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Matsumoto Y, Ogihara N. Direct visualization and measurement of the plantar aponeurosis behavior in foot arch deformation via the windlass mechanism. Clin Anat 2024. [PMID: 38642017 DOI: 10.1002/ca.24171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/28/2024] [Accepted: 04/11/2024] [Indexed: 04/22/2024]
Abstract
The plantar aponeurosis (PA) is an elastic longitudinal band that contributes to the generation of a propulsive force in the push-off phase during walking and running through the windlass mechanism. However, the dynamic behavior of the PA remains unclear owing to the lack of direct measurement of the strain it generates. Therefore, this study aimed to visualize and quantify the PA behavior during two distinct foot postures: (i) neutral posture and (ii) windlass posture with midtarsal joint plantarflexion and metatarsophalangeal joint dorsiflexion, using computed tomography scans. Six healthy adult males participated in the experiment, and three-dimensional reconstruction of the PA was conducted to calculate its path length, width, thickness, and cross-sectional area. This study successfully visualized and quantified the morphological changes in the PA induced by the windlass mechanism, providing a precise reference for biomechanical modeling. This study also highlighted the interindividual variability in the PA morphology and stretching patterns. Although the windlass posture was not identical to that observed in the push-off phase during walking, the observed PA behavior provides valuable insights into its mechanics and potential implications for foot disorders.
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Affiliation(s)
- Yuka Matsumoto
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
- Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
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2
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Alfuth M. Pain improvement after three weeks of daily self-executed cross-friction massage using a fascia ball in a patient with recent-onset plantar heel pain: a case report. J Man Manip Ther 2024:1-9. [PMID: 38448397 DOI: 10.1080/10669817.2024.2325186] [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: 08/21/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Plantar heel pain is described as sharp pain at the medial plantar aspect of the calcaneus and medial longitudinal arch of the foot. There are various treatment options that usually need a clinician or a therapist for application. The present case report aimed to describe the outcomes of self-executed cross-friction massage using a fascia ball in a patient with recent-onset plantar heel pain. CASE DESCRIPTION The patient was a 42-year-old man who reported plantar heel pain during the first steps in the morning along with decreased function of the foot and ankle lasting about three months. He was instructed to self-execute cross-friction massage using a fascia ball daily in the evening at home for six weeks. OUTCOMES Pain during treatment decreased from a Numeric Pain Rating Scale (NPRS)-score of 8/10 and from a Short-Form McGill Pain Questionnaire (SF-MPQ)-score of 34/60 at initial treatment to NPRS- and SF-MPQ-scores of 0/10 and 0/60, respectively, after about three weeks. The patient reported no pain and restored function after six weeks of treatment, and in the follow-up measurements. DISCUSSION Daily self-executed cross-friction massage using a fascia ball may be a useful alternative intervention for treating recent-onset plantar heel pain.
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Affiliation(s)
- Martin Alfuth
- Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany
- Department of Further Education, Sport Physiotherapy, German Sport University Cologne, Cologne, Germany
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Boob MA, Phansopkar P, Somaiya KJ. Comprehensive Physiotherapy Rehabilitation Protocol of Plantar Fasciitis for a 45-Year-Old Female: A Case Report. Cureus 2024; 16:e51585. [PMID: 38313979 PMCID: PMC10835201 DOI: 10.7759/cureus.51585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/03/2024] [Indexed: 02/06/2024] Open
Abstract
Plantar fasciitis is stated to arise because of inadequate accumulated tension at the plantar fascia's enthesis. Tensile load and prolonged strain cause tiny rips in the fascia, which trigger a chronic inflammation process of healing. This case report shows the diagnostic evaluations, assessment of the condition, and physical rehabilitation management for a 45-year-old female nurse working in the neurosurgical critical care unit who had been experiencing plantar medial and posterior heel pain, as well as discomfort at the calcaneal tuberosity, for the previous six months. To increase functional mobility and alleviate symptoms, the patient sought out physiotherapy intervention. In this case, a physiotherapeutic program was implemented to treat plantar fasciitis, enhance mobility, and encourage long-term recovery. The evaluation included a detailed review of the patient's gait, biomechanics, and circumstances that may have contributed to the ongoing problems. The multimodal strategy used in the intervention plan included manual therapy, strengthening and stretching exercises, as well as patient education and counselling on self-management techniques. The patient's functional mobility increased along with a steady reduction in discomfort during the duration of the physiotherapy sessions. The instance emphasises how important it is to manage persistent plantar fasciitis with a customised physical therapy strategy that takes the patient's specific requirements into account and addresses contributory variables. The present study adds to the extant literature on efficacious physiotherapeutic approaches for plantar fasciitis, highlighting the need for a holistic approach in attaining favourable results for individuals enduring heel discomfort.
