Enhancement of the Effectiveness of Extracorporeal Shock Wave Therapy with Topical Corticosteroid in Treatment of Chronic Plantar Fasciitis: A Randomized Control Clinical Trial

Document Type : Original Article

Authors
Babak Vahdatpour 1
Arghavan Mokhtarian 1
Seyed Ahmad Raeissadat 2
Farnaz Dehghan 1
Nafiseh Nasr 3
Mahsa Mazaheri 1
1 Department of Physical Medicine and Rehabilitation, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
2 Physical Medicine and Rehabilitation Research Center, School of Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Radiology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Chronic recalcitrant plantar fasciitis is a disabling condition. We presumed if shock wave could increase the permeability of skin and facilitate penetration of topical corticosteroid through the skin; the combinational therapeutic effect would be stronger than using shock wave alone. The study purpose was to utilize the synergistic effect of shock wave and topical corticosteroid in treatment of plantar fasciitis. Materials and Methods: Patients in both groups (n = 40) received four sessions of shock wave with the same protocol at weekly intervals. At 30 min before each session, we used an occlusive dressing of topical clobetasol for the intervention group and Vaseline oil for the control group. Pain severity was assessed with visual analog scale (VAS) and modified Roles and Maudsley score (RMS) at baseline and 1 month and 3 months after intervention. Plantar fascia (PF) thickness was measured with ultrasonography at baseline and 3 months after intervention. Results: One month after intervention, VAS morning showed significant improvement in intervention group (P = 0.006) and RMS showed better improvement in intervention group (P = 0.026). There was no significant difference between the two groups after 3 months in RMS or VAS score. PF thickness was decreased significantly in both groups, but it was not significant between the two groups (P = 0.292). Conclusions: This combinational therapy yielded earlier pain reduction and functional improvement than using shock wave alone; topical corticosteroid could enhance the effectiveness of shockwave in short-term in the treatment of recalcitrant plantar fasciitis.

Keywords

1.
Irving DB, Cook JL, Young MA, Menz HB. Impact of chronic plantar heel pain on health-related quality of life. J Am Podiatr Med Assoc 2008;98:283-9.  Back to cited text no. 1
[PUBMED]    
2.
Gill LH. Plantar Fasciitis: Diagnosis and conservative management. J Am Acad Orthop Surg 1997;5:109-17.  Back to cited text no. 2
[PUBMED]    
3.
Kibler WB, Goldberg C, Chandler TJ. Functional biomechanical deficits in running athletes with plantar fasciitis. Am J Sports Med 1991;19:66-71.  Back to cited text no. 3
[PUBMED]    
4.
Davis PF, Severud E, Baxter DE. Painful heel syndrome: Results of nonoperative treatment. Foot Ankle Int 1994;15:531-5.  Back to cited text no. 4
[PUBMED]    
5.
Porter MD, Shadbolt B. Intralesional corticosteroid injection versus extracorporeal shock wave therapy for plantar fasciopathy. Clin J Sport Med 2005;15:119-24.  Back to cited text no. 5
[PUBMED]    
6.
Pribut SM. Current approaches to the management of plantar heel pain syndrome, including the role of injectable corticosteroids. J Am Podiatr Med Assoc 2007;97:68-74.  Back to cited text no. 6
[PUBMED]    
7.
Crawford F, Atkins D, Young P, Edwards J. Steroid injection for heel pain: Evidence of short-term effectiveness. A randomized controlled trial. Rheumatology (Oxford) 1999;38:974-7.  Back to cited text no. 7
    
8.
Acevedo JI, Beskin JL. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int 1998;19:91-7.  Back to cited text no. 8
[PUBMED]    
9.
Snow DM, Reading J, Dalal R. Lateral plantar nerve injury following steroid injection for plantar fasciitis. Br J Sports Med 2005;39:e41.  Back to cited text no. 9
[PUBMED]    
10.
McPoil TG, Martin RL, Cornwall MW, Wukich DK, Irrgang JJ, Godges JJ. Heel pain – Plantar fasciitis: Clinical practice guildelines linked to the international classification of function, disability, and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther 2008;38:A1-18.  Back to cited text no. 10
    
