Chronic heel pain with plantar fasciitis is relatively common and can affect adults of all ages regardless of an active or sedentary lifestyle. The purpose of the present study was to evaluate the effectiveness of corticosteroid injection (CSI), extracorporeal shock wave therapy (ESWT), and radiofrequency thermal lesioning (RTL) treatments in chronic plantar heel pain that has been unresponsive to other conservative treatments.
Methods:
We retrospectively analyzed the results of 217 patients treated with CSI (n = 73), ESWT (n = 75), and RTL (n = 69). The treatment efficacy and pain intensity, as measured using the visual analog scale, were recorded and compared at the 6-month follow-up.
Results:
Pain intensity decreased significantly in all patients. However, it decreased significantly more in the CSI and RTL groups than in the ESWT group (P < .001). Age, sex, body mass index, calcaneal spur presence, and symptom duration were similar among 3 groups (P > .05). No complications were noted after the CSI, ESWT, or RTL sessions.
Conclusion:
CSI, ESWT, and RTL successfully treated chronic plantar heel pain that did not respond to other conservative treatments; however, CSI and RTL yielded better therapeutic outcomes.
AllenRHGrossMT.Toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint in individuals with plantar fasciitis. J Orthop Sports Phys Ther. 2003;33(8):468-478.
2.
ArslanAKocaTTUtkanASevimliRAkelI.Treatment of chronic plantar heel pain with radiofrequency neural ablation of the first branch of the lateral plantar nerve and medial calcaneal nerve branches. J Foot Ankle Surg. 2016;55(4):767-771.
3.
AtkinsKLChinKFNooraniAMNairnDS.Image intensifier-guided injection of corticosteroid and local anesthetic agent for the treatment of recalcitrant plantar fasciitis. Foot Ankle Spec. 2010;3(4):172-176.
4.
BallEMMcKeemanHMPattersonC, et al. Steroid injection for inferior heel pain: a randomised controlled trial. Ann Rheum Dis. 2013;72(6):996-1002.
5.
BuchbinderR.Clinical practice. Plantar fasciitis. N Engl J Med. 2004;350(21):2159-2166.
6.
BuchbinderRPtasznikRGordonJBuchananJPrabaharanVForbesA.Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: a randomized controlled trial. JAMA. 2002;288(11):1364-1372.
7.
Cardenuto FerreiraR. Talalgia: plantar fasciitis. Rev Bras Ortop. 2014;49(3):213-217.
8.
CioneJACozzarelliJMullinCJ.A retrospective study of radiofrequency thermal lesioning for the treatment of neuritis of the medial calcaneal nerve and its terminal branches in chronic heel pain. J Foot Ankle Surg. 2009;48(2):142-147.
9.
CozzarelliJSollittoRJThaparJCaponigroJ.A 12-year long-term retrospective analysis of the use of radiofrequency nerve ablation for the treatment of neurogenic heel pain. Foot Ankle Spec. 2010;3(6):338-346.
GencHSaracogluMNacirBErdemHRKacarM.Long-term ultrasonographic follow-up of plantar fasciitis patients treated with steroid injection. Joint Bone Spine. 2005;72(1):61-5.
12.
GerdesmeyerLFreyCVesterJ, et al. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med. 2008;36(11):2100-2109.
13.
HaakeMBuchMSchoellnerC, et al. Extracorporeal shock wave therapy for plantar fasciitis: randomised controlled multicentre trial. BMJ. 2003;327(7406):75.
14.
HormoziJLeeSHongDK.Minimal invasive percutaneous bipolar radiofrequency for plantar fasciotomy: a retrospective study. J Foot Ankle Surg. 2011;50(3):283-286.
15.
KalaciACakiciHHapaOYanatANDogramaciYSevincTT.Treatment of plantar fasciitis using four different local injection modalities: a randomized prospective clinical trial. J Am Podiatr Med Assoc. 2009;99(2):108-113.
16.
KaneDGreaneyTBresnihanBGibneyRFitzGeraldO.Ultrasound guided injection of recalcitrant plantar fasciitis. Ann Rheum Dis. 1998;57(6):383-384.
17.
KonjenNNapnarkTJanchaiS.A comparison of the effectiveness of radial extracorporeal shock wave therapy and ultrasound therapy in the treatment of chronic plantar fasciitis: a randomized controlled trial. J Med Assoc Thai. 2015;98(Suppl 1):S49-S56.
18.
KudoPDaintyKClarfieldMCoughlinLLavoiePLebrunC.Randomized, placebo-controlled, double-blind clinical trial evaluating the treatment of plantar fasciitis with an extracoporeal shockwave therapy (ESWT) device: a North American confirmatory study. J Orthop Res. 2006;24(2):115-123.
19.
