ◽

pp. 192-197 ◽

Cited By ~ 22

Author(s):

C. M. Dojode

Keyword(s):

Corticosteroid Injection ◽

Autologous Blood ◽

Lateral Epicondylitis ◽

Randomised Control Trial ◽

Autologous Blood Injection ◽

Blood Injection ◽

Local Corticosteroid Injection

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A single blinded randomised controlled trial: To evaluate the efficacy of local autologous blood injection versus local corticosteroid injection for treatment of lateral epicondylitis

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2016.v2.i4e.50 ◽

2016 ◽

Vol 2 (4e) ◽

pp. 311-315

Author(s):

Dr. Rajesh Sajjan Shetty ◽

◽

Dr. Sridhar DK ◽

Dr. Jaipalsinh R Mahida ◽

◽

...

Keyword(s):

Randomised Controlled Trial ◽

Corticosteroid Injection ◽

Controlled Trial ◽

Autologous Blood ◽

Lateral Epicondylitis ◽

Autologous Blood Injection ◽

Blood Injection ◽

Randomised Controlled ◽

Local Corticosteroid Injection

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PLANTAR FASCIITIS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.01.2613 ◽

2019 ◽

Vol 26 (01) ◽

Author(s):

Raja Umar Liaqat ◽

Junaid Khan ◽

Fareeha Chaudhry ◽

Muhammad Imran Aftab ◽

Riaz Ahmed

Keyword(s):

Pain Score ◽

Plantar Fasciitis ◽

Corticosteroid Injection ◽

Controlled Trial ◽

Autologous Blood ◽

Heel Pain ◽

Score Study ◽

Plantar Heel Pain ◽

Group A ◽

Group B

Objectives: To compare Intra-lesional corticosteroid injection with autologous blood injection therapy in plantar fasciitis in terms of mean pain score. Study Design: Randomized Controlled Trial (RCT). Place and Duration: At the Department of Orthopaedics, Benazir Bhutto Hospital, Rawalpindi, for a duration of 01 year i.e. from 7th May 2016 to 6th May 2017. Patients and Methods: Patients with unilateral plantar heel pain fulfilling the inclusion criteria were included in the study. Patients were randomly allocated into two groups; A and B. Group A were injected 2mL corticosteroid injection in heel. Those in Group B were injected with 2mL of autologous blood mixed with 1 mL of 2% lidocaine. Outcome was assessed using Visual Analog Score (VAS) at 3 months. Results: A total of 180 patients with unilateral plantar heel pain were included. Mean age of patients was 49.98±11.26 years. 91 (50.6%) were male and 89 (49.4%) females. At 12-weeks post-treatment, mean pain score was significantly high in group A than group B (3.24±1.05 vs. 2.54±1.01; p=0.0005). Conclusion: Autologous blood was more effective than corticosteroid injection in patients with plantar fasciitis as was seen at 3 months follow-up.

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Intralesional Autologous Blood Injection Compared to Corticosteroid Injection for Treatment of Chronic Plantar Fasciitis. A Prospective, Randomized, Controlled Trial

Foot & Ankle International ◽

10.3113/fai.2007.0984 ◽

2007 ◽

Vol 28 (9) ◽

pp. 984-990 ◽

Cited By ~ 61

Author(s):

Tze Gin Lee ◽

Tunku Sara Ahmad

Keyword(s):

