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Comparing the Role of Different Treatment Modalities for Plantar Fasciitis: A Double Blind Randomized Controlled Trial

Indian Journal of Orthopaedics volume 54, pages 31–37 (2020)Cite this article

Abstract

Introduction

Although many treatment modalities including rest, stretching, strengthening, change of shoes, arch supports, orthotics, night splints and anti-inflammatory agents have been advocated for plantar fasciitis, there is no report in the literature which compares the independent effectiveness of each treatment modality without the concomitant use of any other one.

Methods

A double blind, randomized controlled study was undertaken where 140 patients of plantar fasciitis were divided into four groups with 35 patients each. Patients in four groups received analgesics, hot water fomentation and silicon heel pads, plantar fascia stretching and calf stretching exercises, respectively. Heel pain was evaluated using Foot Function Index (FFI) and disability using Foot and Ankle Disability Index (FADI). Clinical evaluation was done weekly up to a period of 4 months and then at 6 months, 8 months, 10 months and 12 months.

Results

Mean age of patients was 43.4 ± 10.6 years with average duration of symptoms being 27.26 weeks (range 4–200 weeks). Both FFI and FADI showed statistically significant improvement at 12 months in all the four groups (p value < 0.0001 for all groups). However, groups 2, 3 and 4 were observed to show statistically better results in terms of heel pain reduction (FFI) as compared to group 1 (ANOVA, p value < 0.0001 for group 1 vs. 2, group 1 vs. 3 and group 1 vs. 4). In terms of disability (FADI), best results were observed in group 3.

Conclusion

Plantar fascia stretching exercises resulted in most significant improvement in both the scores (FFI and FADI), followed by treatment with heat and silicone heel pad and calf stretching exercises.

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Acknowledgements

We are thankful to Indian Council of Medical Research (ICMR), New Delhi, India (Grant No. 5/4-5/3/ORTHO/2013-NCD-1 DATED 26.03.2015) for funding this study.

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Authors and Affiliations

  1. Department of Orthopaedics, Government Medical College Hospital, Chandigarh, Chandigarh, 160030, India

    Ravi Gupta, Anubhav Malhotra, Gladson David Masih, Tanu Khanna, Parmanand Gupta & Shweta Kashyap

  2. Department of Physical Medicine and Rehabilitation, Government Medical College Hospital, Chandigarh, Chandigarh, 160030, India

    Harsimranjit Kaur

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  1. Ravi Gupta
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Correspondence to Ravi Gupta.

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Gupta, R., Malhotra, A., Masih, G.D. et al. Comparing the Role of Different Treatment Modalities for Plantar Fasciitis: A Double Blind Randomized Controlled Trial. JOIO 54, 31–37 (2020). https://doi.org/10.1007/s43465-019-00038-w

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  • DOI: https://doi.org/10.1007/s43465-019-00038-w

Keywords

  • Plantar fasciitis
  • Plantar fascia stretching
  • Calf stretching
  • Analgesics
  • Silicone heel pad and moist heat