LidenBSimmonsMLandsmanAS.A retrospective analysis of 22 patients treated with percutaneous radiofrequency nerve ablation for prolonged moderate to severe heel pain associated with plantar fasciitis. J Foot Ankle Surg. 2009;48(6):642-647.
20.
Mardani-KiviMKarimi MobarakehMHassanzadehZ, et al. Treatment outcomes of corticosteroid injection and extracorporeal shock wave therapy as two primary therapeutic methods for acute plantar fasciitis: a prospective randomized clinical trial. J Foot Ankle Surg. 2015;54(6):1047-1052.
21.
MelegatiGTorneseDBandiMCasertaA.The influence of local steroid injections, body weight and the length of symptoms in the treatment of painful subcalcaneal spurs with extracorporeal shock wave therapy. Clin Rehabil. 2002;16(7):789-794.
22.
OgdenJAAlvarezRGMarlowM.Shockwave therapy for chronic proximal plantar fasciitis: a meta-analysis. Foot Ankle Int. 2002;23(4):301-308.
23.
OzanFKoyuncuSGurbuzKOncelESAltayT.Radiofrequency thermal lesioning and extracorporeal shockwave therapy: a comparison of two methods in the treatment of plantar fasciitis. Foot Ankle Spec. 2017;10(3):204-209.
24.
PorterMDShadboltB.Intralesional corticosteroid injection versus extracorporeal shock wave therapy for plantar fasciopathy. Clin J Sport Med. 2005;15(3):119-124.
25.
RompeJD.Repetitive low-energy shock wave treatment is effective for chronic symptomatic plantar fasciitis. Knee Surg Sports Traumatol Arthrosc. 2007;15(1):107-108.
26.
RompeJDKullmerKVogelJ, et al. Extracorporeal shock-wave therapy. Experimental basis, clinical application. Article in German. Orthopade. 1997;26(3):215-28.
27.
SollittoRJPlotkinELKleinPGMullinP.Early clinical results of the use of radiofrequency lesioning in the treatment of plantar fasciitis. J Foot Ankle Surg. 1997;36(3):215-219, 56.
SpeedCA.Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions. J Bone Joint Surg Br. 2004;86(2):165-171.
30.
SullivanJPappasEBurnsJ.Role of mechanical factors in the clinical presentation of plantar heel pain: implications for management. Foot (Edinb). 2020;42:101636.
31.
TheodoreGHBuchMAmendolaABachmannCFlemingLLZingasC.Extracorporeal shock wave therapy for the treatment of plantar fasciitis. Foot Ankle Int. 2004;25(5):290-297.
32.
TsaiWCWangCLTangFTHsuTCHsuKHWongMK.Treatment of proximal plantar fasciitis with ultrasound-guided steroid injection. Arch Phys Med Rehabil. 2000;81(10):1416-1421.
33.
TuP.Heel pain: diagnosis and management. Am Fam Physician. 2018;97(2):86-93.
34.
UdenHBoeschEKumarS.Plantar fasciitis—to jab or to support? A systematic review of the current best evidence. J Multidiscip Healthc. 2011;4:155-164.
35.
UgurlarMSonmezMMUgurlarOYAdiyekeLYildirimHErenOT.Effectiveness of four different treatment modalities in the treatment of chronic plantar fasciitis during a 36-month follow-up period: a randomized controlled trial. J Foot Ankle Surg. 2018;57(5):913-918.
36.
WangCJWangFSYangKDWengLHKoJY.Long-term results of extracorporeal shockwave treatment for plantar fasciitis. Am J Sports Med. 2006;34(4):592-596.
37.
WhittakerGAMunteanuSEMenzHBBonannoDRGerrardJMLandorfKB.Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2019;20(1):378.
38.
WuPTLeeJSWuKC, et al. Ultrasound-guided percutaneous radiofrequency lesioning when treating recalcitrant plantar fasciitis: clinical results. Ultraschall Med. 2016;37(1):56-62.
39.
WuYTChangCYChouYC, et al. Ultrasound-guided pulsed radiofrequency stimulation of posterior tibial nerve: a potential novel intervention for recalcitrant plantar fasciitis. Arch Phys Med Rehabil. 2017;98(5):964-970.
40.
YalcinEKeskin AkcaASelcukBKurtaranAAkyuzM.Effects of extracorporal shock wave therapy on symptomatic heel spurs: a correlation between clinical outcome and radiologic changes. Rheumatol Int. 2012;32(2):343-347.
41.
YucelIOzturanKEDemiraranYDegirmenciEKaynakG.Comparison of high-dose extracorporeal shockwave therapy and intralesional corticosteroid injection in the treatment of plantar fasciitis. J Am Podiatr Med Assoc. 2010;100(2):105-110.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
