Retrospective evaluation of radiotherapy in plantar fasciitis

Abstract

Plantar fasciitis is a common painful syndrome that is usually treated by irradiation with a fraction dose (fd) of 1 Gy up to a total dose (TD) of 6 Gy according to clinical experience. By analysing our experiences with numerous former patients, we have attempted to find the relationship between dose and effect. To evaluate the effectiveness of radiotherapy and assess the impact of fd and TD in plantar fasciitis radiotherapy, we assessed 1624 irradiations (856 patients) performed using a fd of 1-3 Gy and a TD of 1-45 Gy. Analysis was carried out on the 623 irradiations (327 patients) for which complete follow-up data were available. The mean follow-up period was 74 months. The following parameters were evaluated: pain relief level; period of anaesthetic effect preservation after treatment; presence of pain and the timing of its appearance; and the intake of analgesic drugs at the last follow-up. After treatment, 48% of the patients reported a lack of pain, 21% reported pain relief greater than 50% and 17% reported pain relief less than 50%. The mean pain relief duration was 72 months. The last follow-up found that pain at rest afflicted 25% of the patients, and pain during walking afflicted 32%. A dose-effect relationship was not found. In conclusion, radiotherapy is an effective treatment for plantar fasciitis. A fd of 1.5 Gy and TD of 9 Gy should probably not be exceeded.

Low-Dose Radiotherapy of Painful Heel Spur/Plantar Fasciitis as an Example of Treatment Effects in Benign Diseases

“…However, other studies found no influence of this patient characteristic on treatment outcome [24,30,39].…”

“…To the best of our knowledge, in no study, an influence of gender on treatment outcome has been confirmed [22,24,30,38,39]. In contrast to radiotherapy for oncological indications with high doses, efficacy and tolerability of LD-EBRT seems to be the same concerning gender.…”

Conservative Treatment of Plantar Fasciitis and Posterior Heel Pain: A Review

“…Low dose radiotherapy (3-12 Gy) represents an effective treatment in the majority of examined patients and side effects are negligible: Miszczyk et al [29], affirm that there are no side effects, neither acute nor delayed. Therefore, radiotherapy may be considered as a possible treatment.…”

“…However, a placebo effect cannot be totally excluded [12]. In according to literature, Miszczyk et al [29] considered that there are no acute or late toxicity in cases of plantar fasciitis patient irradiation [24,30,31]. Surenkok et al [32] valued a low risk of secondary cancer after irradiation therapy, and conclude that radiotherapy is an effective therapy solution for relieving pain in calcaneal spur patients.…”

Myofascial Trigger Point: Symptoms, Diagnosis, Intervention

“…The interventions are diverse and range from a simple heel pad to radiotherapy (Miszczyk et al, 2007). Autologous platelet injections is a relatively recent procedure used to reverse the degenerative process of neovascularisation diagnosis of tendinosis (Peerbooms et al, 2010).…”