Journal of Medical Science and Clinical Research Vol||09||Issue||05||Page 132-134||May 2021
Dr Rahmat Ali (Ms (ortho), MCh(ortho))1, Dr Rajendra Chaudhry (MD Medicine)
This article explores new treatment options available for plantar fasciitis- especially looking at the use of injection therapy.
The authors state the consensus of conservative treatment efficacy is around 75% and they wanted to explore treatment via injections for those that fail conservative treatment.
They looked at PRP injections and considered them an effective safe treatment option. PRP injections involves taking of ones own blood, spinning in a centrifuge and platelet rich plasma is removed and injected into the damaged area. PRP injections were also compared to a steroid (cortisone) injection and it was found that the PRP was more advantageous . Regeneration properties of PRP injections to soft tissue was found to be a main positive in the use of this treatment along with the low rate of complications compared to steroid injections.
Prolotherapy was also looked into as a secondary form of treatment for Plantar Fasciitis. This treatment involves injecting a safe yet cellular irritating substance into the damaged tissue. This triggers a healing response similar to that invoked by shockwave therapy. The authors also found this treatment to be more efficacious than a steroid injection.
Bone Marrow Aspirate Concentrate involves with drawing out of bone marrow from the hip region. This is then spun and then four main particles are acquired. 1. Concentration of mesenchymal stem cells (MSCs), White blood cells, 2. Hematopoietic stem cells (HSCs), 3. Growth factors,4. Platelets. This is a relatively new treatment that is not widely used as of yet. It appears there is some positive outcome utilising this as a treatment but it is quite an invasive procedure.
The concluding statements were that conservative treatments including; massage, stretching and strengthening should be the first line of treatment for Plantar Fasciitis. They believe that in non responsive patients biologic (using ingredients from your own body) injections are worth while considering. Authors discourage the use of steroid injections due to the limited effectiveness and possible complications. Surgery should only be considered in patients when all other treatments are exhausted, though they do state that plantar fasciitis is self limiting and should improve within 2 years.
Comments