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12-06-2011 | Internal medicine | Article

Ultrasound measurement demonstrates plantar fasciitis improvement


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MedWire News: Ultrasound can be used to monitor treatment outcomes in patients with plantar fasciitis (fasciosis), US researchers have found.

Recognizing that ultrasound is an effective diagnostic tool for plantar fasciitis, Jerry Fabrikant and Tae Soon Park, from Grossmont Medical Center in La Mesa, California, investigated the use of ultrasound to measure plantar fascia thickness before and after treatment.

Firstly, the researchers measured the plantar fascia in 30 patients with unilateral plantar fascia pain in the heel and instep and 61 feet of 33 patients with non-plantar fascia pain (controls). This demonstrated significantly thicker plantar fascia in affected left and right feet than in control feet.

Next, the team followed-up the affected patients weekly for at least 2 consecutive weeks during treatment, which lasted up to 3 months (mean 4.29 weeks), until they were pain free or had achieved maximum medical improvement.

As well as nonsteroidal anti-inflammatory drugs, affected patients received higher arch inserts with biomechanical posting for valgus, varus, arch or instep augmentation, heel posting, or custom orthotics. Other treatments included local anesthesia injections alone or with steroids, and physical therapy.

Ultrasound revealed that treatment led to a significant reduction in mean plantar fascia thickness, from 0.621 cm at baseline to 0.418 cm after treatment. The faces pain scale demonstrated that patients with plantar fasciitis experienced the greatest pain in the evening, but had significantly less pain after treatment than beforehand.

Although all affected patients had a reduction in plantar fascia thickness and pain with treatment, the two factors were not significantly correlated.

"Subjective assessment of pain, with variance in pain threshold from patient to patient, as well as variance in the time span between the initial and final ultrasound of plantar fascia thickness, may be the large contributing factors in the absence of systematic relationship between the two variables," suggest Fabrikant and Park in the journal The Foot.

They conclude: "Office based ultrasound can help diagnose and confirm plantar fasciitis/fasciosis through the measurement of the plantar fascia thickness, as well as the typical visual presentation of symptomatic plantar fascia.

"As a noninvasive, cost effective and radiation-free diagnostic modality, ultrasound should be considered and implemented early in the diagnosis and treatment of plantar fasciitis/fasciosis."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Lynda Williams

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