Extracorporeal shock wave therapy versus local injection of steroid in treatment of plantar fasciitis : an interventional study

Abstract EN

Background and objectives Plantar fasciitis is a damage and / or inflammation of the fascia of the plantar surface of the foot usually at its calcaneal attachment causing painful heel.

The first line treatment is conservative.

For refractory cases two other methods may be tried before surgery namely local injection of steroid and Extracorporeal Shock Wave Therapy.

Aim is to compare the results of local injection of steroid and extracorporeal shock Wave therapy.

Methods This study was conducted at Duhok Center for Rheumatic Disorders during the period from April 2013 till February 2014.

It included those patients with chronic plantar fasciitis whose symptoms extended for more than 3 months.

The study sample which comprised 119 cases (with 132 painful heels) was subdivided into two groups: Group 1 (51 patients with 55 painful heels) was treated by local injection of steroid and Group 2 (68 patients with 77 painful heels)was treated by Extracorporeal Shock Wave Therapy ( 6 sessions with 2 session per week).

Results The mean body mass index was 33.6 kg/m2.

According to the 10 points visual analog scale for pain, the mean pain severity level dropped from 7.9 to 2.3 after 3 months in Group1, while in group 2 the pain level dropped from 8 to 2.9.

The result of treatment of each group was statistically significant, but the difference between both modalities of treatment did not achieve statistical significance.

Conclusions Both local injection of steroid and Extracorporeal Shock Wave Therapy are effective ways for treatment of chronic plantar fasciitis with the latter being non-invasive and safer.