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Coraci D, Maccarone MC, Ragazzo L, Tognolo L, Restivo DA, Santilli G, Moreira AL, Ferrara PE, Ronconi G, Masiero S. Botulinum toxin in the rehabilitation of painful syndromes: multiperspective literature analysis, lexical analysis and systematic review of randomized controlled trials. Eur J Transl Myol 2024; 34:12509. [PMID: 38767308 PMCID: PMC11264230 DOI: 10.4081/ejtm.2024.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 05/22/2024] Open
Abstract
Pain represents a common symptom of several diseases and is often associated with a reduction in rehabilitation outcomes and recovery. The effectiveness of pain alleviation by botulinum toxin has been recently demonstrated. We searched in PubMed the papers about this topic published in the last ten years, and we selected clinical trials, guidelines, meta-analyses, reviews, and systematic reviews. We used different approaches: multiperspective presentation, lexical evaluation, and systematic review. The systematic review was only performed for the randomized controlled trials. We predominantly found reviews and trials about the rehabilitation of stroke/brain injury and epicondylitis. The most common outcome measures were pain, function, and spasticity. Among the common words, pain was the most frequent and the terms were grouped into different families, especially concerning the outcomes. Rehabilitation showed a relatively low frequency. Finally, the systematic review showed moderate-low levels of bias which confirms the effectiveness of botulinum toxin for pain treatment. The current literature about botulinum toxin is wide and globally diffuse but with some limitations in study strategies and clearness in the formal presentation. The evidence justifies the use of botulinum toxin in treating pain in different diseases.
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Affiliation(s)
- Daniele Coraci
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | | | - Lisa Ragazzo
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | - Lucrezia Tognolo
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | | | - Gabriele Santilli
- Department of Anatomical, Histological and Legal Medical Sciences and Science of the Locomotor System, Rome.
| | - Ana Lucila Moreira
- Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo.
| | | | | | - Stefano Masiero
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
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Tseng WC, Chen YC, Lee TM, Chen WS. Plantar Fasciitis: An Updated Review. J Med Ultrasound 2023; 31:268-274. [PMID: 38264606 PMCID: PMC10802877 DOI: 10.4103/jmu.jmu_2_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/14/2023] [Accepted: 04/10/2023] [Indexed: 01/25/2024] Open
Abstract
Plantar fasciitis (PF) is a common musculoskeletal disease. Histologic findings of patients with PF showed mainly chronic degenerative processes rather than inflammation. In addition to mechanical factors, such as repetitive stress and reduced ankle dorsiflexion, PF is also linked to rheumatologic diseases and genetic factors. Ultrasound is becoming a standard imaging technique for assessing PF. Major sonographic findings included increased plantar fascia thickness and hypoechoic plantar fascia. In addition to traditional B-mode ultrasound, sonoelastography can also be utilized to diagnose PF. Ultrasound can also be used to guide therapeutic interventions. Over 80% of patients with PF improved under nonsurgical treatment. Treatment options for PF include physical therapy, modalities (laser, therapeutic ultrasound), extracorporeal shock wave therapy (ESWT), injections, transcatheter arterial embolization, and surgery. For injections, corticosteroid was mostly used in the past but has been replaced gradually by other techniques such as platelet-rich plasma or dextrose prolotherapy. There is also more and more evidence about ESWT in treating PF. Surgery serves as an option for recalcitrant PF cases, and endoscopic fasciotomy seemed to have good outcomes. Ultrasound plays an important role in diagnosing of PF and evaluating the treatment effect, and the use of sonoelastography in addition to traditional B-mode ultrasound may help in the early detection of PF and assessment of the treatment effect.
