Introduction
Plantar fasciitis is a common condition characterised by heel pain, often linked to various factors such as overuse, obesity, foot type and lower limb mechanics. As conservative treatments vary in efficacy, the study authored by Manuel Pabón-Carrasco et al. aims to compare two therapeutic modalities: iontophoresis and radial extracorporeal shockwave therapy (EWST). This randomized controlled trial investigates their short-term effectiveness in alleviating symptoms of chronic plantar fasciitis, thereby aiding clinical decision-making in the treatment of this painful condition.
Methods
The study adopted a double-blinded, randomized clinical trial design, enrolling a total of 127 patients diagnosed with chronic plantar fasciitis. Participants were evenly assigned to two treatment groups - group A received iontophoresis; a treatment usually used for excessive sweating from the hands and/or feet whereby a weak electric current is passed through water, in this study the authors incorporated lidocaine and dexamethasone, while group B underwent EWST. The study secured comprehensive data collection through baseline assessments and follow-ups over a five-week period. Key evaluation metrics included heel pain, overall health status using the EuroQol-D questionnaire, and measurement of fascia thickness via ultrasound.
Results
The findings revealed statistically significant advantages of the shockwave therapy group in terms of final fascia thickness and observed pain relief, indicated by the Visual Analogue Scale (VAS) (p = 0.001). Patients receiving EWST reported complete pain remission after three weeks of treatment. By the six-week follow-up, both treatment modalities demonstrated effectiveness, with patients from both groups experiencing satisfactory pain reduction. However, the shockwave group exhibited a more favorable perception of treatment efficacy by the end of the protocol, with results indicating a stronger preference for this method (p = 0.001).
Findings
The trial provided valuable insights into the short-term effectiveness of the two different therapies. Shockwave therapy not only significantly reduced the thickness of the fascia but also led to a quicker rate of pain reduction when compared to iontophoresis. While both techniques improved patient outcomes, EWST proved to be superior in achieving earlier and complete remission of plantar fasciitis symptoms within the timeline of the study. Furthermore, patient satisfaction favored EWST, highlighting its potential to enhance the overall treatment experience.
Conclusion
In summary, the research conducted by Pabón-Carrasco et al. emphasises the importance of establishing personalised treatment plans for managing plantar fasciitis. The study conclusively demonstrates that while both iontophoresis and shockwave therapy effectively alleviate pain, the latter offers quicker results and higher patient satisfaction in the short term. These findings contribute significantly to the existing literature on plantar fasciitis treatments, guiding clinicians toward making informed decisions tailored to the needs of their patients. The results underscore the necessity for further research to explore long-term effects and to optimise treatment protocols in managing this prevalent condition.
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