Effectiveness of extra-corporeal shock wave therapy (ESWT) vs methylprednisolone injections in plantar fasciitis

• Published in: Journal of clinical orthopaedics and trauma Vol. 10; no. 2; pp. 401 - 405
• Main Authors: Mishra, Bibhuti Nath, Poudel, Rishi Ram, Banskota, Bibek, Shrestha, Babu Kaji, Banskota, Ashok Kumar
• Format: Journal Article
• Language: English
• Published: India Elsevier B.V 01.03.2019; Elsevier
• Subjects: Corticosteroid injection; Extracorporeal shockwave therapy; General Orthopaedics; Orthopedics; Plantar fasciitis; extra-corporeal shock wave therapy; visual analogue scale; Plantar fasciitis; DMP; body mass index; VAS; point of maximal tenderness; ESWT; methylprednisolne; Corticosteroid injection; PMT; NSAIDs; non-steroid anti-inflammatory drugs; BMI; Extracorporeal shockwave therapy; BMI, body mass index; DMP, methylprednisolne; ESWT, extra-corporeal shock wave therapy; VAS, visual analogue scale; PMT, point of maximal tenderness; NSAIDs, non-steroid anti-inflammatory drugs
• ISSN: 0976-5662; 2213-3445
• DOI: 10.1016/j.jcot.2018.02.011

Abstract Introduction In Plantar Fasciitis, the main concern of the patients is the pain that disturbs their day to day activities. Different modalities of treatments are being used for its pain management. This study seeks to investigate and compare decrease in level of pain following treatment with Methylprednisolone injections (DMP) Vs Extra-Corporeal Shock Wave Therapy (ESWT) in plantar fasciitis. Methods This prospective comparative non randomized study was conducted in 60 patients of any age presenting with Plantar Fasciitis at B&B Hospital, Kathmandu. Patients were divided into 2 groups (30 each) based on patients preference. Methylprednisolone injection was given to one group and another group received ESWT. Follow up of both groups were carried out at 6 weeks, 3 months and 6 months and the outcome was measured with Visual Analogue Pain Scale (VAS). Statistical analysis wasdone using SPSS software, version 13. Chi-square and Independent t -test were applied to look for significant variations in outcome. Results Follow-up at 6 weeks revealed 26 (86.7%) patients attaining VAS < 5 in ESWT group in comparison to 16 (53.3%) patients of DMP group (p = 0.005). At the end of 6 months, 5 patients in DPM group still had significant pain (VAS ≥ 5) compared to 2 patients in ESWT group (p = 0.02). However 11 patients of DMP group and 23 of ESWT group received single episode of treatment only and had persistent symptomatic pain relief (VAS < 5) during all follow ups at 6 weeks, 3 months and 6 months (p = 0.004). Conclusions Plantar fasciitis was more prevalent in overweight population and females. Significant improvement in pain was observed with both ESWT and DMP Injections. However, ESWT was found to be more effective than DMP Injections for treatment of Plantar Fasciitis.