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Affiliation(s)
- Manali A Boob
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratik Phansopkar
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Kamya J Somaiya
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Digra N, Beri A, Sharma S, Verma R. Autologous Whole-Blood Versus Corticosteroid Local Injection in Treatment of Plantar Fasciitis: A Randomized Single Blind Placebo-Controlled Study. Cureus 2023; 15:e45588. [PMID: 37868394 PMCID: PMC10587858 DOI: 10.7759/cureus.45588] [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: 08/11/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Autologous whole-blood intralesional injection has attracted interest as a possible means of treatment for chronic plantar fasciitis. We contrasted its effectiveness with that of corticosteroids, which have a longer history of success in treating tendinopathies such as plantar fasciitis. In order to monitor the disease's progress naturally, we also compared them with a placebo. METHODS Sixty clinically diagnosed patients were taken up for intralesional injection of autologous whole blood (AWB), corticosteroid, and normal saline as placebo mixed with 2 mL of lignocaine after dividing them into three groups. Two doses were given and followed up in the third, sixth, and 12th weeks. The evaluation was done according to the visual analog scale (VAS) and the number of tablets of paracetamol (PCM) 500 mg consumed for the following period. RESULTS When compared to the placebo group in the third, sixth, and 12th weeks, the corticosteroid group exhibited a significant improvement with a p<0.001 in the VAS score, whereas the autologous whole blood group showed no meaningful difference. When compared to the placebo group at the sixth and 12th weeks, the AWB group's VAS score showed a statistically significant difference with a p>0.001. At each follow-up, the placebo group consumed more analgesics than the corticosteroid group, with a p<0.001. Only in the third week of follow-up did AWB demonstrate a statistically significant difference in PCM consumption as compared to the corticosteroid group. CONCLUSION Statistically significant improvement was seen in both the AWB group and corticosteroid group as compared to the placebo group. The corticosteroid group achieved earlier and superior relief of pain while AWB had a longer lasting effect. Therefore, study results indicate almost similar results in short-term studies.
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Affiliation(s)
- Nikhil Digra
- Orthopedics, Government Medical College and Hospital, Amritsar, IND
| | - Anurag Beri
- Orthopedics, Government Medical College and Hospital, Amritsar, IND
| | - Shashank Sharma
- Orthopedics, Government Medical College and Hospital, Amritsar, IND
| | - Ramkrishna Verma
- Orthopedics, Government Medical College and Hospital, Amritsar, IND
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Sanchez T, Sankey T, Schick S, Arthur R, Young M, Underwood M, Harrelson W, Shah A. PROMIS Scores for Plantar Fasciitis Before and After Gastrocnemius Recession. Foot Ankle Int 2023; 44:459-468. [PMID: 36959741 DOI: 10.1177/10711007231159105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
BACKGROUND There has been an established relationship between increased loading on the Achilles tendon and tension on the plantar fascia. This supports the idea that either tight gastrocnemius and soleus muscles or contractures of the Achilles tendon are risk factors for plantar fasciitis. Gastrocnemius recession has gained popularity as a viable surgical intervention for cases of chronic plantar fasciitis due to isolated gastrocnemius contracture. To our knowledge, this is the first study to investigate Patient-Reported Outcome Measurement Information Systems (PROMIS) scores in patients with plantar fasciitis before and after gastrocnemius recession. METHODS The Electronic Medical Record was queried for medical record numbers associated with Current Procedural Terminology code 27687 (gastrocnemius recession). Our study included all patients with a preoperative diagnosis of chronic plantar fasciitis with treatment via isolated gastrocnemius recession with 1-year minimum follow-up. Forty-one patients were included in our study. Patient variables were collected via chart review. Preoperative and postoperative PROMIS scores were collected in the clinic. RESULTS We followed up 41 patients with a median age of 48 years (interquartile range [IQR] 38-55) and median body mass index of 29.02 (IQR 29.02-38.74) for 1 year post surgery. Preoperative and postoperative PROMIS scores improved for physical function from 39.3 to 44.5 (P = .0005) and for pain interference from 62.8 to 56.5 (P = .0001). PROMIS depression scores were not significantly different (P = .6727). Visual analog scale (VAS) scores significantly decreased from 7.05 to 1.71 (P < .0001). CONCLUSION In this case series, we found the gastrocnemius recession to be an effective option for patients with refractory pain in plantar fasciitis. Our PROMIS and VAS data confirm this procedure's utility and highlight its ability to significantly decrease pain and improve physical function in patients with chronic plantar fasciitis, although final median scores did not reach normative standards for the population, suggesting some residual pain and/or dysfunction was, on average, present. Based on the results of this study, the authors conclude that gastrocnemius recession is a reasonable treatment option for chronic plantar fasciitis patients who fail nonoperative management. LEVEL OF EVIDENCE Level III, retrospective cohort study.
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Affiliation(s)
- Thomas Sanchez
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Turner Sankey
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sam Schick
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rodney Arthur
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Matt Young
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Meghan Underwood
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Whitt Harrelson
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ashish Shah
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
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Noriega DC, Cristo Á, León A, García-Medrano B, Caballero-García A, Córdova-Martinez A. Plantar Fasciitis in Soccer Players-A Systemic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14426. [PMID: 36361304 PMCID: PMC9653655 DOI: 10.3390/ijerph192114426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
Soccer is one of the most popular sports in the world. Players often suffer a variety of injuries, the most common being injuries to muscles and tendons. It is striking that with soccer, being the most practiced sport, and considering that most injuries occur in the lower extremities, plantar fasciitis (PF) is not one of the most frequent injuries (at least in terms of clinical data collected). The purpose of this review was to provide a comprehensive update of the topic "plantar fasciitis" focusing on soccer players. The review was conducted in accordance with the PRISMA (Preferred Reportiog ltems for Systmiatic reviews and Meta-Analyses) statement. PubMed, Cochrane Library and Scopus were researched. PICO (Patient, Population or Problem; Intervention; Comparison; and Outcome) components were identified. The keywords used were "plantar fasciitis", "plantar fasciitis and sport", "plantar fasciitis risk factors", "plantar fasciitis soccer" and "plantar fasciitis football players". With respect to the objective proposed for the research, we found eight specific articles focused on soccer. Of these, five were general reviews discussing the different methods of treatment of this pathology, and we have only found three studies that focused on PF in soccer, with two of them referring to a clinical case whereby the report and discussion only dealt with the specific treatment followed by the soccer player. After reviewing the manuscripts included in this work, we were surprised that there is no data in which the Silfverskiöld test was performed, as this test explores the passive mobility of the ankle and the degree of dorsiflexion in the supine position. We concluded that soccer players suffer pain in the sole of the foot compatible with plantar fasciitis; however, as indicated by Suzue et al., it is often not diagnosed because the athlete does not consider performing the clinical examinations necessary for its diagnosis. The shortage of reported publications in soccer may mask other PF-associated injuries.