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Affiliation(s)
- Wen-Che Tseng
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Yun-Chang Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Tsung-Min Lee
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Shiang Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
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Charles R, Fang L, Zhu R, Wang J. The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: a systematic review and meta-analysis. Front Immunol 2023; 14:1193835. [PMID: 37662911 PMCID: PMC10468604 DOI: 10.3389/fimmu.2023.1193835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Background Tendinopathy is a growing global concern affecting many people, like athletes, workers, and the elderly. Despite its commonality among the sporting population, there is no practical clinical guideline for patellar tendinopathy (PT). Furthermore, there is conflicting evidence between clinical guidelines on shockwave therapy's application and clinical utility for Achilles tendinopathy (AT) and plantar fasciitis (PF). Thus, our aim of this study is to evaluate the evidence for shockwave therapy; to provide a Grading of Recommendation, Assessment, Development and Evaluation (GRADE) level of the evidence and effectiveness of shockwave therapy for patellar tendinopathy, Achilles tendinopathy, and Plantar fasciitis. Method Medical Literature Analysis and Retrieval System Online (Medline), Embase, The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro) and China National Knowledge Infrastructure database (CNKI) were searched to find relevant studies published before December 14th, 2022. Results Our study showed that for PT in the short term, extracorporeal shockwave therapy (ESWT) or ESWT + eccentric exercise (EE) has a negligible effect on pain and function compared to a placebo or placebo + EE. On the contrary, ESWT significantly affects pain compared to conservative treatment (CT). For AT, ESWT has a small inconclusive effect on pain and function in the short term compared to EE. On the other hand, a placebo outperformed ESWT in improving function for AT but not pain outcomes. PF showed that ESWT significantly affects short- and long-term pain and function. When ESWT was compared to other interventions such as low laser therapy (LLLT), corticosteroid injection (CSI), or CT, there was a small inconclusive effect on pain and function in the short term. Conclusion There is low-moderate evidence that ESWT has a negligible effect on pain and function for PT and AT. However, high-quality evidence suggests ESWT has a large effect on pain and function for PF. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023396835, identifier CRD42023396835.
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Affiliation(s)
- Ravon Charles
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Fang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Centre of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
- Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Ranran Zhu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jinxiang Wang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Guimarães JDS, Arcanjo FL, Leporace G, Metsavaht LF, Conceição CS, Moreno MVMG, Vieira TEM, Moraes CC, Gomes Neto M. Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis. Clin Rehabil 2022; 37:727-746. [PMID: 36571559 DOI: 10.1177/02692155221143865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To determine the effects of different therapeutic interventions that have ever been evaluated in randomized controlled trials on pain due to plantar fasciitis. METHODS We searched different electronic databases until September 2022. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the overall certainty evidence. RESULTS A total of 236 studies met the study criteria, including 15,401 patients. Botulinum toxin MD -2.14 (CI: -4.15, -0.14), micronized dehydrated human amnion/chorion membrane injection MD -3.31 (CI: -5.54, -1.08), dry needling MD -2.34 (CI: -4.64, -0.04), low-dye taping MD -3.60 (CI: -4.16, -3.03), low-level laser therapy MD -2.09 (CI: -2.28, -1.90), myofascial releases MD -1.79 (CI: -2.63, -0.94), platelet-rich plasma MD -2.40 (CI: -4.16, -0.63), radiofrequency MD -2.47 (CI: -4.65, -0.29), and stretching MD -1.14 (CI: -2.02, -0.26) resulted in being effective treatments for pain when compared to the control in the short term. In the medium and long term, only extracorporeal shock wave therapy MD -0.97 (CI: -1.13, -0.81)/MD -2.49 (CI: -3.17, -1.82) was effective for improving pain when compared to the control. CONCLUSIONS Considering the available studies, this systematic review and meta-analysis showed that different therapeutic interventions seem to be useful strategies for improving pain in patients with plantar fasciitis. In the medium and long term, only extracorporeal shock wave therapy was effective in improving pain when compared to the control.