Blood Group ◽

Plantar Fasciitis ◽

Corticosteroid Injection ◽

Autologous Blood ◽

Randomized Controlled ◽

Pressure Algometer ◽

Significant Difference ◽

Autologous Blood Injection ◽

Blood Injection ◽

Over Time

Background: The response of chronic plantar fasciitis to any treatment is unpredictable. Autologous blood might provide cellular and humoral mediators to induce healing in areas of degeneration, the underlying pathology in plantar fasciitis. This study compared the efficacy of intralesional autologous blood with corticosteroid injection for plantar fasciitis present for more than 6 weeks. Methods: A prospective, randomized, controlled, observer-blinded study was done over a period of 6 months. Sixty-four patients were randomly allocated to either the autologous blood or corticosteroid treatment group. All patients were assessed for the worst pain daily on visual analogue scale (VAS) and tenderness threshold (TT) at the plantar fascia origin using a pressure algometer before treatment, and at 6 weeks, 3 months, and 6 months after treatment. A p value of 0.05 was considered significant. Results: Data were complete for 61 patients. The reduction in VAS and increase in TT for both groups was significant over time ( p < 0.0001). At 6 weeks and 3 months, the corticosteroid group had significantly lower VAS than the autologous blood group ( p < 0.011 and p < 0.005, respectively), but the difference was not significant at 6 months. The corticosteroid group had significantly higher TT than the autologous blood group at 6 weeks, 3 months and 6 months ( p < 0.003, p < 0.003, p < 0.008, respectively). Although the trends were different, repeated-measures F test of both VAS and TT showed no significant difference in improvement between the groups over time. Conclusions: Intralesional autologous blood injection is efficacious in lowering pain and tenderness in chronic plantar fasciitis, but corticosteroid is more superior in terms of speed and probably extent of improvement.

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Results of autologous venous blood injections in plantar fasciitis: a prospective clinical study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174580 ◽

2017 ◽

Vol 5 (10) ◽

pp. 4478

Author(s):

Khurshid Ahmad Bhat ◽

Suhail Ahmad Bhat ◽

Khalid Muzaffar ◽

Muhammad Haseeb

Keyword(s):

Pain Score ◽

Plantar Fasciitis ◽

Autologous Blood ◽

Venous Blood ◽

Plantar Fascia ◽

Heel Pain ◽

Prospective Clinical Study ◽

History Of ◽

Autologous Blood Injection ◽

Blood Injection

Background: Plantar fasciitis is a degenerative disease of plantar fascia and is one of the most common causes of heel pain. The response to any treatment modality is unpredictable. The autologous blood might induce healing in the areas of degeneration by providing cellular and humoral components. The aim of this study was therefore to evaluate the results of autologous blood injection in plantar fasciitis.Methods: Thirty-two patients (average age of 42.4 years), 14 males (43.7%) and 18 females (56.2%) with history of chronic heel pain of more than 6 months duration were taken up for autologous blood injection. All the patients in this study were clinically evaluated and the visual analogous pain score was calculated from each patient pre-procedure and at 3 and 6 months after the procedure.Results: There was a significant improvement in VAS pain score in this study. Pre-procedure VAS pain score of 6.9 (average 4-10) was reduced to a mean score of 4.28 (average 0-9) at 3 months and a mean score of 3 (average 0-9) at 6 months.Conclusions: Autologous blood is an effective method of controlling pain in patients with plantar fasciitis.

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Autologous Blood Injection and Wrist Immobilisation for Chronic Lateral Epicondylitis

Advances in Orthopedics ◽

10.1155/2012/387829 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Nicola Massy-Westropp ◽

Stuart Simmonds ◽

Suzanne Caragianis ◽

Andrew Potter

Keyword(s):

Tennis Elbow ◽

Autologous Blood ◽

Lateral Epicondylitis ◽

Contralateral Limb ◽

Cortisone Injection ◽

Autologous Blood Injection ◽

Blood Injection ◽

And Function ◽

Prospective Longitudinal ◽

Extensor Carpi Radialis

Purpose. This study explored the effect of autologous blood injection (with ultrasound guidance) to the elbows of patients who had radiologically assessed degeneration of the origin of extensor carpi radialis brevis and failed cortisone injection/s to the lateral epicondylitis.Methods. This prospective longitudinal series involved preinjection assessment of pain, grip strength, and function, using the patient-rated tennis elbow evaluation. Patients were injected with blood from the contralateral limb and then wore a customised wrist support for five days, after which they commenced a stretching, strengthening, and massage programme with an occupational therapist. These patients were assessed after six months and then finally between 18 months and five years after injection, using the patient-rated tennis elbow evaluation.Results. Thirty-eight of 40 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not.Conclusions. Autologous blood injection improved pain and function in a worker’s compensation cohort of patients with chronic lateral epicondylitis, who had not had relief with cortisone injection.

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