Shirvan Rastegar1,2, Sadegh Baradaran Mahdavi3,4,5, Babak Hoseinzadeh6,7,8, Sajad Badiei1,5. 1. Department of Orthopaedics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 2. Department of Orthopaedic Surgery, Al-Zahra Teaching Hospital, Sofeh St, Isfahan, Iran. 3. Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 4. Department of Physical Medicine and Rehabilitation, Al-Zahra Teaching Hospital, Sofeh St, Isfahan, Iran. 5. Students Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran. 6. Department of Orthopaedics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Babak.med85@gmail.com. 7. Department of Orthopaedic Surgery, Al-Zahra Teaching Hospital, Sofeh St, Isfahan, Iran. Babak.med85@gmail.com. 8. Students Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran. Babak.med85@gmail.com.
Abstract
INTRODUCTION:Plantar fasciitis is a common cause of heel pain. Considering different interventions which are applied for patients with plantar fasciitis, dry needling is proposed as a new modality of treatment recently. The aim of this study is to evaluate the effectiveness of dry needling versus steroid injection for plantar fasciitis. METHODS:Sixty-six patients were recruited to this single-blind clinical trial study. Participants were randomly allocated to receive 1 ml (40 mg) of Depo-Medrol (methylprednisolone acetate) or dry needling. They were followed up for 12 months and monitored for total perception of pain using the visual analogue scale (VAS), with data obtained in baseline and at three weeks, six weeks, three months, six months and one year after treatment. RESULTS:Mean VAS score before treatment was 6.96 ± 0.87 for the steroid group and 6.41 ± 0.83 for the dry-needling group (P value = 0.54). Steroid injection reduced VAS scores rapidly until three weeks after treatment compared with dry needling (0.32 ± 0.71 and 3.47 ± 1.32, respectively; P value < 0.001). However, patients who were underwent dry needling reported lower VAS scores at the end of follow-up compared with the steroid group (0.69 ± 0.93 and 2.09 ± 1.58, respectively; P value = 0.004). Over the long term, 82.3% and 17.6% of changes in pain were contributed to time since treatment and treatment method, respectively (P values < 0.001). CONCLUSIONS:Steroid injection can palliate plantar heel pain rapidly but dry needling can provide more satisfactory results for patients with plantar fasciitis in the long term.
RCT Entities:
INTRODUCTION:Plantar fasciitis is a common cause of heel pain. Considering different interventions which are applied for patients with plantar fasciitis, dry needling is proposed as a new modality of treatment recently. The aim of this study is to evaluate the effectiveness of dry needling versus steroid injection for plantar fasciitis. METHODS: Sixty-six patients were recruited to this single-blind clinical trial study. Participants were randomly allocated to receive 1 ml (40 mg) of Depo-Medrol (methylprednisolone acetate) or dry needling. They were followed up for 12 months and monitored for total perception of pain using the visual analogue scale (VAS), with data obtained in baseline and at three weeks, six weeks, three months, six months and one year after treatment. RESULTS: Mean VAS score before treatment was 6.96 ± 0.87 for the steroid group and 6.41 ± 0.83 for the dry-needling group (P value = 0.54). Steroid injection reduced VAS scores rapidly until three weeks after treatment compared with dry needling (0.32 ± 0.71 and 3.47 ± 1.32, respectively; P value < 0.001). However, patients who were underwent dry needling reported lower VAS scores at the end of follow-up compared with the steroid group (0.69 ± 0.93 and 2.09 ± 1.58, respectively; P value = 0.004). Over the long term, 82.3% and 17.6% of changes in pain were contributed to time since treatment and treatment method, respectively (P values < 0.001). CONCLUSIONS:Steroid injection can palliate plantar heel pain rapidly but dry needling can provide more satisfactory results for patients with plantar fasciitis in the long term.
Authors: Glen A Whittaker; Shannon E Munteanu; Hylton B Menz; Daniel R Bonanno; James M Gerrard; Karl B Landorf Journal: BMC Musculoskelet Disord Date: 2019-08-17 Impact factor: 2.362
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