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 relevanceSilicone insole may be considered as a first-line treatment option in patients with plantar fasciitis.
Aim: The objective of this study is the evaluation of the effect of vitamin D replacement treatment on musculoskeletal symptoms and quality of life in patients with chronic widespread musculoskeletal pain (CWP) including fibromyalgia (FM) and vitamin D deficiency.Method: Patients with nonspecific CWP and vitamin D deficiency (25-OH D3 < 25 ng/mL) were included into the study. Replacement treatments of 50 000 IU/week oral vitamin D3 for 3 months were given to the patients. Patients were assessed pre-and post-treatment in terms of serum levels of Ca, P, alkaline phosphatase, 25-OH D3, severity of pain (visual analogue scale [VAS]-pain), severity of asthenia (VAS-asthenia), Beck Depression Inventory (BDI), quality of life scale (Short Form [SF]-36), tender point count (TPC), severity of waking unrefreshed, headache, tenderness on tibia, meeting the criteria of FM, and level of patient satisfaction.Results: Fifty-eight patients with a mean age of 36.9 AE 9.2 years were included into the study. 25-OH D3 levels of patients elevated from 10.6 AE 5.1 ng/mL to 46.5 AE 24.0 ng/mL after replacement treatment (P < 0.001). Marked decrease in VAS-pain, VAS-asthenia, severity of waking unrefreshed, TPC, and BDI and an evident increase in subgroups of SF-36 were established in patients after treatment (P < 0.001). The number of FM+ patients was 30 (52%) before treatment and regressed to 20 (34%) after treatment (P = 0.013); 85% of patients stated satisfaction with the treatment.Conclusions: Vitamin D replacement treatment in patients with nonspecific CWP has provided improvements in musculoskeletal symptoms, level of depression and quality of life of patients. Patients with CWP should be investigated for vitamin D deficiency.
The rehabilitation team should be aware of the fact that the perceived care burden may be greater due to the lack of knowledge concerning available resources and due to the inability to cope with stress effectively.
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