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Affiliation(s)
- Janice de S Guimarães
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Fabio L Arcanjo
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Gustavo Leporace
- Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Biocinética, Rua Visconde de Pirajá, Rio de Janeiro, Brazil
| | | | - Cristiano Sena Conceição
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Marcus V M G Moreno
- Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Tulio E Marçal Vieira
- Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Carolina Cunha Moraes
- Foot and Ankle Medicine and Surgery Department, Portuguese Hospital of Bahia, Salvador, Bahia, Brazil
| | - Mansueto Gomes Neto
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Department, Physiotherapy course, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
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Melese H, Alamer A, Getie K, Nigussie F, Ayhualem S. Extracorporeal shock wave therapy on pain and foot functions in subjects with chronic plantar fasciitis: systematic review of randomized controlled trials. Disabil Rehabil 2022; 44:5007-5014. [PMID: 34038642 DOI: 10.1080/09638288.2021.1928775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 04/29/2021] [Accepted: 05/07/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE The aim of this review was to synthesize current evidence on the efficacy of extracorporeal shock wave therapy on pain, and foot function in subjects with plantar fasciitis. MATERIALS AND METHODS A comprehensive search of PubMed/Medline, CINAHL, AMED, PEDro, Cochrane Library, and Scopus were done to identify randomized controlled trials of extracorporeal shock wave therapy in subjects with plantar fasciitis. PEDro scale was used to evaluate the methodological quality of included trials. Visual Analogue Scale and Foot Function Index were the primary outcome measures of this review. Due to varying of entailed trials, meta-analysis was not carried out. RESULTS Eleven randomized controlled trials with 658 patients were included. Extracorporeal shock wave therapy exhibited a moderate confirmation to better pain, and foot function of individuals with chronic plantar fasciitis. CONCLUSION Extracorporeal shock wave therapy could be a promising rehabilitation intervention and might support to improve pain, and foot function of subjects with chronic plantar fasciitis.IMPLICATIONS FOR REHABILITATIONExtracorporeal shock wave therapy (ESWT) exerted beneficial effects on pain and functional outcomes for chronic plantar fasciitis.ESWT could be effectively performed with no side effects.ESWT could be an alternative to the conventional management of chronic plantar fasciitis.
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Affiliation(s)
- Haimanot Melese
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
| | - Abayneh Alamer
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
| | - Kefale Getie
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
| | - Fetene Nigussie
- Department of Nursing Institute of Medicine, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Sileshi Ayhualem
- Department of Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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6
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Burton I, McCormack A. The Effectiveness of Combined Extracorporeal Shockwave Therapy and Exercise for Plantar Heel Pain: A Systematic Review. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2022; 7:39-52. [DOI: 10.14218/erhm.2021.00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Acosta-Olivo C, Simental-Mendía LE, Vilchez-Cavazos F, Peña-Martínez VM, Elizondo-Rodíguez J, Simental-Mendía M. Clinical Efficacy of Botulinum Toxin in the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2021; 103:364-371.e2. [PMID: 34688605 DOI: 10.1016/j.apmr.2021.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/24/2021] [Accepted: 10/01/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the efficacy of botulinum toxin A (BTX-A) for the treatment of plantar fasciitis through a meta-analysis of randomized controlled trials (RCTs) focusing on pain and functional outcomes since current literature has supported a potential benefit of BTX-A. DATA SOURCES The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched until December 2020 for RCTs reporting the effects of BTX-A injections on plantar fasciitis. The complementary literature search included Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, and greylit.org. STUDY SELECTION Only RCTs assessing the effect of BTX-A injections on pain, functional improvement, or plantar fascia thickness in patients with plantar fasciitis were included. Multiple researchers carried out the screening process of the 413 records. DATA EXTRACTION Data were extracted independently and in duplicate using a standardized data extraction format. Information was contrasted by a third observer. DATA SYNTHESIS BTX-A injections resulted in significant pain relief (mean difference, -2.07 [95% CI, -3.21 to -0.93]; P=.0004; I2=97%) and functional improvement (standardized mean difference, 1.15 [95% CI, 0.39-1.91]; P=.003; I2=87%). A subanalysis indicated that pain relief was sustained at 12 months while functional improvement remained significant after 0-6 months. The results were not affected by a single study after sensitivity analysis. The site of injection and the use or not of ultrasound-guided injections may account for potential sources of interstudy heterogeneity. CONCLUSIONS This meta-analysis suggests both a statistically significant and a clinically meaningful improvement on plantar fasciitis symptoms after BTX-A treatment.
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Affiliation(s)
- Carlos Acosta-Olivo
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Hospital Universitario "Dr José Eleuterio González," School of Medicine, Monterrey, México
| | - Luis E Simental-Mendía
- Instituto Mexicano del Seguro Social, Unidad de Investigación Biomédica, Delegación Durango, Durango, México
| | - Félix Vilchez-Cavazos
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Hospital Universitario "Dr José Eleuterio González," School of Medicine, Monterrey, México
| | - Víctor M Peña-Martínez
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Hospital Universitario "Dr José Eleuterio González," School of Medicine, Monterrey, México
| | - Jorge Elizondo-Rodíguez
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Hospital Universitario "Dr José Eleuterio González," School of Medicine, Monterrey, México
| | - Mario Simental-Mendía
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Hospital Universitario "Dr José Eleuterio González," School of Medicine, Monterrey, México.
