Novel and Conservative Approaches Towards Effective Management of Plantar Fasciitis

Assad, Salman; Ahmad, Awaiz; Kiani, Immad; Ghani, Usman; Wadhera, Vikram; Tom, Todd N

doi:10.7759/cureus.913

Cited by 15 publications

(18 citation statements)

References 18 publications

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“…[ 82 ] The FFI is the most widely used foot-specific self-reporting measure[ 83 ] and is a commonly used outcome measure in patients with PF. [ 22 , 32 , 41 ] The FFI has been shown to be valid, reliable and sensitive to change in various populations with a variety of foot and ankle disorders. [ 83 , 84 ] Subscale scores range from 0% to 100%, with higher scores indicating lower levels of function and poorer foot health-related quality of life.…”

Section: Methodsmentioning

confidence: 99%

“…For cases of persistent PF, physicians often recommend corticosteroid injections;[ 8 , 31 ] however, while corticosteroid injections may be useful for managing PF symptoms at short-term, long-term outcomes appear to be lacking. [ 23 , 32 , 33 ] Moreover, steroid injections have been linked with plantar fat pad atrophy, calcaneal osteomyelitis, plantar fascia weakening and rupture. [ 34 – 36 ] Platelet rich plasma treatment has also been found to be effective for PF;[ 37 ] nevertheless, platelet rich plasma injections are considered controversial, expensive and are not normally covered by insurance plans.…”

Section: Introductionmentioning

confidence: 99%

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Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial

et al. 2018

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Study DesignRandomized, single-blinded, multi-center, parallel-group trial.ObjectivesTo compare the effects of adding electrical dry needling into a program of manual therapy, exercise and ultrasound on pain, function and related-disability in individuals with plantar fasciitis (PF).BackgroundThe isolated application of electrical dry needling, manual therapy, exercise, and ultrasound has been found to be effective for PF. However, no previous study has investigated the combined effect of these interventions in this population.MethodsOne hundred and eleven participants (n = 111) with plantar fasciitis were randomized to receive electrical dry needling, manual therapy, exercise and ultrasound (n = 58) or manual therapy, exercise and ultrasound (n = 53). The primary outcome was first-step pain in the morning as measured by the Numeric Pain Rating Scale (NPRS). Secondary outcomes included resting foot pain (NPRS), pain during activity (NPRS), the Lower Extremity Functional Scale (LEFS), the Foot Functional Index (FFI), medication intake, and the Global Rating of Change (GROC). The treatment period was 4 weeks with follow-up assessments at 1 week, 4 weeks, and 3 months after the first treatment session. Both groups received 6 sessions of impairment-based manual therapy directed to the lower limb, self-stretching of the plantar fascia and the Achilles tendon, strengthening exercises for the intrinsic muscles of the foot, and therapeutic ultrasound. In addition, the dry needling group also received 6 sessions of electrical dry needling using a standardized 8-point protocol for 20 minutes. The primary aim was examined with a 2-way mixed-model analysis of covariance (ANCOVA) with treatment group as the between-subjects variable and time as the within-subjects variable after adjusting for baseline outcomes.ResultsThe 2X4 ANCOVA revealed that individuals with PF who received electrical dry needling, manual therapy, exercise and ultrasound experienced significantly greater improvements in first-step morning pain (F = 22.021; P<0.001), resting foot pain (F = 23.931; P<0.001), pain during activity (F = 7.629; P = 0.007), LEFS (F = 13.081; P<0.001), FFI Pain Subscale (F = 13.547; P<0.001), FFI Disability Subscale (F = 8.746; P = 0.004), and FFI Total Score (F = 10.65; P<0.001) than those who received manual therapy, exercise and ultrasound at 3 months. No differences in FFI Activity Limitation Subscale (F = 2.687; P = 0.104) were observed. Significantly (X2 = 9.512; P = 0.023) more patients in the electrical dry needling group completely stopped taking medication for their pain compared to the manual therapy, exercise and ultrasound group at 3 months. Based on the cutoff score of ≥+5 on the GROC, significantly (X2 = 45.582; P<0.001) more patients within the electrical dry needling group (n = 45, 78%) achieved a successful outcome compared to the manual therapy, exercise and ultrasound group (n = 11, 21%). Effect sizes ranged from medium to large (0.53

