Cryoultrasound therapy in the treatment of chronic plantar fasciitis with heel spurs. A randomized controlled clinical study.

Abstract

BACKGROUND:

Plantar fasciitis is one of the most common causes of pain in the inferior heel and is very frequent in some running sports. It affects up to 10% of general population and accounts for 11% to 15% of all foot pain symptomatology. Several treatments have been suggested, but there is no evidence supporting a specific conservative management strategy.

AIM:

Evaluation of the efficacy of combined cryoultrasound therapy on chronic plantar fasciitis with heel spurs resistant to pharmacological and instrumental therapies.

DESIGN:

Single-blind randomized clinical trial.

POPULATION:

102 consecutive patients affected by chronic plantar fasciitis with painful symptomatology for at least 6 months, intensity of pain higher than 5 on the VAS score, presence of heel spurs, use of plantar orthoses and ineffectiveness of previous therapies.

METHODS:

The patients were randomized into two groups: Group A treated with cryoultrasound therapy and Group B with cryotherapy. Our protocol was based on 10 daily treatments, lasting 20 minutes. Each participant was evaluated using VAS score before (T0) the treatment and 3 months (T1), 12 months (T2) and 18 months (T3) after. Effectiveness index was calculated from T1 to T3.

RESULTS:

Both treatments have been found effective. The difference in pain intensity on the VAS scale between the two groups at T2 was 4.35 points in favor of Group A (IC 95% 3.75; 4.95; P<0.001), reaching the primary end point. The difference in pain intensity on the VAS scale between the two groups at T1, T2 and T3 was 3.00, 4.35 and 4.81 respectively, showing a statistically significant difference between VAS average scores at all follow-ups in favor of Group A. Scores of at least 66% at the effectiveness index were only achieved in Group A (P values <0.001).

CONCLUSION:

Cryoultrasound therapy could be an efficient treatment option for chronic plantar fasciitis.

CLINICAL REHABILITATION IMPACT:

Cryoultrasound therapy promises an effective and long-lasting clinical improvement in patients with chronic plantar fasciitis, granted its high therapeutic efficiency, patients' satisfaction, its limited cost and its short and repeatable protocol of use.

• Authors: C Costantino, M C Vulpiani, D Romiti, M Vetrano, V M Saraceni
• Journal: European journal of physical and rehabilitation medicine (Eur J Phys Rehabil Med) Vol. 50 Issue 1 Pg. 39-47 (Feb 2014) ISSN: 1973-9095 [Electronic] Italy
• PMID: 24172641 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)

Topics

• Adult
• Aged
• Cryotherapy (methods)
• Fasciitis, Plantar (complications, diagnosis, therapy)
• Female
• Follow-Up Studies
• Heel Spur (complications, diagnosis, therapy)
• Humans
• Male
• Middle Aged
• Pain Measurement
• Patient Satisfaction
• Single-Blind Method
• Time Factors
• Treatment Outcome
• Ultrasonic Therapy (methods)