2Department of Radiation Oncology, Karadeniz Technical University Faculty of Medicine, Trabzon-Turkey
3Department of Orthopaedics and Traumatology, Yavuz Selim Bone Disease Hospital, Trabzon-Turkey
4Department of Physical Therapy and Rehabilition, Fizyotem Special Center, Trabzon-Turkey
5Department of Orthopaedics and Traumatology, Karadeniz Technical University Faculty of Medicine, Trabzon-Turkey DOI : 10.5505/tjo.2021.2731 OBJECTIVE
The aim of this study is, therefore, to compare three different treatment modalities for symptomatic plantar fasciitis (PF), namely, effective in pain control.
METHODS
This study involved 205 patients with a diagnosis of painful PFs, treated during the years 2013 through
2017 at three institutions. Of these, 67 patients received a total dose of 6.0 Gy radiotherapy (RT in
3-weekly fractions of 1 Gy (RT arm); 65 patients received local steroid injection (SI) of 40 mg (1 ml)
of methylprednisolone; and 0.5 ml of 1% lidocaine in the painful heel spur, using palpation (palpation
guided) (PG SI arm) and 73 received extracorporeal shock wave therapy (ESWT) in five sessions with
weekly intervals (ESWT arm). Patients recorded visual analog scale (VAS) score, a modified Pannewitz
score and a 5-level function score. Patients with available ?12 months of data were included in the present
study.
RESULTS
Follow-up data were available for patients with a median of 15.5 (range, 6.5-37.4) months. There was
a significant improvement in VAS scores and 5-level function scores in the RT arm at 3 and 6 month
period arm (p<0.001). In univariate and multivariate analyses, only treatment scheme was associated
with considerable pain control (p=0.006).
CONCLUSION
These findings suggest that all treatment modalities provide significant pain relief in patients with painful
heel spur. This analysis also demonstrates RT is superior choice for chronic PF in cases of failure with
conservative treatments when compared to extracorporeal shock wave therapy and PG SI.