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Dextrose prolotherapy versus radial extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: A randomized, controlled clinical trial. Foot Ankle Surg 2021; 27:643-649. [PMID: 32919897 DOI: 10.1016/j.fas.2020.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 02/04/2023]
Abstract
In the recent years, prolotherapy is increasingly being used in the field of musculoskeletal medicine. However, few studies have investigated its effectiveness in plantar fasciitis (PF). The purpose of this study was to compare the effectiveness of ultrasound-guided dextrose prolotherapy with radial extracorporeal shock wave therapy (ESWT) in the treatment of chronic PF. This randomized controlled trial was conducted on 59 patients with chronic PF. Patients were randomly assigned into two groups receiving three sessions of radial ESWT (29 patients) vs. two sessions of ultrasound-guided intrafascial 2 cc dextrose 20% injection (30 patients). The following outcome measures were assessed before and then six weeks and 12 weeks after the treatments: pain intensity by visual analog scale (VAS), daily life and exercise activities by Foot and Ankle Ability Measure (FAAM), and the plantar fascia thickness by ultrasonographic imaging. The VAS and FAAM scales showed significant improvements of pain and function in both study groups 6 weeks and 12 weeks after the treatments. A significant reduction was noted for plantar fascia thickness at these intervals (all p < .05). The inter-group comparison revealed that except for the FAAM-sport subscale which favored ESWT, the interaction effects of group and time were not significant for other outcome measures. Dextrose prolotherapy has comparable efficacy to radial ESWT in reducing pain, daily-life functional limitation, and plantar fascia thickness in patients with PF. No serious adverse effects were observed in either group. LEVEL OF EVIDENCE: Level I, randomized controlled trial.
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Coheña-Jiménez M, Pabón-Carrasco M, Pérez Belloso AJ. Comparison between customised foot orthoses and insole combined with the use of extracorporeal shock wave therapy in plantar fasciitis, medium-term follow-up results: A randomised controlled trial. Clin Rehabil 2020; 35:740-749. [PMID: 33233945 DOI: 10.1177/0269215520976619] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the clinical results of custom-made foot orthoses versus placebo flat cushioning insoles combined with an extracorporeal shock wave therapy on pain and foot functionality in patients with plantar fasciitis. DESIGN AND SETTING A randomised controlled clinical trial with follow-up at six months. Faculty of Podiatry and Centre Clinical private of Physiotherapy, Seville, Spain. SUBJECTS AND INTERVENTIONS Patients with plantar fasciitis were randomly assigned to either group A (n = 42), which received custom-made foot orthoses, or group B (n = 41), which received placebo insoles. All the participants received active extracorporeal shock wave therapy including stretching exercises. Recruitment period was from Mach 2019 to July 2020. MAIN MEASUREMENTS The main outcome was foot pain, measured by visual analogue scale and the secondary outcome measures were recorded by Roles and Maudsley scores respectively, at the beginning and at one week, one month and six months. RESULTS Eighty-eight patients were assessed for eligibility. Eighty-three patients were recruited and randomised. This study showed significant differences between both groups according to the visual analogue scale. In control group, the difference was at baseline (P 0.01) and, in the experimental group was at the one- and six-month follow-up (P 0.001). The mean (SD) visual analogue scale at baseline were Control group 6.31 (1.69) and Experimental group 5.27 (1.64); and at six months were 7.52 (3.40) and 3.29 (4.26), respectively. The custom-made foot orthosis was perceived as 'good' (85%) and 'excellent' (97.5%) at medium-long term. CONCLUSION Wearing a custom-made foot orthosis leads to a improvement in patients with plantar fasciitis; it reduced foot pain and improved foot functionality.