11.
Alvarez R. Preliminary results on the safety and efficacy of the OssaTron for treatment of plantar fasciitis. Foot Ankle Int 2002;23:197-203.  Back to cited text no. 11
[PUBMED]    
12.
Buch M, Knorr U, Fleming L, Theodore G, Amendola A, Bachmann C, et al. Extracorporeal shockwave therapy in symptomatic heel spurs. An overview. Orthopade 2002;31:637-44.  Back to cited text no. 12
[PUBMED]    
13.
Eslamian F, Shakouri SK, Jahanjoo F, Hajialiloo M, Notghi F. Extra corporeal shock wave therapy versus local corticosteroid injection in the treatment of chronic plantar fasciitis, a single blinded randomized clinical trial. Pain Med 2016;17:1722-31.  Back to cited text no. 13
[PUBMED]    
14.
Wang CJ, Chen HS, Huang TW. Shockwave therapy for patients with plantar fasciitis: A one-year follow-up study. Foot Ankle Int 2002;23:204-7.  Back to cited text no. 14
[PUBMED]    
15.
Aqil A, Siddiqui MR, Solan M, Redfern DJ, Gulati V, Cobb JP. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Clin Orthop Relat Res 2013;471:3645-52.  Back to cited text no. 15
[PUBMED]    
16.
Aronow MS. Commentary on an article by Hans Gollwitzer, MD, et al. Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: A randomized, controlled multicenter study. J Bone Joint Surg Am 2015;97:e44.  Back to cited text no. 16
[PUBMED]    
17.
Ogden JA, Alvarez RG, Levitt R, Marlow M. Shock wave therapy (Orthotripsy) in musculoskeletal disorders. Clin Orthop Relat Res 2001:387:22-40.  Back to cited text no. 17
    
