Eliminate Heel Pain Caused By Plantar Fasciitis | Arthritis Information

 

New Treatment Eliminates Heel Pain Caused By Plantar Fasciitis

Combining an ultrasound-guided technique with steroid injection is 95 percent effective at relieving the common and painful foot problem called plantar fasciitis, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

"There is no widely accepted therapy or standard of care for patients when first-line treatments fail to relieve the pain of plantar fasciitis," said the study's lead author, Luca M. Sconfienza, M.D., from Italy's University of Genoa. "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 percent to 15 percent of all foot symptoms requiring professional care and affects one million people annually in the U.S.

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 shockwave therapy, in which sound waves are directed at the area of heel pain to stimulate healing. Shockwave therapy is painful, requires multiple treatments and is not always effective. Complications may include bruising, swelling, pain, numbness or tingling and rupture of the plantar fascia. In the most severe cases of plantar fasciitis, patients may undergo invasive surgery to detach the fascia from the heel bone.

For this study, Dr. 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 injection of a small amount of anesthesia, the anesthetic needle is used to repeatedly puncture the site where the patient feels the pain. This technique is known as dry-needling. Dry-needling creates a small amount of local bleeding that helps to heal the fasciitis. Lastly, a steroid is injected around the fascia to eliminate the 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.

After the 15-minute procedure, symptoms disappeared for 42 of the study's 44 patients (95 percent) within three weeks.

"This therapy is quicker, easier, less painful and less expensive than shockwave therapy," Dr. Sconfienza said. "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."

Notes:

Co-authors are Francesca Lacelli, M.D., Giovanni Serafini, M.D., Giacomo Garlaschi, M.D., and Enzo Silvestri, M.D.

Copies of RSNA 2008 news releases and electronic images will be available online at http://www.RSNA.org/press08 beginning Monday, Dec. 1.

RSNA is an association of more than 42,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (http://www.RSNA.org)

For patient-friendly information on ultrasound and ultrasound-guided treatments, visit http://www.RadiologyInfo.org.

Source:
Linda Brooks
Radiological Society of North America

< ="/rater/rater.js" =text/>I want to say before I go this is a great post. I suffer from Plantar Fasciitis. I will ask my doc about it. Thanks Lynn- my husband has been having this pain and the dr. said it was the beginnings of a bone spur. He got two cortizone shots and they didn't work. (within days of each other) I am going to print this out- maybe he should see a new dr. My sister in law has this problem on & off as well.OUCH, OUCH, OUCH, OUCH, but if it works.  Wish they'd come up with some type of therapy for the Achilles tendon pain associated with PsA.  Mine comes and go but boy is it painful.  Exercises help some.  If anyone has this done I hope they post, there are so many on the forum with PF.  LindyI get cortizone injections in my heels about 2x/year and it works wonderfully. I just make sure my rheumy sprays lots of the freezing/numbing stuff on it first.This is really timely for me, as I am suffering from this disorder.  I recently had an injection for tendonitis and I am certainly not adverse to injections for my new problem. I thought I had this before I was dx with RA.  Two foot doctors said I had it.  However, it did not go away.  I had a cortizone shot and it worked for about 10 minutes until the nova cane wore off.  Then after several months of treatment for RA--Birkenstock orthortics, it got better.  My RA dr said I never had plantar facitis, it was the RA.  I went through all the exercises, went to a chiropractor and got yanked and pulled--seemed to loosen things up a bit--but realy no help.  Just be sure you really have plantar facitis and not just RA in your feet.  wow.. PF is a pain that took me to the dr's when I was beginning a flare!!  nothing else hurt but was incredibly swollen... but that pain.. WOW!  awful....
Copyright ArthritisInsight.com