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Tracy K, Slater JB. Early-Application Extracorporeal Shockwave Therapy for Plantar Fasciitis in a Chiropractic Clinic: A Case Report. J Chiropr Med 2020; 19:91-95. [PMID: 33192196 DOI: 10.1016/j.jcm.2019.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/19/2019] [Accepted: 10/10/2019] [Indexed: 11/26/2022] Open
Abstract
Objective The purpose of this report is to describe the successful management of plantar fasciitis (PF) using only extracorporeal shockwave therapy. Clinical Features A 26-year-old male former athlete presented with insidious right posterior medial foot pain of 3 months' duration. He reported a past history of similar symptoms 12 years previously and was successfully treated with tape, ice, and electric stimulation. For the current episode, he attempted to manage with orthotics, motor nerve stimulation, and ice, and when that was insufficient, he sought care in our clinic. Initial history and evaluation found provocation of pain and functional limitations while wearing dress shoes, running, and playing basketball. Examination found palpatory tenderness at the medial aspect of the distal right calcaneus, and pain with right ankle dorsiflexion. Radiographs were unremarkable. Patient presentation and exam findings supported a working diagnosis of PF. Intervention and Outcomes Treatment was applied with a Richard Wolf WellWave low-energy shockwave therapy unit with focused dosage of 4000 shock pulsations at 10-mm depth to the site of pain. Treatment was applied 11 × over 5 weeks, after which the patient reported a complete resolution of pain and resumption of all activities. Conclusion Extracorporeal shockwave therapy appeared to be an effective treatment approach for the management of this patient's PF.
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Affiliation(s)
- Kily Tracy
- Clinical Department, Palmer College of Chiropractic, San Jose, California
| | - Jonathan B Slater
- Clinical Department, Palmer College of Chiropractic, San Jose, California
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Hasegawa M, Urits I, Orhurhu V, Orhurhu MS, Brinkman J, Giacomazzi S, Foster L, Manchikanti L, Kaye AD, Kaye RJ, Viswanath O. Current Concepts of Minimally Invasive Treatment Options for Plantar Fasciitis: a Comprehensive Review. Curr Pain Headache Rep 2020; 24:55. [PMID: 32785856 DOI: 10.1007/s11916-020-00883-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW Chronic foot pain constitutes a large portion of the chronic pain burden in the overall population. Plantar fasciitis is one of the most common and most easily identifiable causes of chronic foot pain. The syndrome has been estimated to cause 11 to 15% of foot pain visits, requiring professional care. Moreover, studies have suggested that 1 in 10 people will develop plantar fasciitis at some point in their life. Conservative management has been shown to be effective and considered first-line treatment. Minimally invasive treatment options are typically reserved for those who fail conservative management. With the advent of new techniques and improvements in current therapeutic options, there has been an expansion of available minimally invasive treatment options. The purpose of this review is to provide a comprehensive update on the current understanding of minimally invasive treatments of plantar fasciitis. RECENT FINDINGS This review shows that conservative management continues to be the first-line therapy, whereas other treatment options were those who failed conservative management using modern techniques that have shown improving effectiveness, with successful restoration of patient functionality, recovery, and satisfaction. However, a multitude of these minimally invasive treatment options are evolving. CONCLUSION While conservative management continues to be the mainstay of treatment for plantar fasciitis, multiple minimally invasive treatment options are emerging with potential effectiveness in reducing pain and improving the function.
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Affiliation(s)
- Morgan Hasegawa
- Creighton University School of Medicine at Regional Campus St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Ivan Urits
- Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
| | - Vwaire Orhurhu
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mariam Salisu Orhurhu
- Department of Anesthesia, Critical Care, and Pain Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Joseph Brinkman
- Creighton University School of Medicine at Regional Campus St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Stephen Giacomazzi
- Creighton University School of Medicine at Regional Campus St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Lukas Foster
- Creighton University School of Medicine at Regional Campus St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | | | - Alan D Kaye
- Louisiana State University Health Science Center, Shreveport, LA, USA
| | - Rachel J Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Omar Viswanath
- Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.,Valley Anesthesiology and Pain Consultants, Phoenix, AZ, USA.,Department of Anesthesiology, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA.,Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA
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12
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[Comparison between extracorporeal shockwave therapy and radial pressure wave therapy in plantar fasciitis]. Rehabilitacion (Madr) 2020; 54:11-18. [PMID: 32007177 DOI: 10.1016/j.rh.2019.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/01/2019] [Accepted: 09/07/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Plantar fasciitis is a common cause of heel pain. The aetiology of this condition remains unclear. Patients typically have pain upon palpation of the medial plantar calcaneal region. Extracorporeal shockwave therapy has shown favourable outcomes in various studies. The aim of this study was to compare the effect of focused extracorporeal shockwave therapy with radial pressure wave therapy. PATIENTS AND METHODS Seventy-nine non-randomised patients diagnosed with plantar fasciitis were included between January 2017 and June 2018. Patients from the Arnau de Vilanova Hospital in Valencia were treated with focused extracorporeal shockwave therapy, and patients from Llíria Hospital with radial pressure wave therapy. Measured outcome variables were: visual analog scale; ultrasonographic measurement of plantar fascia thickness; self-reported foot-specific pain and disability using the Foot Function Index; self-reported health-related quality of life using the Euroqol-5D; self-reported pain and limitations of activity using the Roles & Maudsley Scale. RESULTS At inclusion, the 2groups showed no significant differences in demographic or clinical characteristics. Three months after treatment completion, both groups showed improvement in all outcome variables, without statistically significant differences between the 2groups. No adverse effects or complications were observed. CONCLUSIONS Both extracorporeal shockwave therapy and radial pressure wave therapy are effective treatments for plantar fasciitis.