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Affiliation(s)
- David C. Noriega
- Department of Orthopedic Surgery, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
| | - Ángel Cristo
- Department of Orthopedic Surgery, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain
| | - Alejandro León
- Department of Orthopedic Surgery, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain
| | - Belén García-Medrano
- Department of Orthopedic Surgery, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain
| | - Alberto Caballero-García
- Department of Anatomy and Radiology, Faculty of Health Sciences, GIR Physical Exercise and Aging University of Valladolid, University Campus Los Pajaritos, 42004 Soria, Spain
| | - Alfredo Córdova-Martinez
- Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, Campus Duques de Soria, University of Valladolid, 42004 Soria, Spain
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Seligman DAR, Dawson D, Streiner DL, Seligman DJ, Davis A. Treating Heel Pain in Adults: A Randomized Controlled Trial of Hard vs Modified Soft Custom Orthotics and Heel Pads. Arch Phys Med Rehabil 2020; 102:363-370. [PMID: 33217374 DOI: 10.1016/j.apmr.2020.10.124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study compared the effectiveness of soft vs hard orthotics in treating heel pain and plantar fasciitis in adults. It also compared the level of function after orthotic use, cost, and number of visits for orthotics and explored whether age was a factor in orthotic effectiveness. DESIGN Randomized controlled trial. Before randomization, patients were stratified by age (younger vs older adults) in blocks of 4 to ensure that there were an equal number of participants in each group (soft vs hard orthotics). SETTING An orthotic clinic in a community-based hospital and a private orthotic clinic. PARTICIPANTS The participants were adults aged 18 years or older (N=44) with heel pain and plantar fasciitis. INTERVENTION Participants received hard or soft customized orthotics. MAIN OUTCOME MEASURES Participants rated their pain intensity and pain interference before and after orthotic use using subscales from the Brief Pain Inventory. Function was similarly measured using the Late Life Function and Disability Instrument: Function component. Analyses of age, cost, and number of visits were also compared. RESULTS There was a reduction in pain intensity (P=.010) and pain interference (P<.001) but no change in function over time (P=.333), and no difference between the groups who received hard vs soft orthotics. Age had no effect on orthotic effectiveness. Soft orthotics were less expensive (P<.0001) and required fewer visits for fabrication (P<.0001). CONCLUSION Both soft and hard orthotics provided effective pain relief, but soft orthotics are less expensive.
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Affiliation(s)
- Deborah A R Seligman
- Department of Occupational Therapy, Baycrest, Toronto, Ontario, Canada; Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada; Orthotics Clinic, Toronto, Ontario, Canada.
| | - Deirdre Dawson
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada; Rotman Research Institute, Baycrest, University of Toronto, Toronto, Ontario, Canada
| | - David L Streiner
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada; St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - David J Seligman
- Faculty of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aileen Davis
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Physical Therapy and Surgery, Rehabilitation Science Institute, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
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Gatz M, Betsch M, Quack V, Bejder L, Schrading S, Tingart M, Dirrichs T. Shear wave elastography for treatment monitoring of plantar fasciitis. J Sports Med Phys Fitness 2020; 60:1137-1147. [PMID: 32955840 DOI: 10.23736/s0022-4707.20.10702-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Plantar fasciitis is a common cause of heel pain. Monitoring therapy effects is challenging with conventional B-mode ultrasound. Shear wave elastography (SWE) provides important diagnostic information beyond B-mode, with typically lower tissue stiffness in symptomatic plantar fascia. Up to now little is known about SWE features for therapy monitoring in plantar fasciitis. We evaluated the clinical effects of a 3-month physical therapy based treatment and its influence on B-mode and SWE ultrasound findings in patients suffering from plantar fasciitis, correlating ultrasound findings to score-based symptom development. METHODS Prospective, IRB-approved clinical study in plantar fasciitis patients undergoing a 3-month physical therapy based treatment. Measurement time points were before (T0), after 1 (T1) and 3 (T2) months of treatment, consisting of clinical orthopedic (FFI, AOFAS-Score) and multimodal radiologic sonographic examinations (B-mode/SWE) using a high-resolution linear 18-MHz probe. RESULTS A total of 33 patients with 43 symptomatic plantar fascia were included. We found a significant (P<0.001) clinical score improvement (AOFAS +14, FFI-Pain -21, FFI-Function -18) between T0 and T2. Mean initial thickness (T0) of symptomatic plantar fascia was 4.2 (±1.2) mm, compared to 3.2 (±0.7) mm at the asymptomatic contralateral side (P<0.001). No significant thickness changes were seen at T1 (4.2±1.1 mm) and T2 (4.5±1.3 mm), even though clinical scores improved significantly. Mean initial stiffness (T0) of symptomatic plantar fascia was 59.57 (±43.3) kPa, compared to 83.23 (±47.3) kPa at the asymptomatic contralateral side (P<0.001). In contrast to B-mode ultrasound, SWE values increased significantly between T0 (59.6±43.3 kPa), T1 (82.6±47.3 kPa) and T2 (102.5±47.2 kPa) (P<0.001-0.009), with positive correlations for AOFAS/FFI-Pain/Function scores (r=0.285-0.473, P<0.001-0.002). CONCLUSIONS A physical therapy based treatment relieves plantar fasciitis symptoms during a 3-month period. In line with symptom reduction, stiffness (Young's-moduli) of plantar fascia increased significantly, while B-mode ultrasound revealed no measurable changes during the healing process. Shear wave elastography was able to quantify plantar fascia pathologies and their recovery under therapy.
