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New treatment eliminates heel pain caused by plantar fasciitis
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Combining an ultrasound-guided technique with steroid injection is 95% effective at relieving plantar fasciitis, according to a study presented this week at the Radiological Society of North America 2008 Annual Meeting.
“There is no widely accepted therapy or standard of care for patients when first-line treatments fail to relieve the pain of plantar fasciitis,” lead author Luca M. Sconfienza, MD, from the University of Genoa, Italy, said in a press release. “Our new technique is an effective, one-time outpatient procedure.”
Plantar fasciitis, the most common cause of heel pain, is an inflammation of the connective tissue called the plantar fascia that runs along the bottom of the foot from the heel to the ball of the foot. The condition accounts for 11% to 15% of all foot symptoms requiring professional care and affects 1 million people annually in the United States, according to the press release.
Conservative treatments, which may take up to a year to be effective, include rest, exercises to stretch the fascia, night splints and arch supports. When the condition does not respond to conservative treatments, patients may opt for surgery (in severe cases) or shock wave therapy, in which sound waves are directed at the area of heel pain to stimulate healing. However, shock wave therapy is typically painful, requires multiple treatments and is not always effective, he noted in the press release.
For this study, Sconfienza and colleagues used a new ultrasound-guided technique, along with steroid injection, on 44 patients with plantar fasciitis that was unresponsive to conservative treatments.
After injecting a small amount of anesthesia, the researchers used the anesthetic needle to repeatedly puncture the site where the patient felt pain. This process, known as dry-needling, creates a small amount of local bleeding that helps heal the fasciitis. Finally, they injected a steroid around the fascia to eliminate inflammation and pain.
The technique is performed with ultrasound guidance to improve accuracy and to avoid injecting the steroids directly into the plantar fascia, which could result in rupture, Sconfienza said in the press release.
After the 15-minute procedure, symptoms disappeared for 42 of the study's 44 patients (95%) within 3 weeks.
“This therapy is quicker, easier, less painful and less expensive than shock wave therapy,” he said in the press release. “In cases of mild plantar fasciitis, patients should first try noninvasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option.”
Reference:
- Sconfienza LM, Lacelli F, Serafini G, et al. What’s new in the treatment of plantar fasciitis: A percutaneous ultrasound (U.S.)-guided approach. Paper SSA13-07. Presented at the Radiological Society of North America 2008 Annual Meeting. Nov. 30-Dec. 5, 2008. Chicago.