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Conservative Treatments vs Local Steroid Injection in the Management of Planter Fasciitis

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Nov 12, 2014.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1

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    Comparative Study of: Non-Invasive Conservative Treatments with Local Steroid Injection in the Management of Planter Fasciitis.
    Narula R, Iraqi AA, Narula K, Katyal R, Saxena MS.
    J Clin Diagn Res. 2014 Sep;8(9):
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    - claimed it was randomized, but no details given. Ended up with exactly 100 in each group --> red flag
    - conservative group got:
    - no idea what the outcome measures were! No info given; but categorical: excellent, good and fair - no criteria given for any of them!
    - as categorical, used Chi-squared .... not how you are supposed to analyze a RCT
    - 76 dropouts - no info on them given; no 'intention to treat' analysis
    - etc
    - yawn

    :boohoo:
     
  3. Admin2

    Admin2 Administrator Staff Member

  4. daisyboi

    daisyboi Active Member

    "...is considered a self limiting condition. Symptoms resolve in 80% to 90% of cases within ten months. "

    I read/hear this all the time but is there actually any evidence of this? I can't recall having read any research which substantiates this claim but not being an avid digester of journal articles I'm willing to concede I may have missed it. Can anyone point me in the direction of good research which establishes this claim?

    Thanks

    Dave
     
  5. Of course, any one who says this, doesn't account for the sometimes severe loss of mobility, loss of work, psychological stress and lack of ability to walk and run comfortably while the symptoms are present. We don't treat statistics, we treat people in pain.
     
  6. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    There is no specific evidence that I am aware of, but you only have to look at the placebo group in all RCT's of plantar fasciitis and see how they improve - the treatment groups improve more, but the placebo group does as well --> the natural history is plantar fasciitis is to get better ..... eventually.

    But as Kevin says, that is not a reason not to treat it as it hurts. It just means that the treatment used needs to have been shown to lead to better outcomes than just using a placebo
     
  7. daisyboi

    daisyboi Active Member

    Thanks for that Craig and yes you are of course correct, but there is a huge difference between improving and spontaneously resolving within ten months. I just feel such figures are regularly plucked out of thin air with no basis and then used as an excuse to not intervene.

    Dave
     
  8. Has anyone used instrument assisted soft tissue mobilization for treating plantar fasciitis. I have found it to be a great tool to enable the restoration of biomechanical foot and ankle function. It is such a great tool that it needs to be seen for the valuable tool that it is.It has prevented some of my patients' from having injections and/or surgery. It allows the joint to be opened up and to help more normal function.
     
  9. Ian Reilly

    Ian Reilly Active Member

    Craig

    i always appraise ur insight as a novice researcher myself. So why don't the journal reviewers pick up on such things?

    TU

    Ian
     
  10. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    Its a low quality journal with lax/poor or non-existent editorial and/or peer review.
     
  11. Ian Reilly

    Ian Reilly Active Member

    Roger that.

    ... given the amount that has been written on PF,i still don't get why there isn't THE definitive injections protocol: is best drug, dose, site, frequency...etc...
     
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