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Affiliation(s)
- Matthias Gatz
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Marcel Betsch
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Valentin Quack
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Ljudmila Bejder
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Simone Schrading
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Markus Tingart
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Timm Dirrichs
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany -
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Tseng W, Uy J, Chiu Y, Chen W, Vora A. The Comparative Effectiveness of Autologous Blood‐derived Products Versus Steroid Injections in Plantar Fasciitis: A Systematic Review and Meta‐analysis of Randomized Controlled Trials. PM R 2020; 13:87-96. [DOI: 10.1002/pmrj.12373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 02/25/2020] [Accepted: 03/20/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Wen‐Che Tseng
- Department of Epidemiology, Harvard T.H. Chan School of Public Health Harvard University Boston MA USA
- Department of Physical Medicine and Rehabilitation National Taiwan University Hospital Taipei Taiwan
| | - Jhanna Uy
- Department of Epidemiology, Harvard T.H. Chan School of Public Health Harvard University Boston MA USA
| | - Yi‐Hsiang Chiu
- 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
| | - Ariana Vora
- Department of Physical Medicine Harvard Medical School, Harvard University Boston MA USA
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10
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Zhou JP, Yu JF, Feng YN, Liu CL, Su P, Shen SH, Zhang ZJ. Modulation in the elastic properties of gastrocnemius muscle heads in individuals with plantar fasciitis and its relationship with pain. Sci Rep 2020; 10:2770. [PMID: 32066869 PMCID: PMC7026110 DOI: 10.1038/s41598-020-59715-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 01/29/2020] [Indexed: 12/12/2022] Open
Abstract
The objectives of this study were (1) to investigate the passive stiffness of the medial gastrocnemius (MG) and lateral gastrocnemius (LG) in patients with and without plantar fasciitis (PF), (2) to explore the correlation between gastrocnemius stiffness and plantar fascia thickness (PFT) as well as the intensity of pain in patients with PF, (3) to detect optimal cut-off points for stiffness of the MG and LG for identifying patients with PF. Forty patients (mean age = 51.1 years ± 12.9) participated in this study. The elastic properties of the MG and LG were quantified using shear wave elastography ultrasound. The thickness of the plantar fascia was measured by B-mode imaging. The intensity of pain was assessed using a visual analogue scale. The results showed that when the ankle was in the relaxed position, patients with PF had increased passive stiffness in the MG (P < 0.05) but not in the LG. Significant correlations were found between pain and the stiffness of the MG (middle, distal; all P-values < 0.05) and no correlation was observed between pain and PFT (P = 0.416). The initial cut-off point for the stiffness of the MG was 29.08 kPa when the ankle was in the relaxed position. The findings from the present study show that an increase in muscle stiffness is not the same in the individual muscles of the gastrocnemius muscle. Traditional treatment of the whole gastrocnemius muscle might not be targeted at the tight muscle.
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Affiliation(s)
- Ji-Ping Zhou
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jia-Feng Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ya-Nan Feng
- Luoyang Orthopedics Hospital of Henan Province, Luoyang, China
| | - Chun-Long Liu
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Pan Su
- Luoyang Orthopedics Hospital of Henan Province, Luoyang, China
| | - Su-Hong Shen
- Luoyang Orthopedics Hospital of Henan Province, Luoyang, China
| | - Zhi-Jie Zhang
- Luoyang Orthopedics Hospital of Henan Province, Luoyang, China.
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Urits I, Hasegawa M, Orhurhu V, Peck J, Kelly AC, Kaye RJ, Orhurhu MS, Brinkman J, Giacomazzi S, Foster L, Manchikanti L, Kaye AD, Viswanath O. Minimally Invasive Treatment of Chronic Ankle Instability: a Comprehensive Review. Curr Pain Headache Rep 2020; 24:8. [PMID: 32020393 DOI: 10.1007/s11916-020-0840-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Chronic ankle pain is a prevalent and significant cause of chronic pain. While the definition of chronic ankle pain is heterogeneous and poorly defined in the literature, systematic reviews and meta-analyses have estimated this condition to be a prevalent and debilitating source of chronic pain. The most identifiable and prominent cause of chronic ankle pain is chronic ankle instability (CAI), a condition defined by instability of the ankle-joint complex. It is a common consequence of lateral ankle sprains or ligamentous injuries and can be described as a failure of the lateral ankle joint complex after an acute, or recurring, ankle injury. The objective of this manuscript is to provide a comprehensive review of CAI diagnosis and our current understanding of minimally invasive treatment options. RECENT FINDINGS First-line treatment is conservative management, some of which includes neuromuscular rehabilitation, balance training, nonsteroidal anti-inflammatory drugs (NSAIDs), manual mobilization, ice therapy, and compression. While conservative management is effective, additional treatments for those who fail conservative management, or who seek alternative options also have been explored. Recent advances and modern techniques have expanded available treatment options, many of which are becoming less invasive, and have shown improving functionality, recovery, and patient satisfaction. Minimally invasive treatments highlighted in this review include: arthroscopic surgery, steroid injections, plasma-rich plasma injections, hyaluronic acid (HA) injections, medicinal signaling cell injections, radiofrequency therapies, and shockwave therapies. This review will discuss some of these current treatments for minimally invasive treatment of CAI, as well as suggest novel treatments for clinical trials and further investigation.