18.
Vahdatpour B, Sajadieh S, Bateni V, Karami M, Sajjadieh H. Extracorporeal shock wave therapy in patients with plantar fasciitis. A randomized, placebo-controlled trial with ultrasonographic and subjective outcome assessments. J Res Med Sci 2012;17:834-8.  Back to cited text no. 18
[PUBMED]    
19.
Notarnicola A, Moretti B. The biological effects of extracorporeal shock wave therapy (ESWT) on tendon tissue. Muscles Ligaments Tendons J 2012;2:33-7.  Back to cited text no. 19
[PUBMED]    
20.
Doukas AG, Kollias N. Transdermal drug delivery with a pressure wave. Adv Drug Deliv Rev 2004;56:559-79.  Back to cited text no. 20
[PUBMED]    
21.
Gambihler S, Delius M.In vitro interaction of lithotripter shock waves and cytotoxic drugs. Br J Cancer 1992;66:69-73.  Back to cited text no. 21
[PUBMED]    
22.
Abul K, Ozer D, Sakizlioglu SS, Buyuk AF, Kaygusuz MA. Detection of normal plantar fascia thickness in adults via the ultrasonographic method. J Am Podiatr Med Assoc 2015;105:8-13.  Back to cited text no. 22
[PUBMED]    
23.
Cardinal E, Chhem RK, Beauregard CG, Aubin B, Pelletier M. Plantar fasciitis: Sonographic evaluation. Radiology 1996;201:257-9.  Back to cited text no. 23
[PUBMED]    
24.
Kane D, Greaney T, Shanahan M, Duffy G, Bresnihan B, Gibney R, et al. The role of ultrasonography in the diagnosis and management of idiopathic plantar fasciitis. Rheumatology (Oxford) 2001;40:1002-8.  Back to cited text no. 24
[PUBMED]    
25.
Saliba S, Mistry DJ, Perrin DH, Gieck J, Weltman A. Phonophoresis and the absorption of dexamethasone in the presence of an occlusive dressing. J Athl Train 2007;42:349-54.  Back to cited text no. 25
[PUBMED]    
26.
Byl NN. The use of ultrasound as an enhancer for transcutaneous drug delivery: Phonophoresis. Phys Ther 1995;75:539-53.  Back to cited text no. 26
[PUBMED]    
27.
Karabay N, Toros T, Hurel C. Ultrasonographic evaluation in plantar fasciitis. J Foot Ankle Surg 2007;46:442-6.  Back to cited text no. 27
[PUBMED]    
28.
Mohseni-Bandpei MA, Nakhaee M, Mousavi ME, Shakourirad A, Safari MR, Vahab Kashani R. Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: A systematic review. Ultrasound Med Biol 2014;40:1737-54.  Back to cited text no. 28
[PUBMED]    
29.
Haake M, Buch M, Schoellner C, Goebel F, Vogel M, Mueller I, et al. Extracorporeal shock wave therapy for plantar fasciitis: Randomised controlled multicentre trial. BMJ 2003;327:75.  Back to cited text no. 29
[PUBMED]    
30.
Ogden JA, Alvarez RG, Levitt RL, Johnson JE, Marlow ME. Electrohydraulic high-energy shock-wave treatment for chronic plantar fasciitis. J Bone Joint Surg Am 2004;86-A: 2216-28.  Back to cited text no. 30
[PUBMED]    
31.
McMillan AM, Landorf KB, Gilheany MF, Bird AR, Morrow AD, Menz HB. Ultrasound guided corticosteroid injection for plantar fasciitis: Randomised controlled trial. BMJ 2012;344:e3260.  Back to cited text no. 31
[PUBMED]    
32.
Kassan DG, Lynch AM, Stiller MJ. Physical enhancement of dermatologic drug delivery: Iontophoresis and phonophoresis. J Am Acad Dermatol 1996;34:657-66.  Back to cited text no. 32
[PUBMED]    
33.
Menon GK, Kollias N, Doukas AG. Ultrastructural evidence of stratum corneum permeabilization induced by photomechanical waves. J Invest Dermatol 2003;121:104-9.  Back to cited text no. 33
[PUBMED]    
34.
Prausnitz MR, Langer R. Transdermal drug delivery. Nat Biotechnol 2008;26:1261-8.  Back to cited text no. 34
[PUBMED]    
35.
Machet L, Boucaud A. Phonophoresis: Efficiency, mechanisms and skin tolerance. Int J Pharm 2002;243:1-15.  Back to cited text no. 35
[PUBMED]    
36.
Rao R, Nanda S. Sonophoresis: Recent advancements and future trends. J Pharm Pharmacol 2009;61:689-705.  Back to cited text no. 36
[PUBMED]    
37.
Delius M, Adams G. Shock wave permeabilization with ribosome inactivating proteins: A new approach to tumor therapy. Cancer Res 1999;59:5227-32.  Back to cited text no. 37
[PUBMED]    
38.
Kodama T, Doukas AG, Hamblin MR. Shock wave-mediated molecular delivery into cells. Biochim Biophys Acta 2002;1542:186-94.  Back to cited text no. 38
[PUBMED]    
39.
Jagadeesh G, Prakash GD, Rakesh SG, Allam US, Krishna MG, Eswarappa SM, et al. Needleless vaccine delivery using micro-shock waves. Clin Vaccine Immunol 2011;18:539-45.  Back to cited text no. 39
[PUBMED]    
40.
Tatli YZ, Kapasi S. The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies. Curr Rev Musculoskelet Med 2009;2:3-9.  Back to cited text no. 40
[PUBMED]    
41.
Maier M, Averbeck B, Milz S, Refior HJ, Schmitz C. SubstancePand prostaglandin E2 release after shock wave application to the rabbit femur. Clin Orthop Relat Res 2003;406:237-45.  Back to cited text no. 41
Advanced Biomedical Research
Volume 2018, April
April 2018
Pages 1-7