title: Steroid injection for inferior heel pain: a randomised controlled trial.
abstract: BACKGROUND
  Plantar fasciitis is a common cause of heel pain. The aim of this study was twofold: to compare steroid injection with placebo injection and to compare ultrasound guided with unguided steroid injection in the management of this condition.
  
  
  METHODS
  65 patients with inferior heel pain were recruited between November 2008 and June 2011. Heel pain was measured using a visual analogue scale (VAS) at baseline and follow-up 6 and 12 weeks after injection.
  
  
  RESULTS
  22 patients were randomised to ultrasound guided steroid injection, 21 patients to palpation guided steroid injection and 22 to ultrasound guided placebo injection. There was a significant difference in VAS scores between the groups at 6 and 12 weeks (p=0.018 and p=0.004, respectively). There was a 19.7 (95% CI 2.5 to 37.0) difference in mean VAS scores at 6 weeks between the ultrasound guided steroid group and the placebo group and a 24.0 (95% CI 6.6 to 41.3) difference between the unguided steroid group and the placebo group at 6 weeks. At 12 weeks, the mean difference was 25.1 (95% CI 6.5 to 43.6) and 28.4 (95% CI 11.1 to 45.7) respectively between both steroid injection groups and the placebo group. There was no difference in VAS scores following steroid injection between the ultrasound guided and the unguided groups at either time point. Plantar fascia thickness was significantly reduced after injection in both active treatment groups (p=0.00).
  
  
  CONCLUSIONS
  In this study, steroid injection showed a clear benefit over placebo at 6 weeks and this difference was maintained at 12 weeks. Trial Registration No ISRCTN79628180 (www.controlled-trials.com).
authors: Department of Rheumatology, Musgrave Park Hospital, and Centre for Public Health, Queens' University Belfast, Belfast, UK. elisabethball21@gmail.com
authors: Elisabeth M A
authors: EM
authors: Ball
authors: Helen M A
authors: HM
authors: McKeeman
authors: Christopher
authors: C
authors: Patterson
authors: James
authors: J
authors: Burns
authors: Wing Hoi
authors: WH
authors: Yau
authors: Owen A
authors: OA
authors: Moore
authors: Claire
authors: C
authors: Benson
authors: Joanne
authors: J
authors: Foo
authors: Gary D
authors: GD
authors: Wright
authors: Allister J
authors: AJ
authors: Taggart
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D036981:Fasciitis, Plantar / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077555:Methylprednisolone Acetate; D008875:Middle Aged; D010147:Pain Measurement; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D000893:Anti-Inflammatory Agents; D000077555:Methylprednisolone Acetate; D008775:Methylprednisolone