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Affiliation(s)
- 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.
| | - Morgan Hasegawa
- Creighton University School of Medicine at Regional Campus St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Vwaire Orhurhu
- Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Jacquelin Peck
- Mount Sinai Medical Center of Florida, Department of Anesthesiology, Miami Beach, FL, USA
| | - Angele C Kelly
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA
| | - Rachel J Kaye
- Medical University of South Carolina, Charleston, SC, 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
- Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Omar Viswanath
- 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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Thong-On S, Bovonsunthonchai S, Vachalathiti R, Intiravoranont W, Suwannarat S, Smith R. Effects of Strengthening and Stretching Exercises on the Temporospatial Gait Parameters in Patients With Plantar Fasciitis: A Randomized Controlled Trial. Ann Rehabil Med 2019; 43:662-676. [PMID: 31918529 PMCID: PMC6960082 DOI: 10.5535/arm.2019.43.6.662] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 08/27/2019] [Indexed: 12/18/2022] Open
Abstract
Objective To investigate the effects of physical therapy interventions using strengthening and stretching exercise programs on pain and temporospatial gait parameters in patients with plantar fasciitis (PF). Methods Eighty-four patients with PF participated in the study and were randomly assigned to the strengthening or stretching exercise groups. All patients received 8 physical therapy interventions two times per week in the first 4 weeks and performed daily strengthening or stretching exercises three times per day. After 4 weeks, they continued the assigned exercise programs every day for 8 weeks. Pain visual analogue scale (VAS) scores at the worst and in the morning and temporospatial gait parameters were evaluated at the baseline, intermediate of the intervention, end of the intervention, and the first and second month follow-up. Results There were significant effects of the time on the worst pain, morning pain, cadence, stride time, stride length, total double support, and gait speed, but there was no effect on step width. In addition, the main effect of the group and the interaction effects of the time and the group were not found in any parameters. For intra-group comparisons, there were significant differences in worst pain, morning pain, cadence, and stride time among the assessment times in both groups. For inter-group comparisons, there were no significant differences in all parameters. Conclusion Both strengthening and stretching exercise programs significantly reduced pain and improved gait in patients with PF.
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Affiliation(s)
| | | | | | - Warinda Intiravoranont
- Physical Therapy Center, Faculty of Physical Therapy, Mahidol University, Bangkok, Thailand
| | - Sarawut Suwannarat
- Physical Therapy Center, Faculty of Physical Therapy, Mahidol University, Bangkok, Thailand
| | - Richard Smith
- Discipline of Exercise and Sport Science, Faculty of Health Science, The University of Sydney, Sydney, Australia
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13
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Jacobs JL, Ridge ST, Bruening DA, Brewerton KA, Gifford JR, Hoopes DM, Johnson AW. Passive hallux adduction decreases lateral plantar artery blood flow: a preliminary study of the potential influence of narrow toe box shoes. J Foot Ankle Res 2019; 12:50. [PMID: 31700547 PMCID: PMC6829837 DOI: 10.1186/s13047-019-0361-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/04/2019] [Indexed: 11/10/2022] Open
Abstract
Background Blood flow is essential in maintaining tissue health. Thus, compromised blood flow can prevent tissue healing. An adducted hallux, as seen inside a narrow shoe, may put passive tension on the abductor hallucis, compressing the lateral plantar artery into the calcaneus and restricting blood flow. The purposes of this study were to compare lateral plantar artery blood flow before and after passive hallux adduction and to compare blood flow with arch height. Methods Forty-five healthy volunteers (20 female, 25 male; age = 24.8 ± 6.8 yr; height = 1.7 ± 0.1 m; weight = 73.4 ± 13.5 kg) participated in this cross-over design study. Arch height index (AHI) was calculated, and blood flow measurements were obtained using ultrasound (L8-18i transducer, GE Logiq S8). The lateral plantar artery was imaged deep to abductor hallucis for 120 s: 60 s at rest, then 60 s of passive hallux adduction. Maximal passive hallux adduction was performed by applying pressure to the medial side of the hallux. Blood flow was calculated in mL/min, and pre-passive hallux adduction was compared to blood flow during passive hallux adduction. Results Log transformed data was used to run a paired t-test between the preadduction and postadduction blood flow. The volume of blood flow was 22.2% lower after passive hallux adduction compared to before (- 0.250 ± 0.063, p < 0.001). As AHI decreased, there was a greater negative change in blood flow. As baseline blood flow increased, there was also a greater negative change in blood flow. Conclusions Our preliminary findings of decreased blood flow through passive hallux adduction indicate conditions that elicit passive hallux adduction (e.g. wearing narrow-toed shoes) may have important effects on foot blood flow. Individuals with lower AHI appear to have a greater risk of decreased blood flow with passive hallux adduction.
