Plantar fasciitis (fasciosis) treatment outcome study: Plantar fascia thickness measured by ultrasound and correlated with patient self-reported improvement.
Fabrikant JM, Park TS. Foot (Edinb). 2011 Mar 11. [Epub ahead of print]
Ultrasound may reveal a decrease in thickness of the fascia if a modality clinically demonstrated to effect such a decrease is utilized.
I have noted fairly consistent decreases in plantar fascial thickness in cases of plantar fasciosis post ESWT.
Here is one paper:
Arch Orthop Trauma Surg. 2005 Feb;125(1):6-9. Epub 2003 Oct 3.
Ultrasonographic evaluation at 6-month follow-up of plantar fasciitis after extracorporeal shock wave therapy.
Hammer DS, Adam F, Kreutz A, Rupp S, Kohn D, Seil R.
Orthopaedic University Hospital , 66421, Homburg/Saar, Germany.
INTRODUCTION: The aim of this study was to investigate the effect of extracorporeal shock wave therapy (ESWT) on the ultrasonographic appearance of chronically painful, proximal plantar fasciitis. MATERIALS AND METHODS: Twenty-two patients with a unilateral proximal plantar fasciitis were prospectively enrolled after unsuccessful conservative treatment lasting 6 months. The contralateral plantar fascia was used as the control. ESWT (3x3000 shock waves/session of 0.2 mJ/mm2) was performed at weekly intervals. The thickness of the plantar fascia was measured ultrasonographically about 2 cm distal of the medial calcaneal tuberosity. Pain estimation on a visual analogue scale (VAS) and the comfortable walking time were recorded. No local anaesthesia was applied. Follow-up was done at 6, 12 and 24 weeks. RESULTS: Before ESWT, the plantar fasciitis side was ultrasonographically significantly thicker than the control side (p<0.05), whereas 6 months after ESWT, the thickness of the fascia was no longer significantly different. The decrease in thickness of the plantar fasciitis side was significant (p<0.05). Pain during activities of daily living decreased by 79% according to the VAS, and the comfortable walking time increased, both significantly (p<0.01). In patients with little pain (VAS<30), the thickness of the plantar fasciitis side was significantly less (p<0.01) compared with patients who still suffered more pain (VAS>30). CONCLUSION: After ESWT, the thickness of the plantar fascia in patients with plantar fasciitis decreased, pain and walking time improved (all significantly).
Also:
Journal List > J Korean Acad Rehabil Med > v.33(3); Jun 2009
The Effect of Extracorporeal Shock Wave Therapy in Plantar Fasciitis
Kim SB, Lee KW, Lee JH, Kim YD, Yoon K, Joe YL.
J Korean Acad Rehabil Med
33(3):333-338 Jun 2009. Korean.
Total References:22
Cited Korean References:1
Times Cited:0
Click here to read
OBJECTIVE: To evaluate the effect of extracorporeal shock wave therapy (ESWT) in plantar fasciitis with visual analog scale score and thickness of fascia by ultrasonography. METHOD: The subjects consisted of 32 feet (24 patients) with established diagnosis of chronic plantar fasciitis, including 17 feet in the ESWT group and 15 feet in the control group. In the ESWT group, three session of ESWT (0.24 mJ/mm2 FED, 1,200 impulse, weekly) were performed. The visual analog scale (VAS) score and thickness of the plantar fascia were measured by ultrasound before therapy and at the 6-week and 6-month follow-up. Patients in the control group were treated with medication, orthotics, physical therapy and exercise program. VAS and thickness of plantar fascia was evaluated at the same time as ESWT group. RESULTS: In the ESWT group, thickness of plantar fascia decreased significantly at 6-week follow-up (p <0.05) and 6-month follow-up (p <0.05). Control group showed no significant difference at follow-up (>0.05). Visual analog scale score showed no significantly difference at 6-week follow-up (>0.05), but decreased at 6-month follow-up. On the other hand, in the control group, thickness of plantar fascia did not change significantly at 6-week follow-up (>0.05) and 6-month follow-up (>0.05). VAS score was not significant different at the 6-week follow-up (>0.05), but decreased at the 6-month follow-up (p <0.05). CONCLUSION: ESWT in plantar fasciitis is effective in relieving subjective pain and reducing thickness of plantar fascia at 6-month follow-up.
Affiliation:
Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Korea. suezoe79@hanmail.net
Department of Physical Medicine and Rehabilitation, Inchang Hospital, Korea.
Intra- and interobserver reliability of quantitative ultrasound measurement of the plantar fascia.
Skovdal Rathleff M, Moelgaard C, Lykkegaard Olesen J. J Clin Ultrasound. 2011 Mar-Apr;39(3):128-34.
I use ultrasound to confirm clinical suspicion of plantar fasciitis and have found it to be accurate in detecting the condition. The beauty is you can immediately compare with the asymptomatic side not only the thickness, which can be easily visualised on screen, but also the echotexture in real time scanning, which may not always come across so clearly on static images.
Reproducibility of sonographic measurement of thickness and echogenicity of the plantar fascia.
Cheng JW, Tsai WC, Yu TY, Huang KY. J Clin Ultrasound. 2011 Nov 22.
I would agree that longitudinal scanning is far better than the transverse plane for measuring thickness, however for guided injection therapy, I use the transverse plane.
Correlation between computerised findings and newman's scaling on vascularity using power Doppler ultrasonography imaging and its predictive value in patients with plantar fasciitis.
Chen H, Ho HM, Ying M, Fu SN. Br J Radiol. 2011 Dec 13.
Application of Ultrasound in the Assessment of Plantar Fascia in Patients With Plantar Fasciitis: A Systematic Review.
Mohseni-Bandpei MA, Nakhaee M, Mousavi ME, Shakourirad A, Safari MR, Vahab Kashani R. Ultrasound Med Biol. 2014 May 2
Prospective study of plantar fascia thickness correlated to efficacy of conservative treatment for plantar fasciitis using ultrasonography
Gerald Kuwada The Foot and Ankle Online Journal 9 (3): 9
Coexistence of plantar calcaneal spurs and plantar fascial thickening in individuals with plantar heel pain.
Menz HB et al Rheumatology (Oxford). 2019 Feb 1 ;58
Ultrasonographic Measurements of Plantar Fascia Thickness and Echogenicity in Individuals with and without Plantar Fasciitis: Reliability and Group Differences
SamanSalehi et al The Foot 8 July 2021, 101849
An assessment of plantar fascia with ultrasound findings in patients with plantar fasciitis: a systematic review
Abdul Sattar Arif Khammas et al J Ultrasound. 2022 Aug 30