Luca Maria Sconfienza MD, Presenter: Nothing to Disclose

Francesca Lacelli MD, Abstract Co-Author: Nothing to Disclose

Riccardo Piccazzo MD, Abstract Co-Author: Nothing to Disclose

Alessandro Muda MD, Abstract Co-Author: Nothing to Disclose

Giovanni Serafini MD, Abstract Co-Author: Nothing to Disclose

Enzo Silvestri MD, Abstract Co-Author: Nothing to Disclose

The purpose of our work was to compare the short- and long-term outcome of US-guided percutaneous treatment of plantar fasciitis based on dry needling and local injection of steroid of patient affected with plantar fasciitis, compared with similar patients treated with simple steroid injection or dry needling.

IRB approval and informed consent were obtained. Among 75 patients referred for US-guided treatment of plantar fasciitis, 25 (12 males, 13 females; age 43.8±7.6 [mean±standard deviation]) were treated with dry needling and local injection of steroid together; 25 (12 males, 13 females; age 46.2±12.3) were treated with dry needling only; 25 (11 males, 14 females; age 52.7±10.0) were treated only with local injection of steroid. Pain was assessed using the visual analogue scale (VAS) at baseline and at 7, 14, 30, 90, 180, 360 days after the procedure; fascial thickness was measured with US scanning at baseline and at 180 and 360 days later. Kruskall Wallis test was used.

Patients treated with the complete procedure had a faster and more permanent decrease of symptoms (VAS at 7 days=1.2±0.4 and VAS at 360 days=0.0± 0.1). Patients treated only with injection of steroid had a quick decrease of pain that was not permanent on a long-term basis (VAS at 7 days=1.2±0.6 and VAS at 360 days=5.2± 0.4). Patients treated only with needling had a permanent but very slow decrease of symptoms (VAS at 7 days=5.7±0.5, at 30 days VAS=2.6± 0.4, at 90 days VAS=0.3±0.8, and at 360 days VAS=0.1±0.2). Difference was statistically significant (p<.001).

Patients treated with the combined procedure had a better outcome than other groups. Pain relief is faster and more permanent compared with slower or not stable results obtained in the other patients.

The combined approach of needling and steroid injection seems to be the treatment of choice in patient affected by plantar fasciitis, compared to the other two partial treatments.

Sconfienza, L, Lacelli, F, Piccazzo, R, Muda, A, Serafini, G, Silvestri, E, One-year Outcome of Ultrasound-guided Percutaneous Treatment of Plantar Fasciitis: A Randomized Controlled Trial.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015343.html