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Affiliation(s)
- Julia L Jacobs
- 1Department of Exercise Sciences, Brigham Young University, 106 Smith Fieldhouse, Provo, UT 84602 USA
| | - Sarah T Ridge
- 1Department of Exercise Sciences, Brigham Young University, 106 Smith Fieldhouse, Provo, UT 84602 USA
| | - Dustin A Bruening
- 1Department of Exercise Sciences, Brigham Young University, 106 Smith Fieldhouse, Provo, UT 84602 USA
| | - K Annie Brewerton
- 1Department of Exercise Sciences, Brigham Young University, 106 Smith Fieldhouse, Provo, UT 84602 USA
| | - Jayson R Gifford
- 1Department of Exercise Sciences, Brigham Young University, 106 Smith Fieldhouse, Provo, UT 84602 USA
| | - Daniel M Hoopes
- Revere Health Orthopaedics, 1055 North 500 West #121, Building C, Provo, UT 84604 USA
| | - A Wayne Johnson
- 1Department of Exercise Sciences, Brigham Young University, 106 Smith Fieldhouse, Provo, UT 84602 USA
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14
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Narindra LHRNO, Herinirina NF, Rakotonirina H, Andrianah GE, Ranoharison HD, Randriamboavonjy R, Ahmad A. Thickness of the Plantar Fascia in Asymptomatic Subjects. J Med Ultrasound 2019; 27:121-123. [PMID: 31867173 PMCID: PMC6905272 DOI: 10.4103/jmu.jmu_72_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/07/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives: The objectives of this study are to determine the average and extreme values of the thickness of plantar fascia (PF) and to evaluate its correlations with anthropometric parameters and walking activity. Materials and Methods: Analytic study of 226 feet. On these feet, the thickness of the PF was measured on ultrasound; and its correlation with the age, height, weight, body mass index (BMI), gender, and daily walking of the participants were studied. Results: Thickness of the PF was symmetrical; the extreme values were 1.8 mm and 4.3 mm with an average of 3 mm ± 0.5. There was positive correlation of PF thickness with age, height, weight, BMI, and daily walking (P < 0.05). The variation of the PF thickness with gender was not significant (P > 0.05). Conclusion: Thickness of PF has a close correlates with age, height, weight, BMI, and walking activity.
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Affiliation(s)
| | | | | | | | | | | | - Ahmad Ahmad
- Imagerie Médicale CHU JRA, Antananarivo, Madagascar
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15
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Wang W, Liu Y, Zhao J, Jiao R, Liu Z. Electroacupuncture versus manual acupuncture in the treatment of plantar heel pain syndrome: study protocol for an upcoming randomised controlled trial. BMJ Open 2019; 9:e026147. [PMID: 30948595 PMCID: PMC6500181 DOI: 10.1136/bmjopen-2018-026147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 01/07/2019] [Accepted: 02/14/2019] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Plantar heel pain syndrome(PHPS) is a common cause of heel pain. It may worsen a patient's quality of life, and potentially lead to knee, hip or lower back problems. Previous studies have shown that electroacupuncture (EA) and manual acupuncture (MA) are effective treatments for relieving pain in patients with PHPS. However, little evidence supports the use of one intervention over the other. METHODS AND ANALYSIS A total of 92 patients diagnosed with PHPS will be recruited and randomly assigned to an EA group or an MA group at a ratio of 1:1. Patients in both groups will receive a 30 min acupuncture treatment (three times per week) for a total of 12 sessions over 4 weeks. The primary outcome will be the proportion of patients with at least 50% reduction from baseline in the worst pain intensity measured by visual analogue scale (0-100, higher scores signify worse pain) at first steps in the morning after 4-week treatment. The secondary outcomes will include change in worst pain intensity at first steps in the morning, change in mean pain intensity at first steps in the morning, change in worst pain intensity during the day, change in mean pain intensity during the day, change in the pressure pain threshold, change in ankle-dorsiflexion range of motion, change in Foot and Ankle Ability Measure total score and subscale scores, patients' global improvement assessment, patients' expectations for acupuncture and safety evaluation. We will perform all statistical analysis following the intention-to-treat principle. ETHICS AND DISSEMINATION The study has been approved by our ethics review board (Protocol Approval No. 2018-010-KY). The study findings will be disseminated through presentation at a high-impact medical journal, with online access. We also to plan to present it in select conferences and scientific meetings. TRIAL REGISTRATION ChiCTR-1800016531; Pre-results.
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Affiliation(s)
- Weiming Wang
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jie Zhao
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ruimin Jiao
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhishun Liu
- Acupuncture and Moxibustion Department, Guang'anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
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Mistry RR, Patro P, Agarwal V, Misra DP. Enthesitis-related arthritis: current perspectives. Open Access Rheumatol 2019; 11:19-31. [PMID: 30774484 PMCID: PMC6354696 DOI: 10.2147/oarrr.s163677] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In this narrative review, we overview the recent literature on enthesitis-related arthritis (ERA). For the purpose of our review, we searched Scopus for recent articles on this subject from 2013 onward, including some classic older articles for perspective. ERA is a juvenile idiopathic arthritis (JIA) subtype more common in males, associated in a majority with human leucocyte antigen B27. Such children generally present with asymmetric oligoarthritis or polyarthritis, predominantly of lower limb joints, associated with enthesitis or sacroiliitis. While diagnosis remains clinical, ultrasound is being increasingly used to detect subclinical enthesitis and for guiding entheseal site injections. Spine MRI can help detect sacroiliitis, inflammatory spinal changes, and pelvic sites of enthesitis in such patients. The recent juvenile spondyloarthropathy disease activity index recognizes the key clinical features of ERA, viz enthesitis and inflammatory back pain, which other disease activity indices used in JIA did not include. Management includes NSAIDs with physical therapy. Conventional disease-modifying agents like sulfasalazine and methotrexate may be used to minimize duration of NSAID use and in those with high inflammatory burden. In patients refractory to these drugs, biologics such as antitumor necrosis factor alpha agents have proven useful, based on evidences from randomized controlled trials and retrospective registry analyses. Factors predicting a poorer outcome in such children include hip or ankle involvement or restricted spinal mobility. Considering that children with ERA have overall poorer long-term outcomes than other subtypes of JIA, there is a need to further optimize therapeutic strategies for such patients.
