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Treatment of Plantar Fasciitis Using Four Different Local Injection Modalities

A Randomized Prospective Clinical Trial

Aydiner Kalaci, MD ^*, Hüsamettin Çakici, MD , Onur Hapa, MD , Ahmet Nedim Yanat, MD ^*, Yunus Dogramaci, MD ^* and Teoman Toni Sevinç, MD ^*

^* Department of Orthopaedics and Traumatology, Mustafa Kemal University Faculty of Medicine, Antakya, Hatay, Turkey.
Department of Orthopaedics and Traumatology, Bolu Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
Department of Orthopaedics and Traumatology, Government Hospital, Bolu, Turkey.

Corresponding author: Aydiner Kalaci, MD, Department of Orthopaedics and Traumatology, Mustafa Kemal University Faculty of Medicine, Antakya, Hatay, 31100, Turkey. (E-mail: orthopedi{at}gmail.com)

Abstract

Background: To determine the effectiveness of four different local injection modalities in the treatment of plantar fasciitis.

Methods: In a prospective randomized multicenter study of plantar fasciitis, 100 patients were divided into four equal groups and were treated using four different methods of local injection: group A was treated with 2 mL of autologous blood alone; group B, an anesthetic (2 mL of lidocaine) combined with peppering; group C, a corticosteroid (2 mL of triamcinolone) alone; and group D, a corticosteroid (2 mL of triamcinolone) combined with peppering. The outcome was defined by using a 10-cm visual analog scale and modified criteria of the Roles and Maudsley score 3 weeks and 6 months after the injection and compared with the pretreatment condition.

Results: The successful results in all of the groups after injections were higher than those in the pretreatment condition (P = .000). In groups C and D, in which local corticosteroid injections were used, excellent results were obtained, with superior effect in the group in which peppering was used (P < .05).

Conclusions: In the treatment of plantar fasciitis, combined corticosteroid injections and peppering is effective and produces better clinical results. (J Am Podiatr Med Assoc 99(2): 108–113, 2009)