What treatments work for Plantar Fasciitis?
No consensus has been reached about the best treatment method of plantar fasciitis, and the results of the treatment methods have been inconsistent. A recent study in the September 2018 edition of the Journal of Foot and Ankle Surgery compared the therapeutic effects of extra-corporeal shockwave therapy, platelet-rich plasma injection, local steroid injections, and prolotherapy (glucose/local anaesthetic injections) for the treatment of chronic plantar fasciitis using a randomized, controlled, prospective study. The first group studied received extracorporeal shock wave therapy, the second group received prolotherapy, the third group received platelet-rich plasma injection, and the fourth group received a local corticosteroid injection. The study included 158 consecutive patients with a diagnosis of chronic plantar fasciitis with a symptomatic heel spur. The clinical outcomes were assessed using the visual analog scale and Revised Foot Function Index. At the end of the follow-up period, the mean visual analog scale scores for all 4 groups were similar to the mean visual analog scale scores before treatment. At the end of the follow-up period, no significant improvement was noted in the Revised Foot Function Index score in any of the groups. The corticosteroid injection was more effective in the first 3 months and extracorporeal shock wave therapy was an effective treatment method in the first 6 months in regard to pain. Importantly, the corticosteroid injection lost its effectiveness during the follow-up period. The effect of prolotherapy and platelet-rich plasma was seen within 3 to 12 months; however, at the 36-month follow-up point, no differences were found among the 4 treatments.
This study did not have a control group (no treatment or “sham” treatment) with which to compare the other interventions, so we’re still not sure if the plantar fasciitis may have improved by itself. This again reinforces the need for a multifactorial approach to managing plantar fasciitis, and we cannot employ a “one size fits all” approach. Our Podiatrists are highly trained at determining the exact cause of your heel pain, and employ many techniques to assist with reducing these symptoms. This includes prescription foot orthoses made with specific features designed to reduce high loads in the plantar fascia and improve healing times.
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