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

Babaei-Ghazani, Arash; Karimi, Neda; Forogh, Bijan; Madani, Seyed Pezhman; Ebadi, Safoora; Fadavi, Hamid Reza; Sobhani-Eraghi, Amir; Razavi, Seyede Zahra Emami; Raeissadat, Seyed Ahmad; Eftekharsadat, Bina

doi:10.1093/pm/pny066

Cited by 27 publications

(20 citation statements)

References 19 publications

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“…They also achieved the same result that steroid injection provided a more rapid and short-term therapeutic effect. On the other hand, they concluded that ozone (O2–O3) injection could be a beneficial option with slow onset and a longer durability 31. Among their findings, the latter was not supported by the present data.…”

Section: Discussioncontrasting

confidence: 97%

“…Few studies have been conducted on the efficacy of ozone injection in chronic inflammatory diseases, and there has been only one previous study,31 comparing the effects of local ozone injection versus the corticosteroids for plantar fasciopathy. Therefore, we have firstly compared our results with earlier studies on other treatment methods.…”

Section: Discussionmentioning

confidence: 99%

“…It has previously been proven to be effective in the management of knee osteoarthritis, myofascial pain syndrome (MPS), and several other conditions 28–30. To the best of our knowledge,31–35 except for one article,31 there are no prospective studies comparing the efficacy of local steroid injection with ozone for the treatment of plantar fasciopathy. Therefore, in this trial we aimed to compare the efficacy and safety of these two injections added to standard conservative treatments available for plantar fasciopathy.…”

Section: Introductionmentioning

confidence: 99%

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Local ozone (O2–O3) versus corticosteroid injection efficacy in plantar fasciitis treatment: a double-blinded RCT

Bahrami¹,

Raeissadat²,

Barchinejad³

et al. 2019

JPR

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Purpose To compare the efficacy of local ozone injection versus corticosteroid in plantar fasciopathy treatment. Patients and methods This double-blinded randomized trial was performed on 44 adult patients with plantar fasciopathy. One group (23 patients) received local injection of 40 mg methylprednisolone, while a local injection of 3 cc oxygen-ozone solution was performed for the other group (21 subjects). Severity of pain, functional level, and pressure-pain threshold (PPT) were measured before treatment and 1, 4, and 12 weeks after injection using VAS, Foot and Ankle Ability Measure (FAAM) questionnaire, and algometer for PPT, respectively. Results The majority (65.9%) of the total 44 patients analyzed, were women. Both treatments efficiently relieved patients' pain and improved their functions at 1 and 3 months follow-up time-points. But one week after injection, the improvement in VAS ( p <0.001) and FAAM ( p <0.001) was significant only in the corticosteroid group. During the first month, VAS ( p =0.35) and PPT ( p =0.003) were still better in the corticosteroid group. However, FAAM revealed no remarkable difference between the two groups ( p =0.083). Eventually, at the third month of follow-up, there was no remarkable preference between the treatments regarding any of the outcome measures ( p >0.05). Nevertheless, both methods efficiently improved patients' symptoms, ie, over the 50% of pain reduction and 30% improvement in functional status. Conclusion The present results showed no remarkable superiority between the two groups. In other words, although ozone injection showed a slower efficacy than methylprednisolone, it could be used in plantar fasciitis management as an appropriate alternative.

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Section: Discussioncontrasting

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Local ozone (O2–O3) versus corticosteroid injection efficacy in plantar fasciitis treatment: a double-blinded RCT

Bahrami¹,

Raeissadat²,

Barchinejad³

et al. 2019

JPR

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“…In addition, some other recent original studies and reviews have demonstrated the usefulness of oxygen-ozone therapy, in the treatment of other musculoskeletal conditions 19–23,28–30. Based on the previous researches, ozone has no serious side effect.…”

Section: Discussionmentioning

confidence: 99%

Interesting effectiveness of ozone injection for carpal tunnel syndrome treatment: a randomized controlled trial

