New ultrasound treatment may eliminate heel pain from plantar fasciitis

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CHICAGO—Combining an ultrasound-guided technique with steroid injection is 95 percent effective at relieving the common and painful foot problem called plantar fasciitis, according to a study presented today at the 94th annual meeting of the Radiological Society of North America (RSNA).

“There is no widely accepted therapy or standard of care for patients when first-line treatments fail to relieve the pain of plantar fasciitis,” said the study's lead author, Luca M. Sconfienza, MD, from University of Genoa in Italy, who presented the study. “Our new technique is an effective, one-time outpatient procedure.”

Plantar fasciitis accounts for 11 percent to 15 percent of all foot symptoms requiring professional care and affects one million people annually in the United States.
For this study, Sconfienza and colleagues used a new ultrasound-guided technique, along with steroid injection, on 44 patients with plantar fasciitis that was unresponsive to conservative shockwave treatments.  

After injection of a small amount of anesthesia, the anesthetic needle is used to repeatedly puncture the site where the patient feels the pain, known as dry-needling. Dry-needling creates a small amount of local bleeding that helps to heal the fasciitis. Lastly, a steroid is injected around the fascia to eliminate the inflammation and pain. The technique is performed with ultrasound guidance to improve accuracy and to avoid injecting the steroids directly into the plantar fascia, which could result in rupture.

The investigators followed-up all the patients clinically after the treatment for four to six months.

After the 15-minute procedure, the researchers found that symptoms disappeared for 95 percent of the patients within three weeks.

“This [ultrasound-guided] therapy is quicker, easier, less painful and less expensive than shockwave therapy,” Sconfienza said. “In cases of mild plantar fasciitis, patients should first try noninvasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option.”