Background/Purpose: Proximal plantar fasciitis is the most common cause of plantar heel pain in adults. Plantar fasciitis is a degenerative syndrome of the plantar fascia resulting from repeated trauma at its origin on the calcaneus. Prolotherapy  has evolved as a new treatment option for refractory Plantar Fascitis.   In this study we compared the efficacy of prolotherapy versus corticosteroid injection and phonophorezis for the treatment plantar fasciitis.

Methods: A hundred and fifty patients with clinically determined plantar fasciitis were recruited.  Patients were assigned to receive dextrose prolotherapy, corticosteroid injection or corticosteroid phonophoresis for treatment of plantar fasciitis. The first group underwent at baseline followed by a second injection 2 weeks later. The second group was performed local corticosteroid injection as single dose and the third group  received phonophoresis. All patients were given an exercise program. Heel Sensitivity Index (THI), Visual Analogue Scale (VAS),  Foot Function Index (FFI), Foot and Ankle Outcome Score (FAOS) and SF-36 were measured at baseline and at 1 and 3 months’ follow-up. Besides plantar fascia thickness was measured by Ultrasonography (USG) before treatment, 1 and 3 months after treatment.

Results: Within each group, the analysis demonstrated statistically significant improvements in all parameters from baseline to 1 and 3 months (p <0.05). There was no significant difference  between groups in terms of efficacy of treatment (p> 0.05).  Aside from injection-associated pain, no adverse reactions were reported. The plantar fascial thickness between the baseline and final measurements revealed a mean decrease in thickness, statistically significant difference (p <0.05) in three groups.  Between groups before treatment, 1 and 3 months after treatment in terms of plantar fascia thickness there was no statistically significant difference (p> 0.05). (Table 1)

Table 1. The Distribution of Plantar Fascia Thickness of between Treatment Groups and  within Each Group

^bIn post-hoc pairwise comparisons result of “Post-Therapy First Month” with no significant difference was found.

^c In post-hoc pairwise comparisons result of “Post-Therapy Third Month” with no significant difference was detected..

Conclusion: Prolotherapy, corticosteroid  and phonophorosis therapies were generally well tolerated and appeared to provide benefit of patients with plantar fasciitis. As a result prolotherapy can be an effective way to treat plantar fasciitis

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prolotherapy-versus-corticosteroid-injections-and-phonophoresis-for-the-treatment-of-plantar-fasciitis-a-randomized-controlled-trial/