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Affiliation(s)
- Rutviz Rajendra Mistry
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India,
| | - Pallavi Patro
- Department of Pharmacology, Sriram Chandra Bhanja (SCB) Medical College, Cuttack, India
| | - Vikas Agarwal
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India,
| | - Durga Prasanna Misra
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India,
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Dedes V, Tzirogiannis K, Polikandrioti M, Dede AM, Nikolaidis C, Mitseas A, Panoutsopoulos GI. Radial Extra Corporeal Shockwave Therapy Versus Ultrasound Therapy in the Treatment of Plantar Fasciitis. Acta Inform Med 2019; 27:45-49. [PMID: 31213743 PMCID: PMC6511272 DOI: 10.5455/aim.2019.27.45-49] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction: Patients with plantar fasciitis usually suffer from reduced mobility due to the pain caused by the movement of the tendons involved. Aim: This study was aimed to compare both shockwave and ultrasound therapies in patients with plantar fasciitis by assessing the pain intensity, and both the functionality of the lower limbs and the quality of life impairments. Methods: Total amount of 88 patients with plantar fasciitis constituted the shockwave group, 56 the ultrasound group and 15 the control group. The self-administered questionnaire “University of Peloponnese Pain, Functionality and Quality of Life Questionnaire” was used. The intensity of pain, functionality impairment and quality of life impairment were evaluated on a five-point Likert scale, before treatment, immediately after and at 4-week follow-up. Results: The pain reduction and the improvement of functionality and quality of life after shockwave treatment and ultrasound treatment significantly increased both post-treatment (p<0,001) and at the 4-week follow-up (p<0,001) compared to post-treatment. However, the improvements in the ultrasound group were not as pronounced as in shockwave group (p<0,001). Conclusions: Although both radial shockwave and ultrasound therapies were found to be effective in patients with plantar fasciitis, the statistical analysis showed that radial shockwave is significantly more effective than ultrasound therapy.
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Affiliation(s)
- Vasileios Dedes
- Laboratory of Physiology-Pharmacology, Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
| | - Konstantinos Tzirogiannis
- Laboratory of Physiology-Pharmacology, Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
| | - Maria Polikandrioti
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
| | - Ariadni Maria Dede
- Engineering in Biotechnology Department, Absalon University College, Kalundborg, Sjelland, Denmark
| | - Christos Nikolaidis
- Laboratory of Physiology-Pharmacology, Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
| | | | - Georgios I Panoutsopoulos
- Laboratory of Physiology-Pharmacology, Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
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Hubbard MJ, Hildebrand BA, Battafarano MM, Battafarano DF. Common Soft Tissue Musculoskeletal Pain Disorders. Prim Care 2018; 45:289-303. [DOI: 10.1016/j.pop.2018.02.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nahin RL. Prevalence and Pharmaceutical Treatment of Plantar Fasciitis in United States Adults. THE JOURNAL OF PAIN 2018; 19:885-896. [PMID: 29597082 DOI: 10.1016/j.jpain.2018.03.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/01/2018] [Accepted: 03/14/2018] [Indexed: 11/25/2022]
Abstract
This study provides prevalence estimates of plantar fasciitis in U.S. adults, as well as the types and frequencies of pharmaceutical treatment specifically for this pain. Data are from the 2013 National Health and Wellness Survey, a large (n = 75,000) internet panel survey designed to approximate the adult U.S. POPULATION Strengths of associations are determined using multivariable logistic regression. It was estimated that .85% (95% confidence interval [CI] = .77-.92) of the sample reported diagnosed plantar fasciitis with pain in the past month. Higher prevalence of plantar fasciitis was seen in women (1.19%; referent) versus men (.47%), in those aged 45 to 64 (1.33%) versus those aged 18 to 44 (.53%; referent) years, and in the obese (1.48%) versus those with a body mass <25 (.29%; referent). Prescription medications for pain were used by 41.04% of plantar fasciitis respondents, but only 6.31% attributed this use specifically to plantar fasciitis pain. Nonsteroidal anti-inflammatory drugs (4.01%) and opioids (2.21%) were the most prevalent prescription drugs used specifically for plantar fasciitis pain. Almost 70% of individuals with plantar fasciitis used over the counter (OTC) analgesics for general pain management, with OTC nonsteroidal anti-inflammatory drugs being used by 49.47% and acetaminophen by 26.93% of respondents. Individuals diagnosed by medical specialists had twice the odds of using prescription drugs as those diagnosed by other providers (odds ratio = 2.12; 95% CI = 1.01-4.46). Non-Hispanic black individuals were more likely to use prescription pain medications specifically for plantar fasciitis pain than non-Hispanic white individuals (odds ratio = 3.02; 95% CI = 1.05-8.70). PERSPECTIVE The current study provides additional insights into the pain and disability associated with plantar fasciitis, as well as the pharmaceutical treatments being used for its management. Prescription as well as OTC medications are used to manage plantar fasciitis symptoms despite limited, if any, clinical trial data supporting their use.
