Novel and Conservative Approaches Towards Effective Management of Plantar Fasciitis

Abstract

We assessed the effectiveness of the different treatments for plantar fasciitis (PF) based on the changes in functional outcomes. A systematic literature search was carried out and studies from 2010 to 2016 were included in this review. The databases from Google Scholar, PubMed and Cochrane were used for the various treatment modalities of plantar fasciitis. The objectives measured included visual analog scale (VAS), Roles and Maudsley scale, foot function index (FFI), plantar fascia thickness and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot scale as the tools to predict the improvement in symptoms of pain and discomfort. Eight randomized controlled trails that met the selection criteria were included in this review. Extracorporeal shock wave lithotripsy (ESWL) with botulinum toxin type A, corticosteroid injections, autologous whole blood and plasma treatment, novel treatments like cryopreserved human amniotic membrane, effect of placebo, platelet rich plasma injections and corticosteroid injections, physiotherapy and high strength training were analyzed. All the treatment modalities applied did lead to the reduction in pain scores, but for long term management autologous condition plasma and platelet rich plasma are the preferred treatment options. Impact of physiotherapy and high strength training is equivalent to corticosteroid injections and hence is suited for patients avoiding invasive forms of treatment.

Keywords: botulinum type a toxin; corticosteroids; physiotherapy; plantar fasciitis; treatment.

Figure 1. Flow chart of selection of studies

Figure 2. Tools to predict the improvement in symptoms (VAS, RM Scale, AOFAS)

Visual Analogue Scale (VAS) _(2a) Roles and Maudsley (RM) Scale _(2b) American Orthopaedic Foot and Ankle Society (AOFAS) Scale _(2c)