Prospective Randomized Comparison of the Effectiveness of Radiation Therapy and Local Steroid Injection for the Treatment of Plantar Fasciitis.

Abstract

PURPOSE:

The purpose of this study was to conduct a randomized trial of radiation therapy for plantar fasciitis and to compare radiation therapy with local steroid injections.

METHODS AND MATERIALS:

Between March 2013 and April 2014, 128 patients with plantar fasciitis were randomized to receive radiation therapy (total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy three times a week) or local corticosteroid injections a 1 ml injection of 40 mg methylprednisolone and 0.5 ml 1% lidocaine under the guidance of palpation. The results were measured using a visual analog scale, a modified von Pannewitz scale, and a 5-level function score. The fundamental phase of the study was 3 months, with a follow-up period of up to 6 months.

RESULTS:

The median follow-up period for all patients was 12.5 months (range, 6.5-18.6 months). For the radiation therapy patients, the median follow-up period was 13 months (range, 6.5-18.5 months), whereas in the palpation-guided (PG) steroid injection arm, it was 12.1 months (range, 6.5-18.6 months). After 3 months, results in the radiation therapy arm were significantly superior to those in the PG steroid injection arm (visual analog scale, P<.001; modified von Pannewitz scale, P<.001; 5-level function score, P<.001). Requirements for a second treatment did not significantly differ between the 2 groups, but the time interval for the second treatment was significantly shorter in the PG steroid injection group (P=.045).

CONCLUSION:

This study confirms the superior analgesic effect of radiation therapy compared to mean PG steroid injection on plantar fasciitis for at least 6 months after treatment.

• Authors: Emine Canyilmaz, Fatih Canyilmaz, Ozlem Aynaci, Fatma Colak, Lasif Serdar, Gonca Hanedan Uslu, Osman Aynaci, Adnan Yoney
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 92 Issue 3 Pg. 659-66 (Jul 01 2015) ISSN: 1879-355X [Electronic] United States
• PMID: 25936814 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Anesthetics, Local
• Glucocorticoids
• Lidocaine
• Methylprednisolone

Topics

• Adult
• Aged
• Analysis of Variance
• Anesthetics, Local (administration & dosage)
• Fasciitis, Plantar (drug therapy, radiotherapy)
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage)
• Humans
• Lidocaine (administration & dosage)
• Male
• Methylprednisolone (administration & dosage)
• Middle Aged
• Pain Measurement
• Palpation
• Prospective Studies
• Radiotherapy Dosage
• Time Factors
• Treatment Outcome