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Extracorporeal shock wave therapy versus other therapeutic methods for chronic plantar fasciitis. Foot Ankle Surg 2020; 26:33-38. [PMID: 30502222 DOI: 10.1016/j.fas.2018.11.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/24/2018] [Accepted: 11/03/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND To conduct a meta-analysis comparing the efficacy of general ESWT with that of other therapies and to assess its effectiveness in chronic plantar fasciitis. METHODS A literature search was performed in PubMed, Embase, Web of Science and the Cochrane Library for information from the earliest date of data collection to March 2018. Studies comparing the benefits and risks of extracorporeal shock wave therapy with those of other therapies for chronic plantar fasciitis were included. Statistical heterogeneity was quantitatively evaluated by a X2 test with the significance set as P<0.10 or I2>50%. RESULTS Thirteen trials consisting of 1,185 patients were included (637 patients were treated with ESWT; 548 patients, with OT). The results showed that patients treated with ESWT had increased success or improvement rates, an increased modified Roles & Maudsley (RM) score, a reduction of pain scales, reduced return to work time, and fewer complications than patients treated with other therapy methods (P<0.1). CONCLUSIONS Compared with patients who received other therapies for chronic plantar fasciitis, patients treated with ESWT responded better, had less complications and showed a clear difference in efficacy between ESWT and other therapy in chronic plantar fasciitis. LEVEL OF EVIDENCE Level IV, therapeutic study.
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Piezoelectric focal waves application in the treatment of plantar fascitis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2019. [DOI: 10.1016/j.recote.2019.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Vaamonde-Lorenzo L, Cuenca-González C, Monleón-Llorente L, Chiesa-Estomba R, Labrada-Rodríguez YH, Castro-Portal A, Archanco Olcese M, Garvin Ocampos L. Piezoelectric focal waves application in the treatment of plantar fascitis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2018; 63:227-232. [PMID: 30467069 DOI: 10.1016/j.recot.2018.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/21/2018] [Accepted: 09/15/2018] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Plantar fasciitis (PF) is one of the most frequent causes of thalalgia and disability. The effectiveness of extracorporeal shock wave therapy is an ideal alternative to conservative treatments. OBJETIVE To evaluate the effectiveness of the treatment with Piezoelectric Focal Shock Waves with echographic support and maintenance of the effect at 3 and 6 months. MATERIALS AND METHODS Causi-experimental, retrospective statistical study,June 2015 to June 2017, of 90 patients, 36.6% men and 63.3% women, with a mean age of 52 years, diagnosed with PF. Three sessions (one weekly for 3 weeks) of shock wave therapy (PiezoWave F10 G4 generator) were performed, with echographic support and weekly revision and at 3 and 6 months. MAIN VARIABLES pain,using Visual Analog Scale before and after each session and at 3 and 6 months and Roles and Maudsley Scale at the end of treatment and at 3 and 6 months. RESULTS 2000 pulses per session were applied, medium energy intensity 0.45 mJ /mm2, median frequency 8 MHz and median depth of focus of 15 mm. Statistically significant improvement was observed in the Visual Analog Scale between the 3 treatment sessions and after 3 and 6 months posttreatment,obtaining a statistically significant improvement in all values (p <0.05). CONCLUSION Treatment with piezoelectric focal shock waves in PF may reduces pain from the first session and achieves a subjective perception of improvement, maintaining these results at 6 months post -treatment.
