Effectiveness of Local Steroid Injection in Treatment of Plantar Fasciitis

Kushvaha RP

Abstract


Introduction: Plantar fasciitis is a common pathological condition affecting the hind foot, and can often be a challenge for clinicians to successfully treat. Successful treatment of plantar fasciitis usually requires a combination of treatment modalities, rather than administering only one treatment at a time. The aim of this study was to find out the efficacy of single dose steroid injection in treatment of planter fasciitis which is an easy procedure and can be carried out on an OPD basis.

Method: A prospective interventional study was done in Narayani Subregional Hospital over a period of 1 Year (Jan-2016 to Dec.2016). 50 patients of age more than 18 years and painful heel
of more than 3 months were included in the study. Patients with associated Diabetes Mellitus, local infection, tumor, previous surgery or fracture were excluded. Injection is performed with
2ml of a 50/50 mixture of triamcinolone acetonide (20 mg per ml) and xylocaine (1ml) 2%, given locally by 21 gauge needle at the site of maximum tenderness on medial tubercle of calcaneus by
palpatery methods. Pre-procedure visual analogue scale (VAS) and the foot function index (pain sub-scale) were assessed. The patient was followed up at 1 month, 3 months and 6 months after
the injection. Obtained data were analyzed in SPSS.

Result: Of the 50 cases with 57 heels enrolled in our study, the mean age was 38.92 years. 70% of the patients were in the age group of 18-40 years with M: F ratio of1:1. Majority of patients were physically active (70%) followed by sedentary lifestyle (30%). The mean duration of symptoms was 6.7 months and the mean BMI was 25.58. About one fourth (24%) of the patients
had calcaneal spur. The mean pre-procedure pain score and the foot function index were 8.82. and 81.54 respectively. Reduction in patient’s pain score (VAS )and improvement in foot function
index scale were significantly greater at 1 month but at 3 month and 6 month follow-up, no therapeutic advantage could be detected.

Conclusion: A single dose steroid injection doesn’t offer a therapeutic benefit in long term.

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