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Affiliation(s)
- Richard L Nahin
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland.
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20
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Engkananuwat P, Kanlayanaphotporn R, Purepong N. Effectiveness of the Simultaneous Stretching of the Achilles Tendon and Plantar Fascia in Individuals With Plantar Fasciitis. Foot Ankle Int 2018; 39:75-82. [PMID: 28985685 DOI: 10.1177/1071100717732762] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Since the plantar fascia and the Achilles tendon are anatomically connected, it is plausible that stretching of both structures simultaneously will result in a better outcome for plantar fasciitis. METHODS Fifty participants aged 40 to 60 years with a history of plantar fasciitis greater than 1 month were recruited. They were prospectively randomized into 2 groups. Group 1 was instructed to stretch the Achilles tendon while group 2 simultaneously stretched the Achilles tendon and plantar fascia. RESULTS After 4 weeks of both stretching protocols, participants in group 2 demonstrated a significantly greater pressure pain threshold than participants in group 1 ( P = .040) with post hoc analysis. No significant differences between groups were demonstrated in other variables ( P > .05). Concerning within-group comparisons, both interventions resulted in significant reductions in pain at first step in the morning and average pain at the medial plantar calcaneal region over the past 24 hours, while there were increases in the pressure pain threshold, visual analog scale-foot and ankle score, and range of motion in ankle dorsiflexion ( P < .001). More participants in group 2 described their symptoms as being much improved to being completely improved than those in group 1. CONCLUSION The simultaneous stretching of the Achilles tendon and plantar fascia for 4 weeks was a more effective intervention for plantar fasciitis. Patients who reported complete relief from symptoms at the end of the 4-week intervention in the simultaneous stretching group (n = 14; 56%) were double that of the stretching of the Achilles tendon-only group (n = 7; 28%). LEVEL OF EVIDENCE II, lesser quality RCT or prospective comparative study.
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Affiliation(s)
- Phoomchai Engkananuwat
- 1 Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Rotsalai Kanlayanaphotporn
- 1 Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Nithima Purepong
- 2 Carolina Asia Center, The University of North Carolina at Chapel Hill, NC, USA
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Ge W, Leson C, Vukovic C. Dry cupping for plantar fasciitis: a randomized controlled trial. J Phys Ther Sci 2017; 29:859-862. [PMID: 28603360 PMCID: PMC5462687 DOI: 10.1589/jpts.29.859] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 02/13/2017] [Indexed: 12/19/2022] Open
Abstract
[Purpose] The purpose of this study was to determine the effects of dry cupping on pain
and function of patients with plantar fasciitis. [Subjects and Methods] Twenty-nine
subjects (age 15 to 59 years old, 20 females and 9 males), randomly assigned into the two
groups (dry cupping therapy and electrical stimulation therapy groups), participated in
this study. The research design was a randomized controlled trial (RCT). Treatments were
provided to the subjects twice a week for 4 weeks. Outcome measurements included the
Visual Analogue Pain Scale (VAS) (at rest, first in the morning, and with activities), the
Foot and Ankle Ability Measure (FAAM), the Lower Extremity Functional Scale (LEFS), as
well as the pressure pain threshold. [Results]The data indicated that both dry cupping
therapy and electrical stimulation therapy could reduce pain and increase function
significantly in the population tested, as all the 95% Confidence Intervals (CIs) did not
include 0 except for the pressure pain threshold. There was no significant difference
between the dry cupping therapy and electrical stimulation groups in all the outcome
measurements. [Conclusion] These results support that both dry cupping therapy and
electrical stimulation therapy could reduce pain and increase function in the population
tested.
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Affiliation(s)
- Weiqing Ge
- Department of Physical Therapy, Youngstown State University, USA
| | - Chelsea Leson
- Department of Physical Therapy, Youngstown State University, USA
| | - Corey Vukovic
- Department of Physical Therapy, Youngstown State University, USA
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Petraglia F, Ramazzina I, Costantino C. Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review. Muscles Ligaments Tendons J 2017; 7:107-118. [PMID: 28717618 DOI: 10.11138/mltj/2017.7.1.107] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Plantar fasciitis (PF) is reported in different sports mainly in running and soccer athletes. Purpose of this study is to conduct a systematic review of published literature concerning the diagnosis and treatment of PF in both recreational and élite athletes. The review was conducted and reported in accordance with the PRISMA statement. METHODS The following electronic databases were searched: PubMed, Cochrane Library and Scopus. As far as PF diagnosis, we investigated the electronic databases from January 2006 to June 2016, whereas in considering treatments all data in literature were investigated. RESULTS For both diagnosis and treatment, 17 studies matched inclusion criteria. The results have highlighted that the most frequently used diagnostic techniques were Ultrasonography and Magnetic Resonance Imaging. Conventional, complementary, and alternative treatment approaches were assessed. CONCLUSIONS In reviewing literature, we were unable to find any specific diagnostic algorithm for PF in athletes, due to the fact that no different diagnostic strategies were used for athletes and non-athletes. As for treatment, a few literature data are available and it makes difficult to suggest practice guidelines. Specific studies are necessary to define the best treatment algorithm for both recreational and élite athletes. LEVEL OF EVIDENCE Ib.
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Affiliation(s)
| | - Ileana Ramazzina
- Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Italy
| | - Cosimo Costantino
- Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Italy
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