Comparison of the Effectiveness of USG and Palpation Guidance Steroid Injection in Patients With Plantar Fasciitis
Condition: Plantar Fasciitis
MeSH terms: Fasciitis; Fasciitis, Plantar
Study type: Interventional

Summary: 
      Plantar fasciitis, often described as overloading of the plantar fascia, is the most common
      cause of heel pain in adults. It is characterized by a sharp pain along the medial aspect of
      the heel, which is worse with the first step taken in the morning or at the beginning of an
      activity and decreases as the person warms up. The etiology of plantar fasciitis is
      multifactorial and not well understood. Poor biomechanics and changes in the structure of the
      foot can lead to repeated micro-trauma at the beginning of the plantar fascia, causing
      inflammation and degeneration. Plantar fasciitis is more common in sedentary individuals and
      athletes and those participating in running sports. Other risk factors associated with
      plantar fasciitis include reduced ankle dorsiflexion, increased body mass index (BMI), and
      work-related weight loss activities.

      Current treatments for plantar fasciitis, such as plantar fascia stretching exercises,
      strapping, extracorporeal shock wave therapy, nonsteroidal anti-inflammatory drugs (NSAIDs),
      arch braces, and heel pads are mainly aimed at reducing inflammation. Corticosteroid
      injections are usually reserved for refractory plantar fasciitis after conservative
      noninvasive attempts have failed. It has been shown to effectively reduce heel pain in
      patients with plantar fasciitis. The strong anti-inflammatory effect of corticosteroids can
      speed up the process of pain relief.

      In our study, we aimed to compare the effectiveness of USG and palpation guidance blind
      steroid injection in patients diagnosed with plantar fasciitis.
    

Detailed description: 
      It is planned to enroll 60 (sixty) patients in the study. Patients diagnosed with plantar
      fasciitis, between the ages of 18-75, who have failed conservative treatment (stretching
      exercises, non-steroidal anti-inflammatory drugs and heel pads) for at least 3 months, and
      those with a Visual Anolog Scale value of 5 and above will be included in the study. Any
      local injection therapy and physical therapy for heel pain in the last 4 months, any surgery
      history for heel pain, history of tarsal tunnel syndrome, ankle effusion showing
      intra-articular disease, healed calcaneal fracture, Achilles tendinopathy, foot including pes
      and any deformity of the ankle, planus or pes cavus deformity; Patients with systemic
      disorders such as diabetes mellitus, rheumatoid arthritis, hematological disease or gout,
      pregnancy, history of aspirin or aspirin-like medication, and mental insufficiency will be
      excluded from the study.

      In the study, the patients will be filled in Visual Analogue Scale (VAS) and Foot Function
      Indez (FFI) questionnaires. Patients will be randomized into 2 groups according to the Random
      Number Generation. The first group will be the USG-guided steroid injection group, and the
      second group will be the palpation-guided steroid injection group. In the USG-guided group,
      steroid injection will be made to the area where the fascia is thickened under the guidance
      of USG. In the palpation-guided group, the most painful point will be found by palpation on
      the calcaneus bone and steroid injection will be made to that part. The content of the
      steroid solution will be 1 ml of 1% Lidocaine + 1 ml (40 mg) methylprednisolone. There will
      be pre-injection, 1st month and 3rd month controls after injection.
    

Intervention name(s): USG-guided steroid injection; Palpation-guided steroid injection
Intervention type(s): Drug; Drug
Intervention description(s): In the palpation-guided group, the most painful point will be found by palpation on the calcaneus boIn the USG-guided group, steroid injection will be made to the area where the fascia is thickened under USG guidance. The content of the steroid solution will be 1 ml of 1% Lidocaine + 1 ml (40 mg) methylprednisolone.ne and steroid injection will be made to that part. The content of the steroid solution will be 1 ml of 1% Lidocaine + 1 ml (40 mg) methylprednisolone.; In the palpation-guided group, the most painful point will be found by palpation on the calcaneus bone and steroid injection will be made to that part. The content of the steroid solution will be 1 ml of 1% Lidocaine + 1 ml (40 mg) methylprednisolone.
Other intervention name(s): no other names; no other names
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Plantar Fasciitis; USG; Steroid; Injection