Value of dexamethasone Iontophoresis vs. local Injection of dexamethasone In the treatment of plantar dfasciitis

Abstract EN

Objective: To evaluate the effect of dexamethasone (DXM) iontophoresis in treating plantar fasciitis compared to the effect of local DXM injection.

Methodology: The study was performed on 21 patients (26 feet) complaining of plantar fasciits of at least 2 months duration.

Patients were selected on the basis of their clinical presentation and confirmed by plain X-ray and diagnostic ultrasonography.

Patients were classified into 2 groups: Group I (11 patients) received 10 sessions of iontophoresis using solution of 0.4% DXM on alternating days, while Group II (10 patients) received one local steroid injection of DXM into the area of maximum tenderness.

Reassessment of the patients of both groups was done 3 weeks after starting their treatment program by assessment of pain intensity using numerical visual analogue scale (VAS), assessment of tenderness using Heel Tenderness Index (HTI) and ultrasonographic examination.

Results: There was high statistical significant improvement of in all patients of group I, and in 7 patients of group II.

Two feet had steroid flare in group II.

No difference of statistical significance between the 2 groups was detected regarding change in HTI, or change in ultrasound findings.

However, there was a statistical significance difference regarding decrease in pain intensity with higher improvement in group I.

Conclusion: Dexamethasone is an effective anti-inflammatory drug in treating plantar fasciitis whether applied by iontophoresis or by local injection.

However, Iontophoresis has the advantages of painless application with no risk of infection or fascial rupture.