title: Treatment Outcomes of Corticosteroid Injection and Extracorporeal Shock Wave Therapy as Two Primary Therapeutic Methods for Acute Plantar Fasciitis: A Prospective Randomized Clinical Trial.
abstract: The outcome of corticosteroid injection (CSI) and extracorporeal shock wave therapy (ESWT) as primary treatment of acute plantar fasciitis has been debated. The purpose of the present study was to evaluate and compare the therapeutic effects of CSI and ESWT in patients with acute (<6-week duration) symptomatic plantar fasciitis. Of the 116 eligible patients, 68 were randomized to 2 equal groups of 34 patients, each undergoing either ESWT or CSI. The ESWT method included 2000 impulses with energy of 0.15 mJ/mm(2) and a total energy flux density of 900 mJ/mm(2) for 3 consecutive sessions at 1-week intervals. In the CSI group, 40 mg of methyl prednisolone acetate plus 1 mL of lidocaine 2% was injected into the maximal tenderness point at the inframedial calcaneal tuberosity. The success and recurrence rates and pain intensity measured using the visual analog scale, were recorded and compared at the 3-month follow-up visit. The pain intensity had reduced significantly in all patients undergoing either technique. However, the value and trend of pain reduction in the CSI group was significantly greater than those in the ESWT group (p < .0001). In the ESWT and CSI groups, 19 (55.9%) and 5 (14.7%) patients experienced treatment failure, respectively. Age, gender, body mass index, and recurrence rate were similar between the 2 groups (p > .05). Both ESWT and CSI can be used as the primary and/or initial treatment option for treating patients with acute plantar fasciitis; however, the CSI technique had better therapeutic outcomes.
authors.affiliation: Assistant Professor, Orthopedic Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Mardani-Kivi
authors.affiliation: Associate Professor, Orthopedic Department, Kerman University of Medical Sciences, Kerman, Iran. Electronic address: dr_mk.mobarakeh@yahoo.com.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Karimi Mobarakeh
authors.affiliation: Orthopedic Surgeon, Baqiyatallah Hospital, Tehran, Iran.
authors.forename: Zabihallah
authors.initials: Z
authors.lastname: Hassanzadeh
authors.affiliation: Assistant Professor, Orthopedic Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Mirbolook
authors.affiliation: Assistant Professor, Orthopedic Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Asadi
authors.affiliation: Assistant Professor, Orthopedic Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ettehad
authors.affiliation: General Practitioner and Researcher, Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Hashemi-Motlagh
authors.affiliation: General Practitioner and Researcher, Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Khashayar
authors.initials: K
authors.lastname: Saheb-Ekhtiari
authors.affiliation: General Practitioner and Researcher, Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Fallah-Alipour
mesh_terms: D000208:Acute Disease; D000328:Adult; D036981:Fasciitis, Plantar / Q000628:therapy*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D019220:High-Energy Shock Waves; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids
keywords: calcaneus; corticosteroid injection; extracorporeal shock wave therapy; heel pain; plantar fasciitis; randomized clinical trial