Catriona Heaver MBCHB, MRCS, Presenter: Nothing to Disclose

Aabha Sinha, Abstract Co-Author: Nothing to Disclose

Alastair Marsh, Abstract Co-Author: Nothing to Disclose

Ruth Shave, Abstract Co-Author: Nothing to Disclose

Alex Wolinski, Abstract Co-Author: Nothing to Disclose

Plantar fasciitis is a frequently chronic and disabling cause of foot pain in adults. This retrospective study aims to evaluate the long-term analgesic effect of ultrasound guided dry needling in patients with chronic plantar fasciitis, refractory to conservative treatment.

Patients undergoing dry needling for plantar fasciitis, followed by perifascial steroid injection between Jan ’09 and Feb ’10 were identified from the radiology records. Pain scores were recorded on a visual analogue scale from 0(no pain) to 10 (worst pain possible) before the procedure, 2 weeks and 6 weeks post procedure. Patients were also contacted in April `10 to assess their current pain level. Responses were graded as excellent (> 75% pain score improvement), good (50-74%), fair (25-49%) and poor (<25% relief). Any complications or need for any further intervention were recorded.  

55 feet (46 patients) were identified. All patients had no relief with previous treatment. 24 feet with calf tightness had undergone a gastrocnemius muscle lengthening. All patients were assessed by a foot and ankle surgeon and had ultrasonographic confirmation of diagnosis prior to undergoing the procedure.  At 2 weeks: 43/54 (80%)feet had excellent or good pain relief. At 6 weeks: 37/50 (74%) feet reported excellent or good pain relief. 11/13 feet patients with fair to poor response underwent a repeat procedure.   Long-term follow-up: 13 feet (12 patients) lost to follow-up. Follow-up duration ranged from 2 to 13 months. After an average of 7 months follow-up, 55% (n=23) patients had excellent or good results. If symptoms recurred, the average duration of total analgesic effect was 3 months  

Numerous non-operative and operative techniques have been described to manage recalcitrant plantar fascitis. However, no single technique has been shown to be consistently efficacious. This study shows that dry needling is quick, safe and potentially useful technique for long term management of recalcitrant plantar fascitis.

Dry needling is a quick and safe out patient procedure, which can offer long term analgesia for a condition that can be difficult to treat.

Heaver, C, Sinha, A, Marsh, A, Shave, R, Wolinski, A, Ultrasound-guided Dry Needling for Resistant Plantar Fasciitis: Is It Effective?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012039.html