New Treatment Eliminates Heel Pain Caused By Plantar Fasciitis

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New Treatment Eliminates Heel Pain Caused By Plantar Fasciitis

http://www.medicalnewstoday.com/articles/131319.php

Combining an ultrasound-guided technique with steroid injection is 95

percent effective at relieving the common and painful foot problem

called plantar fasciitis, according to a study presented today at the

annual meeting of the Radiological Society of North America (RSNA).

" There is no widely accepted therapy or standard of care for patients

when first-line treatments fail to relieve the pain of plantar

fasciitis, " said the study's lead author, Luca M. Sconfienza, M.D.,

from Italy's University of Genoa. " Our new technique is an effective,

one-time outpatient procedure. "

Plantar fasciitis, the most common cause of heel pain, is an

inflammation of the connective tissue called the plantar fascia that

runs along the bottom of the foot, from the heel to the ball of the

foot. The condition accounts for 11 percent to 15 percent of all foot

symptoms requiring professional care and affects one million people

annually in the U.S.

Conservative treatments, which may take up to a year to be effective,

include rest, exercises to stretch the fascia, night splints and arch

supports.

When the condition does not respond to conservative treatments,

patients may opt for shockwave therapy, in which sound waves are

directed at the area of heel pain to stimulate healing. Shockwave

therapy is painful, requires multiple treatments and is not always

effective. Complications may include bruising, swelling, pain,

numbness or tingling and rupture of the plantar fascia. In the most

severe cases of plantar fasciitis, patients may undergo invasive

surgery to detach the fascia from the heel bone.

For this study, Dr. Sconfienza and colleagues used a new ultrasound-

guided technique, along with steroid injection, on 44 patients with

plantar fasciitis that was unresponsive to conservative treatments.

After injection of a small amount of anesthesia, the anesthetic

needle is used to repeatedly puncture the site where the patient

feels the pain. This technique is known as dry-needling. Dry-needling

creates a small amount of local bleeding that helps to heal the

fasciitis. Lastly, a steroid is injected around the fascia to

eliminate the inflammation and pain. The technique is performed with

ultrasound guidance to improve accuracy and to avoid injecting the

steroids directly into the plantar fascia, which could result in

rupture.

After the 15-minute procedure, symptoms disappeared for 42 of the

study's 44 patients (95 percent) within three weeks.

" This therapy is quicker, easier, less painful and less expensive

than shockwave therapy, " Dr. Sconfienza said. " In cases of mild

plantar fasciitis, patients should first try noninvasive solutions

before any other treatments. But when pain becomes annoying and

affects the activities of daily living, dry-needling with steroid

injection is a viable option. "

Notes:

Co-authors are Francesca Lacelli, M.D., Giovanni Serafini, M.D.,

Giacomo Garlaschi, M.D., and Enzo Silvestri, M.D.

Copies of RSNA 2008 news releases and electronic images will be

available online at http://www.RSNA.org/press08 beginning Monday,

Dec. 1.

RSNA is an association of more than 42,000 radiologists, radiation

oncologists, medical physicists and related scientists committed to

excellence in patient care through education and research. The

Society is based in Oak Brook, Ill. (http://www.RSNA.org)