Li S, Wang K, Sun H, et al. Clinical effects of extracorporeal shock-wave therapy and ultrasound-guided local corticosteroid injections for plantar fasciitis in adults: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018;97(50):e13687.
This weeks article looked at an analysis of studies that reviewed the effectiveness of two different and widely used treatment options, extracorporeal shock wave therapy (EWST) and cortisone injections.
Again the article states that plantar fasciitis is a common condition with 1 in 10 people being affected by this condition in their life time and 10% of all foot pain is as a result of this condition.
They state the cause of plantar fasciitis is believed to be as a result of over stressing of the planar fascia.
The risk factors stated are increasing age, higher BMI, walking and standing for prolonged periods, poor biomechanics, leg length discrepancy and muscle weakness in the feet. (our Ultimate Plantar Fasciitis Treatment Plan works on treating a number of there risk factors… can’t do much about reducing age though)
Conservative treatments including, stretching, massage, strengthening have been listed as treatment options.
The aims of this study was to see what treatment was more superior.
Cortisone injections or ESWT.
Cortisone has been used since the 1960s due to is ability to reduce pain, but there is known side effects of cortisone injections including that of plantar fascia rupture. Cortisone is a steroid drug which reduces the release of inflammatory chemicals from the damaged tissue, thus reducing pain.
ESWT is a new treatment first utilised in the 1970’s but being much more widely available in Australia since 2010. It is thought that ESWT is believed to utilise the bodies inflammatory process to induce healing, along with improving blood flow to the area and help inhibit nerve axons from feeling the sensation of pain.
The outcomes of this study show that both the cortisone injection and ESWT provide good short term success, with ESWT being superior to cortisone injection at the 3 month mark (66.1% V 49.%)
Those who had the cortisone injection did rely on a greater amount of pain killers between treatments compared to those who had the ESWT.
So the outcome of this study showed that ESWT was a far superior treatment option that that of a cortisone injection. Shockwave therapy is an effective treatment, personally we find it far more effective if it is combined with other treatment modalities.
As stated in most of our information, we find decreasing the pull on the plantar fascia by treating it with heat, massage and stretching along with reducing the stress on the plantar fascia by correct footwear and orthotics is going to reduce the stress and allow greater healing potential. A strengthening program is used to both help heal the damaged tissue but it also reduces the reoccurrence as weak intrinsic foot muscles is one of the causative factors.
If we utilise this option which is our Ultimate Plantar Fasciitis Treatment Plan in conjunction with shockwave therapy we would expect much better results than the 66.1%.
Hope this helps!
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