Ultrasound guided local steroid injection versus extracorporeal shockwave therapy in the treatment of plantar fasciitis

Abstract

Objective: This study was conducted to compare and evaluate the therapeutic effects of ultrasound guided local steroid injection versus medium frequency shock wave therapy in plantar fasciitis treatment among Egyptian population.
Patients and methods: Between May 2009 and May 2010, 60 patients (27 males, 33 females), otherwise healthy individuals with the diagnosis of unilateral plantar fasciitis were included in this study. All patients underwent subjective assessment following The Mayo clinical scoring system and objective assessment through measuring plantar fascia thickness by US imaging. Patients were randomly classified into two equal groups; group A had ultrasound guided local steroid injection, and group B
received high dose of extracorporeal shock wave therapy. Results: There was a statistically significant reduction in plantar fascia thickness after treatment in both groups, while no statistically significant difference between the study groups. According to assessment with Mayo clinic scoring system, despite the fact that both groups showed statistically significant improvement at the end of follow up period, there was no statistically significant difference between the study groups.
Conclusion: Both treatment groups showed significant clinical and radiological improvement of plantar fasciitis after therapy with statistically non-significant superior results of the extracorporeal shock wave therapy group. However, we do recommend local steroid injection as our preferred
method of treatment as it attains clinical improvement at a much better cost effective value.