Yung-Tsan Wu1, Chih-Ya Chang2, Yu-Ching Chou3, Chun-Chang Yeh4, Tsung-Ying Li1, Heng-Yi Chu2, Liang-Cheng Chen5. 1. Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China; Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China. 2. Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China. 3. School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China. 4. Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China; Department of Anesthesiology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China. 5. Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China. Electronic address: clctsgh@yahoo.com.tw.
Abstract
OBJECTIVE: To evaluate the therapeutic benefit of ultrasound-guided pulsed radiofrequency (PRF) stimulation at the posterior tibial nerve (PTN) in patients with recalcitrant plantar fasciitis (PF). DESIGN: A prospective, randomized, double-blinded, placebo-controlled trial (12-wk follow-up). SETTING:Outpatient local medical center settings. PARTICIPANTS: Patients (N=36) with recalcitrant PF underwent randomization, and all were included in the final data analysis. INTERVENTIONS: Patients in the PRF group were treated with 1 dose of ultrasound-guided PRF stimulation at the PTN, and those in the control group received 1 dose of 2% lidocaine, 0.5mL, injected at the PTN under ultrasound guidance. MAIN OUTCOME MEASURES: The visual analog scale (first-step and overall pain), American Orthopedic Foot-Ankle Society (AOFAS) ankle-hindfoot scale, and ultrasonographic thickness of the plantar fascia were evaluated at 1, 4, 8, and 12 weeks after treatment. RESULTS:Thirty-six patients (20 feet per group) completed the study. The PRF group had a significantly larger improvement in first-step pain, overall pain, and AOFAS score (all P<.001), as well as plantar fascia thickness (P<.05), compared with those of the control group at all observed time points. CONCLUSIONS: This study shows that ultrasound-guided PRF stimulation at the PTN is effective for treating recalcitrant PF. This simple, reproducible method could be a novel strategy for managing recalcitrant PF.
RCT Entities:
OBJECTIVE: To evaluate the therapeutic benefit of ultrasound-guided pulsed radiofrequency (PRF) stimulation at the posterior tibial nerve (PTN) in patients with recalcitrant plantar fasciitis (PF). DESIGN: A prospective, randomized, double-blinded, placebo-controlled trial (12-wk follow-up). SETTING:Outpatient local medical center settings. PARTICIPANTS: Patients (N=36) with recalcitrant PF underwent randomization, and all were included in the final data analysis. INTERVENTIONS:Patients in the PRF group were treated with 1 dose of ultrasound-guided PRF stimulation at the PTN, and those in the control group received 1 dose of 2% lidocaine, 0.5mL, injected at the PTN under ultrasound guidance. MAIN OUTCOME MEASURES: The visual analog scale (first-step and overall pain), American Orthopedic Foot-Ankle Society (AOFAS) ankle-hindfoot scale, and ultrasonographic thickness of the plantar fascia were evaluated at 1, 4, 8, and 12 weeks after treatment. RESULTS: Thirty-six patients (20 feet per group) completed the study. The PRF group had a significantly larger improvement in first-step pain, overall pain, and AOFAS score (all P<.001), as well as plantar fascia thickness (P<.05), compared with those of the control group at all observed time points. CONCLUSIONS: This study shows that ultrasound-guided PRF stimulation at the PTN is effective for treating recalcitrant PF. This simple, reproducible method could be a novel strategy for managing recalcitrant PF.
Authors: James Dunning; Raymond Butts; Nathan Henry; Firas Mourad; Amy Brannon; Hector Rodriguez; Ian Young; Jose L Arias-Buría; César Fernández-de-Las-Peñas Journal: PLoS One Date: 2018-10-31 Impact factor: 3.240