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial

et al. 2018

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“…Three reviews without meta-analysis reported superiority of PRP treatment. [64][65][66] On the opposite, two recent meta-analysis of nine RCTs failed to confirm those data. 67 68 Tsikopoulos et al 67 showed that corticosteroid injections are more effective in pain relief in the short term, whereas Yang et al 68 ► Most common term referred to a cluster of products including: autologous conditioned plasma, platelet-enriched plasma, platelet-rich concentrate, autogenous platelet gel, platelet releasate, platelet rich in growth factors and others.…”

Section: Plantar Fasciitismentioning

confidence: 99%

“…However, around 10% of patients seemed not to respond positively. 64 Therefore, PRP injections into the plantar fascia, with or without ultrasound guidance, have been recently introduced as an alternative therapy. Recent systematic reviews, comparing corticosteroid versus PRP injections, reported controversial results.…”

Section: Plantar Fasciitismentioning

confidence: 99%

Platelet-rich plasma in orthopaedic sports medicine: state of the art

Milano

Sánchez

et al. 2019

Journal of ISAKOS

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Platelet-rich plasma (PRP) is one of the many new developments within the expanding field of regenerative medicine. It aims to improve the process of tissue repair through local delivery of autologous bioactive agents to influence critical physiological mechanisms such as inflammation, angiogenesis or extracellular matrix synthesis. Within orthopaedics and sports medicine, the use of PRP has been rapidly increasing in popularity as patients seek non-surgical approaches to acute and chronic musculoskeletal injury and disease. The popularity of this new treatment option has prompted a rapid increase in research endeavours. Although preclinical studies were encouraging, clinical studies often reported controversial results. The differences in the composition and application techniques of PRP have made comparisons regarding its efficacy difficult and somehow inconclusive. Although PRP appears to be a safe treatment option with potentially beneficial effects to injured musculoskeletal tissues, continuous efforts are needed to identify factors that influence the biological response to PRP treatment. It is likely that in the near future the PRP preparation will be tailored not only to the specific pathology of interest but also to stage of disease. However, the growing emphasis on an evidence-based approach in the sports medicine setting demands additional research efforts before incorporating this technology in routine clinical care. The current review explores the latest findings on PRP efficacy in several musculoskeletal conditions, focusing on results of the highest level of evidence available.

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“…[ 3 ] It has been estimated that about 90% of patients with PF get relief through conservative management alone. [ 4 ] Although there are many treatment modalities, there is no consensus for a definitive nonsurgical method for symptom relief in individuals with PF. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

Short-term efficacy of kinesiotaping versus extracorporeal shockwave therapy for plantar fasciitis: A randomized study

Tezel

Umay

Bulut

et al. 2020

Saudi J Med Med Sci

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Background: Plantar fasciitis is a degenerative condition that is one of the most common causes of heel and foot pain. Among noninvasive management of plantar fasciitis, extracorporeal shockwave therapy (ESWT) has been extensively studied and found to be effective, but few studies have assessed the effectiveness of kinesiotaping (KT) method. Objective: This study aimed to show the effectiveness of KT compared with ESWT in the management of plantar fasciitis. Methods: A total of 84 patients with plantar fasciitis were enrolled from a single center and randomized into KT and ESWT treatment groups in a 1:1 ratio (i.e., 42 patients in each group); only one foot was considered for each patient. Both KT and ESWT were applied once a week for 6 weeks. Patients' pain, functional status and quality of life were evaluated with the visual analog scale (VAS), Foot Function Index (FFI) and the Short-Form-36 (SF-36) health survey, respectively. Patients' fat pat and plantar fascia thickness were measured using ultrasonography. All evaluations were performed before and immediately after the 6-week intervention. Results: In the KT group, six patients were lost to follow-up; therefore, the final analysis only included 36 patients. After the intervention, there was a statistically significant improvement in the VAS and SF-36 scores of both groups ( P = 0.001), but the FFI score improvement was statistically significant only in the KT group ( P = 0.001). In both groups, the mean thickness of plantar fascia decreased after treatment and the mean thickness of the fat pat increased; however, the change was not statistically significant ( P = 0.935 and P = 0.832, respectively). Conclusion: Both KT and ESWT treatments improved pain levels and quality of life in patients with plantar fasciitis, but KT also improved functionality. Multicentered studies with larger sample size and longer follow-ups are required to further validate these findings.

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Novel and Conservative Approaches Towards Effective Management of Plantar Fasciitis

Cited by 15 publications

References 18 publications

Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial

Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial

Platelet-rich plasma in orthopaedic sports medicine: state of the art

Short-term efficacy of kinesiotaping versus extracorporeal shockwave therapy for plantar fasciitis: A randomized study

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