Prospective Randomized Comparison of the Effectiveness of Radiation Therapy and Local Steroid Injection for the Treatment of Plantar Fasciitis.
OBJECTIVE
The purpose of this study was to conduct a randomized trial of radiation therapy for plantar fasciitis and to compare radiation therapy with local steroid injections.


METHODS
Between March 2013 and April 2014, 128 patients with plantar fasciitis were randomized to receive radiation therapy (total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy three times a week) or local corticosteroid injections a 1 ml injection of 40 mg methylprednisolone and 0.5 ml 1% lidocaine under the guidance of palpation. The results were measured using a visual analog scale, a modified von Pannewitz scale, and a 5-level function score. The fundamental phase of the study was 3 months, with a follow-up period of up to 6 months.


RESULTS
The median follow-up period for all patients was 12.5 months (range, 6.5-18.6 months). For the radiation therapy patients, the median follow-up period was 13 months (range, 6.5-18.5 months), whereas in the palpation-guided (PG) steroid injection arm, it was 12.1 months (range, 6.5-18.6 months). After 3 months, results in the radiation therapy arm were significantly superior to those in the PG steroid injection arm (visual analog scale, P<.001; modified von Pannewitz scale, P<.001; 5-level function score, P<.001). Requirements for a second treatment did not significantly differ between the 2 groups, but the time interval for the second treatment was significantly shorter in the PG steroid injection group (P=.045).


CONCLUSIONS
This study confirms the superior analgesic effect of radiation therapy compared to mean PG steroid injection on plantar fasciitis for at least 6 months after treatment.
Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. Electronic address: dremocan@ktu.edu.tr.
Emine
E
Canyilmaz
Department of Orthopaedics and Traumatology, Yavuz Selim Bone Disease and Rehabilitation Hospital, Trabzon, Turkey.
Fatih
F
Canyilmaz
Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Ozlem
O
Aynaci
Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Fatma
F
Colak
Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Lasif
L
Serdar
Department of Radiation Oncology, Kanuni Research and Education Hospital, Trabzon, Turkey.
Gonca Hanedan
GH
Uslu
Department of Orthopaedics and Traumatology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Osman
O
Aynaci
Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Adnan
A
Yoney
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000008:administration & dosage*; D036981:Fasciitis, Plantar / Q000188:drug therapy* / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement; D010173:Palpation; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D013997:Time Factors; D016896:Treatment Outcome
D000779:Anesthetics, Local; D005938:Glucocorticoids; D008012:Lidocaine; D008775:Methylprednisolone