Bahrami

Raeissadat

et al. 2019

ORR

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Purpose: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the upper limb. Local injection of different substances has been increasingly used as an acceptable conservative treatment in non-severe cases. This study aimed to evaluate the efficacy and safety of local ozone injection in the management of non-severe CTS. Methods: In the current randomized controlled trial (RCT), 40 patients with mild or moderate CTS were included in two parallel groups. Both of them used the resting volar wrist splint for 8 weeks; while the intervention group received a single dose of local ozone injection, except for the same splinting protocol. The main outcome measures including visual analog scale (VAS) for pain; symptom severity or functional status, based on Boston questionnaire (BQ); and median nerve conduction study, were reassessed 10 weeks after the treatment. Results: All of the measures including VAS, symptom severity, functional status and EDX improved significantly in both groups with the maximal changes in VAS. The VAS reduction was more remarkable in the ozone group than the control group [64% versus 45.3%, respectively]. Moreover, both of the BQ subscales showed significantly higher improvement in the ozone group compared to the control group ( P =0.01 and 0.02, respectively). Although the improvement of EDX parameters was slightly better in the ozone group, the difference was not significant. Neither minor nor major side effects were reported. Conclusion: Ozone therapy as a safe and low-cost method, could provide promising results among women with mild to moderate CTS, at least for short-term treatment. Clinical trial registration: IRCT2016040913442N9.

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“…Currently, the most common indications of using ultrasound in PM&R by the practitioners are as follows: as a guide in peripheral nerve block, local anesthesia and other pain control procedures, intraarticular and spinal injections (epidural block, facet joints, ganglions and …), soft tissue injections, and the diagnostic role in pathologies such as tendon, muscle, and nerve injuries [3][4][5][6][7][8][9][10][11][12][13]. Also, this method has been used in evaluating joint disorders such as knee osteoarthritis and temporomandibular joint derangement [14,15].…”

Section: Introductionmentioning

confidence: 99%

Beliefs, attitude, and knowledge of the Iranian physiatrists towards neuromusculoskeletal ultrasound and common barriers in its application

Khodadadi

Karimzade

Rayegani

et al. 2020

BMC Musculoskelet Disord

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Background Regarding the increasing application of neuromusculoskeletal sonography among medical specialties, specifically physiatrists, this study aims to assess the knowledge and skill level of these specialists in neuromusculoskeletal sonography in Iran. Methods This descriptive, cross-sectional study was performed in 2018. The utilized questionnaire developed based on previous studies in collaboration with 6 university lecturers of Shaheed Beheshti, Iran, and Tabriz medical universities and a physiatrist from Hacettepe University (Turkey); it included questions entailing demographic data, knowledge, and performance levels. Its validity and reliability were evaluated through face validation, pilot study, and the Cronbach α calculated via SPSS. Data extraction and analysis were also performed by SPSS-25. Results Of 364 questionnaires distributed, 300 were properly filled and entered into the study, of which, 38% were filled by clinical residents, 10% university lecturers, and 52% other categories (e.g. private sector). The average number of musculoskeletal patient visits was 140.6 ± 119 and the mean number of musculoskeletal sonographies requested was 8.2 ± 5.2 per month (the three most common indications reported as the shoulder, carpal tunnel syndrome, and tendon injuries). 95% of the participants considered the importance of sonography for physiatrists to be “very high” or “high”; with the most valuable applications “as a guide for procedures (90%), its diagnostic utility (68%), and follow up/evaluating the response to treatment (45%). 86% of physiatrists reported they had participated in musculoskeletal sonography courses, 60% during residency, and the rest through workshops. Also, the participants mentioned safety (83%), the possibility of performing simultaneous diagnosis and intervention procedures (70%), repeatability (58%), and dynamic imagery (52%) as the major advantages of musculoskeletal ultrasound. Conclusion a large number of doctors consider musculoskeletal sonography to be essential for physiatrists, though insufficient education on the subject and the low number of ultrasound devices are some of the obstacles in enhancing the use of this technology in PM&R setting. Presenting certified specific training courses during residency, provision of necessary rotations, using the capacities of the PM&R scientific committee, and the private sector for running workshops and professional training courses are suggested for enhancing the knowledge and skills of neuromusculoskeletal sonography.

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

Cited by 27 publications

References 19 publications

<p>Local ozone (O<sub>2</sub>–O<sub>3</sub>) versus corticosteroid injection efficacy in plantar fasciitis treatment: a double-blinded RCT</p>

<p>Local ozone (O<sub>2</sub>–O<sub>3</sub>) versus corticosteroid injection efficacy in plantar fasciitis treatment: a double-blinded RCT</p>

<p>Interesting effectiveness of ozone injection for carpal tunnel syndrome treatment: a randomized controlled trial</p>

Beliefs, attitude, and knowledge of the Iranian physiatrists towards neuromusculoskeletal ultrasound and common barriers in its application

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