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21 May 2022 (Vol 45 , Iss 04 )

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31 May 2022 (Vol 45 , Iss 03 )

Journal ID : TMJ-20-12-2021-10913
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Title : IN THE TREATMENT OF CHRONIC PLANTAR FASCIITIS, A COMPARITIVE STUDY BETWEEN SHOCKWAVE THERAPIES AND LOCAL CORTICOSTEROID INJECTION

Abstract :

One of the most prevalent ailments for which people seek treatment at a foot and ankle surgery facility is heel discomfort. Plantar fasciitis (PF) is almost one of the most common causes of adult heel pain, it account for 11 to 15% of all foot illnesses requiring medical care. The major presenting symptom is pain and soreness at the heel where the plantar fascia attached while starting weight bearing after lengthy periods of rest. Rest, nonsteroidal anti-inflammatory medicines (NSAIDs), stretching of the plantar fascia, physical therapy, foot cushioning, and orthotic devices, which may be utilized to meet the patient's demands, are some of the current conservative therapies for PF (planter fasciitis). In intractable instances of plantar fasciitis, where conservative therapy have failed to provide relief, steroid injections into the plantar fascia are often employed. Other treatment options for PF, including as extracorporeal shockwave therapy (ESWT) are advised if patients do not react to conservative therapies. This study included 50 patients with chronic PF who had failed to react to conservative treatments such as physical therapy, NSAIDs, stretching exercises, and heel cushions for at least 6 months, and who did not have flatfeet or gastrocnemius contracture met the inclusion criteria. Patients were randomly divided into 2 groups:25 patients will get radial Extracorporeal Shockwave Therapy (ESWT) once a week for six weeks (Group I).25 patients will get a single local corticosteroid injection at the plantar fascia's origin (40 mg/2 ml of methylprednisolone together with 1 ml of local anesthesia, once) (Group II). Assessment of heel pain was done at the start of the trial and before each session using VAS score which was the primary outcome measure at 1, 3 and 6 months. A total of 50 individuals with persistent planter fasciitis (PF) were included in this investigation. Their ages varied from 31 to 42 years old. Females made up 70% of the group, while males made up 30%. Group I: 25 patients with PF who got extracorporeal shockwave treatment for 6 weeks at a time (once a week). There were 17 ladies (68%) and 8 males (32%), with ages ranging from 28 to 44(mean SD 18.2). Group II: consisted of 25 individuals with PF who were given a local corticosteroid injection. There were 18 females (86.7 percent) and 7 men (13.3 percent) with ages ranging from 25 to 45 years (mean SD 21.9). Group I included 20 patients (80%) and group II had 22 patients (88%) had pain in one foot, whereas 5 (20%) patients, 3 (12%) patients had pain in both feet, with no statistically significant difference. There was no significant difference between the groups in terms of the VAS score at the start of the trial (p=0.26), mean VAS score were 6.4 & 6.2 in group I& II respectively. At 1 month mean VAS score were 1.6 & 1.2 in group I & II respectively. At 3 months mean VAS score was 2.2 & 1.7 then 5.1 & 2.3 at 6 month for group I &II respectively. ESWT and local corticosteroid injection therapies are safe and effective but Local Corticosteroid injection is more effective than ESWT in the treatment of chronic plantar fasciitis.

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