Is Exercise Program Added to Corticosteroid Injection Effective on Pain and Performance in Plantar Fasciitis?

Kutahya Health Sciences University

Status: Completed

Conditions: Plantar Fascitis

Treatments: Other: Corticosteroid injection; Other: Exercise Program

Study type: Interventional

Funder types: Other

Identifiers

NCT06917937

KSBU-PF

Details and patient eligibility

About

Plantar fasciitis (PF) involves the degeneration of the medial calcaneal tuberosity and nearby perifascial tissues in the heel. It is the leading cause of heel pain, typically resulting from repetitive strain on the plantar fascia, causing structural damage. Key risk factors for PF include an increased body mass index in active individuals and a greater range of plantar flexion motion. Treatment options for PF vary, and there is no clear consensus on the most effective approach. Conservative treatments may include rest, stretching exercises for the plantar fascia and Achilles tendon, strengthening exercises for foot intrinsic muscles, nonsteroidal anti-inflammatory drugs (NSAIDs), orthotics, heel pads, dorsiflexion night splints, and corticosteroid injections. These treatments may be used individually or in combination. Corticosteroid injections are the most frequently used invasive treatment. However, there has been limited research examining the effects of corticosteroid injections combined with exercises targeting intrinsic foot muscle strength on functionality and walking distance. The objective of this study was to evaluate the impact of an exercise program added to corticosteroid injections on pain relief and functional performance in individuals with PF.

Enrollment: 40 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Those over the age of 18
• Those who have pain in the plantar region for 1 month and this pain is 5 or more according to VAS,
• Those who describe pain on the first step of the morning,
• Those with plantar fascia tenderness on palpation,
• Patients who will be in harmony with the physician and physiotherapist in exercise and follow-up throughout the entire study period.

Exclusion criteria

• Cases with fracture, entrapment neuropathy and rupture,
• Those with neurological and systemic diseases,
• Those with a Body Mass Index (BMI) of more than 40,
• Conditions with a local contraindication to corticosteroid,
• Participants who have situations that may prevent their safety, execution or interpretation of the results during the continuation of the training and applied of the test protocol.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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40 participants in 2 patient groups

(Exercise program in added on to corticosteroid injection (Group I)

Experimental group

Description:

Our exercise program in our study; (i) foot intrinsic muscle strengthening exercise (with a load of 3 kg), (ii) plantar fascia stretching with finger extension, (iii) standing gastrocnemius muscle stretching, (iv) sitting achilles tendon stretching, (v) plantar fascia and gastrocnemius stretch on the step, (vi) cold massage exercise in the arch of the foot. We stated that the group to which exercise was added should do the exercises regularly for 6 weeks, in the specified number and time.

Treatment:

Other: Exercise Program

Other: Corticosteroid injection

Corticosteroid injection (Group II)

Active Comparator group

Description:

The orthopedic physician administered the corticosteroid injection as a mixture of 1 ml of arthropane (5 mg of triamcinolone hexacetonide) and 4 ml of citanest. Before the application, the physician cleaned the area to be treated with 10% povidone iodine. He made a single dose injection by entering the painful point determined by palpation around the calcaneal spur and plantar fascia from the percutaneous foot-heel lateral. The patients were in the prone position with the ankle in a neutral position.

Treatment:

Other: Corticosteroid injection