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Affiliation(s)
- L Vaamonde-Lorenzo
- Servicio de Medicina Física y Rehabilitación, Hospital Clínico San Carlos, Madrid, España.
| | - C Cuenca-González
- Servicio de Medicina Física y Rehabilitación, Hospital Clínico San Carlos, Madrid, España
| | - L Monleón-Llorente
- Servicio de Medicina Física y Rehabilitación, Hospital Clínico San Carlos, Madrid, España
| | - R Chiesa-Estomba
- Servicio de Medicina Física y Rehabilitación, Hospital Clínico San Carlos, Madrid, España
| | - Y H Labrada-Rodríguez
- Servicio de Medicina Física y Rehabilitación, Hospital Clínico San Carlos, Madrid, España
| | - A Castro-Portal
- Servicio de Medicina Física y Rehabilitación, Hospital Clínico San Carlos, Madrid, España
| | - M Archanco Olcese
- Servicio de Medicina Física y Rehabilitación, Hospital Clínico San Carlos, Madrid, España
| | - L Garvin Ocampos
- Servicio de Medicina Física y Rehabilitación, Hospital Clínico San Carlos, Madrid, España
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A Comparison of the Efficacy of Dry-Needling and Extracorporeal Shockwave Therapy for Plantar Fasciitis: A Randomized Clinical Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.68908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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17
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Wheeler PC, Tattersall C. Extracorporeal Shockwave Therapy Plus Rehabilitation for Patients With Chronic Plantar Fasciitis Might Reduce Pain and Improve Function but Still Not Lead to Increased Activity: A Case-Series Study With Multiple Outcome Measures. J Foot Ankle Surg 2018; 57:339-345. [PMID: 29032913 DOI: 10.1053/j.jfas.2017.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Indexed: 02/03/2023]
Abstract
Plantar fasciitis is a common cause of plantar-aspect heel pain. Although many patients will improve, a proportion will have ongoing and sometimes debilitating symptoms. Evidence from randomized controlled trials has shown that extracorporeal shockwave therapy (ESWT) results in benefits in treating pain. However, uncertainties remain whether these benefits translate to improvements in overall function. The present prospective case series examined the results from 35 patients with chronic plantar fasciitis who had undergone a course of ESWT in addition to a graded rehabilitation program. Of the 35 subjects, 34% were male, and the median age was 50.9 years. The duration of symptoms before ESWT was 24 months. The results of the present case series demonstrated statistically significant improvements in measures of self-reported "average pain" from a median of 7.0 of 10 at baseline to 5.0 of 10 at 3 months (p < .001) and of "worst pain" from 9.0 of 10 at baseline to 7.0 of 10 at 3 months (p < .001). In addition, significant improvements were found in several validated patient-rated outcome measures of local foot/ankle function but not in overall markers of health, anxiety/depression scores, or activity levels, despite the improvements in pain. No statistically significant correlations were found between gender, age, or chronicity of symptoms and the improvements seen. No significant side effects occurred in the present study. The results of our series support the use of ESWT for patients with chronic plantar fasciitis for local pain symptoms; however, uncertainties remain regarding global benefits to health.
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Affiliation(s)
- Patrick C Wheeler
- Consultant, Sport and Exercise Medicine, Department of Sport and Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Senior Lecturer and Visiting Fellow, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom; Consultant, Sport and Exercise Medicine, National Centre of Sport and Exercise Medicine-East Midlands, Loughborough United Kingdom.
