Amit Dwivedi

Abstract

Introduction: Plantar fasciitis is a disorder resulting in pain in the heel and bottom of the foot. Risk factors include increased exercise, obesity, long periods of standing and heel spur. Non-operative treatment includes rest, contrast bath, sole inserts, stretching exercise, NSAIDS and steroidal medications. Invasive interventions are steroid injections, autologous blood, PRP application and open, endoscopic or percutaneous fascial surgical release of plantar fascia. Aims and Objectives: The aim of this study was to determine the effects on pain and function of PRP obtained manually as a cheap and easy method in the treatment of plantar fasciitis and to compare this data with that of steroid injection which is often used in clinical practice. The hypothesis was that a single dose of manually prepared PRP would reduce pain in plantar fasciitis and this effect is superior to the steroid injection. Materials and Methods: The present study was conduct at our institute during August 2016 to September 2018; 80 consecutive patients with chronic plantar fasciitis were enrolled and randomized in two groups: One group receives the Platelet rich plasma (PRP) therapy and another group receiving corticosteroid injection. The outcomes in both groups were observed and compared by The Foot and Ankle Disability Index (FADI) and Visual Analogue Scale (VAS) at 1st week, 4th week and 12th week post injection. The level of significance was set at p Results: Prospective data was collected of 40 patients. The average follow up duration was about 12 weeks. The score on VAS Scale and FADI improved from the baseline for both the groups but the patients who received PRP therapy had a statistically significant (p Conclusion: The application of PRP appears to be more effective than steroid injection in terms of pain and functional results in the treatment of chronic plantar fasciitis. Keywords: Steroid injection, PRP, Plantar fasciitis, FADI score, VAS scale.

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Abstract

Heel pain, mostly caused by plantar fasciitis (PF), is a common complaint of many patients who requiring professional orthopedic care and are mostly suffering from chronic pain beneath their heels. Plantar fasciitis (PF) is also referred to as plantar heel pain, heel spur syndrome, or painful heel syndrome. It is an enthesopathy (an abnormality or injury at the site of attachment of a ligament or tendon to bone) of the origin of the plantar fascia at the medial tubercle of the calcaneus. It leads to inflammation of the thick tissue that creates the arch of the foot. Plantar fasciitis can be a nuisance to treat and, to date, we’ve had little high quality evidence to guide us. For some time we’ve noted the similarities between plantar fascial problems and tendinopathy. Back in 2006 Scott Wearing wrote an excellent paper on how the two structures shared similar pathology and similar response to load. The present article reviews studies done on the anatomy of plantar fasciitis and their histo-pathological features, factors associated with planter fasciitis, clinical features, imaging studies, differential diagnoses, and diverse treatment modalities for treatment of planter fasciitis, with special emphasis on non-surgical treatment. Anti-inflammatory agents, plantar stretching, and orthosis proved to have highest priority; corticosteroid injection, night splints and extracorporeal shock wave therapy were of next priority, in patients with planter fasciitis. Keywords: Plantar fasciitis, Plantar heel pain, Risk factors, Imaging studies, Treatment, Rehabilitation.

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