| | - Chloe Tattersall
- Nurse Practitioner, Department of Sport and Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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Li H, Lv H, Lin T. Comparison of efficacy of eight treatments for plantar fasciitis: A network meta‐analysis. J Cell Physiol 2018; 234:860-870. [PMID: 30078188 DOI: 10.1002/jcp.26907] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 06/12/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Haibo Li
- Department of Orthopaedics Tianjin Hospital Tianjin China
| | - Hao Lv
- Department of Pediatric Orthopedics Affiliated Hospital of Shandong University of Traditional Chinese Medicine Jinan China
| | - Ting Lin
- Department of Information Management and Information Systems College of Economics and Management, Tianjin University of Science & Technology Tianjin China
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Roerdink R, Dietvorst M, van der Zwaard B, van der Worp H, Zwerver J. Complications of extracorporeal shockwave therapy in plantar fasciitis: Systematic review. Int J Surg 2017; 46:133-145. [DOI: 10.1016/j.ijsu.2017.08.587] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 08/17/2017] [Indexed: 12/12/2022]
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20
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Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Medicine (Baltimore) 2017; 96:e6621. [PMID: 28403111 PMCID: PMC5403108 DOI: 10.1097/md.0000000000006621] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Plantar fasciitis (PF) is the most common reason for heel pain. The efficacy of extracorporeal shock wave therapy (ESWT) as an ideal alternative to conservative treatments and surgery is controversial, and almost all previous articles compared general ESWT with placebo without indicating the kind of shock wave. We undertook a meta-analysis to compare the efficacy of general ESWT, focused shock wave (FSW), and radial shock wave (RSW) with placebo, to assess their effectiveness in chronic PF. METHODS The PubMed, Medline, EmBase, Web of Science, and Cochrane library databases were searched for studies comparing FSW or RSW therapy with placebo in chronic PF. Clinical outcomes included the odds ratios (ORs) of pain relief, pain reduction, and complications. Relevant data were analyzed using RevMan v5.3. RESULTS Nine studies involving 935 patients were included. ESWT had higher improvement rates than the placebo group (OR 2.58, 95% confidence interval [CI] 1.97-3.39, P < .00001). ESWT had markedly lower standardized mean difference than placebo, with heterogeneity observed (standardized mean difference 1.01, 95% CI -0.01 to 2.03, P = .05, I = 96%, P < .00001). FSW and RSW therapies had greater therapeutic success in pain relief than the placebo group (OR 2.17, 95% CI 1.49-3.16, P < .0001; OR 4.63, 95% CI 1.30-16.46, P = .02), but significant heterogeneity was observed in RSW therapy versus placebo (I = 81%, P = .005). CONCLUSION This meta-analysis suggested that FSW therapy can relieve pain in chronic PF as an ideal alternative option; meanwhile, no firm conclusions of general ESWT and RSW effectiveness can be drawn. Due to variations in the included studies, additional trials are needed to validate these conclusions.
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Affiliation(s)
- Jiale Sun
- The Graduate School of Peking Union Medical College
| | - Fuqiang Gao
- Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China
| | - Yanhua Wang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Wei Sun
- Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China
| | - Baoguo Jiang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Zirong Li
- Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China
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Assad S, Ahmad A, Kiani I, Ghani U, Wadhera V, Tom TN. Novel and Conservative Approaches Towards Effective Management of Plantar Fasciitis. Cureus 2016; 8:e913. [PMID: 28083457 PMCID: PMC5215813 DOI: 10.7759/cureus.913] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We assessed the effectiveness of the different treatments for plantar fasciitis (PF) based on the changes in functional outcomes. A systematic literature search was carried out and studies from 2010 to 2016 were included in this review. The databases from Google Scholar, PubMed and Cochrane were used for the various treatment modalities of plantar fasciitis. The objectives measured included visual analog scale (VAS), Roles and Maudsley scale, foot function index (FFI), plantar fascia thickness and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot scale as the tools to predict the improvement in symptoms of pain and discomfort. Eight randomized controlled trails that met the selection criteria were included in this review. Extracorporeal shock wave lithotripsy (ESWL) with botulinum toxin type A, corticosteroid injections, autologous whole blood and plasma treatment, novel treatments like cryopreserved human amniotic membrane, effect of placebo, platelet rich plasma injections and corticosteroid injections, physiotherapy and high strength training were analyzed. All the treatment modalities applied did lead to the reduction in pain scores, but for long term management autologous condition plasma and platelet rich plasma are the preferred treatment options. Impact of physiotherapy and high strength training is equivalent to corticosteroid injections and hence is suited for patients avoiding invasive forms of treatment.
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Affiliation(s)
- Salman Assad
- Department of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Awaiz Ahmad
- Neurosurgery, Shifa International Hospital, Islamabad, Pakistan
| | - Immad Kiani
- Internal Medicine, Shifa International Hospital, Islamabad, Pakistan
| | - Usman Ghani
- Department of Medicine, Shifa International Hospital, Islamabad, Pakistan
| | | | - Todd N Tom
- Surgery, ARH Regional Healthcare Center/University of Kentucky College of Medicine
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