Corticosteroid Injection, Extracorporeal Shock Wave Therapy, and Radiofrequency Ablation for Chronic Plantar Fasciitis:

NCT ID: NCT06737445

Last Updated: 2024-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

49 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-04-01

Study Completion Date

2023-02-01

Brief Summary

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Chronic plantar fasciitis is a prevalent condition causing persistent heel pain, often refractory to conservative treatments. This prospective randomized controlled trial aimed to compare the effectiveness of corticosteroid injection (CSI) , extracorporeal shock wave therapy (ESWT), and radiofrequency thermal lesioning (RTL) in the management of chronic plantar fasciitis.

Detailed Description

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Based on the investigators' understanding of the literature there are no randomized, controlled, prospective studies comparing the therapeutic effects of CSI, ESWT and RTL for recalcitrant plantar fasciitis. In this study, the investigators investigated and compared the outcomes of three treatment techniques in participants who had exhausted conservative treatment options over the past six months.

Conditions

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Chronic Plantar Fasciitis

Keywords

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extracorporeal shock wave therapy (ESWT) radiofrequency thermal lesioning (RTL) Chronic plantar fasciitis corticosteroid injection (CSI)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Radiofrequency thermal lesioning (RTL)

RTL was performed as a single session using the radiofrequency ablation device (NeuroTherm JK4A; NeuroTherm Ltd, Croydon, London, England).

Group Type ACTIVE_COMPARATOR

Radiofrequency ablation alone

Intervention Type PROCEDURE

RTL was performed as a single session using the radiofrequency ablation device (NeuroTherm JK4A; NeuroTherm Ltd, Croydon, London, England).

Extracorporeal shock wave therapy (ESWT)

Patients underwent 3 ESWT sessions applied to the plantar heel area, once a week with the same ESWT dose (15 Hz, 2000 pulse, 4.0 bar energy density) using a BTL-5000 SWT device (BTL Industries, USA).

Group Type ACTIVE_COMPARATOR

Extracorporeal shock wave therapy

Intervention Type OTHER

Patients underwent 3 ESWT sessions applied to the plantar heel area, once a week with the same ESWT dose (15 Hz, 2000 pulse, 4.0 bar energy density) using a BTL-5000 SWT device (BTL Industries, USA).

Corticosteroid Injection

An injection of 1 ml of betamethasone 40 mg/ml and 2 ml of bupivacaine 5 mg/ml was performed.

Group Type ACTIVE_COMPARATOR

Cortisone Injection

Intervention Type PROCEDURE

An injection of 1 ml of betamethasone 40 mg/ml and 2 ml of bupivacaine 5 mg/ml was performed.

Interventions

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Radiofrequency ablation alone

RTL was performed as a single session using the radiofrequency ablation device (NeuroTherm JK4A; NeuroTherm Ltd, Croydon, London, England).

Intervention Type PROCEDURE

Cortisone Injection

An injection of 1 ml of betamethasone 40 mg/ml and 2 ml of bupivacaine 5 mg/ml was performed.

Intervention Type PROCEDURE

Extracorporeal shock wave therapy

Patients underwent 3 ESWT sessions applied to the plantar heel area, once a week with the same ESWT dose (15 Hz, 2000 pulse, 4.0 bar energy density) using a BTL-5000 SWT device (BTL Industries, USA).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Persistant heel pain for ≥ 6 months
* No response to at least 6 weeks of conservative treatment (including at least two of the following: NSAIDs, stretching exercises, ice, heel pads, physical therapy, or night splints)
* Age ≥ 18
* BMI ≤ 35
* VAS ≥ 5 following the first step in the morning or after periods of prolonged inactivity
* Willingness to participate in the study

Exclusion Criteria

* Previous foot or ankle surgery, major trauma
* Tumor, osteomyelitis, or complex regional pain syndrome in the affected limb
* Allergy to local anesthesia or NSAIDs
* Pregnancy or breastfeeding
* History of calcaneal fracture
* Previous cortisone injection, ESWT, or RTL for similar complaints
* BMI \>35
* Age \< 18
* Use of medications for neuropathic pain (Pregabalin, Gabapentin)
* Proximal nerve lesion (e.g., spinal stenosis, sciatica, tarsal tunnel syndrome)
* Regional skin or subcutaneous infections, fat pad atrophy
* History of rheumatic disease, or hematologic conditions
* History of peripheral vascular disease
* Seronegative arthropathies, heart failure, hepatic or metabolic disorders
* Pacemaker
* History of clubfoot, pes cavus, or calcaneovalgus
* Diabetic neuropathy
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kars Harakani State Hospital

OTHER

Sponsor Role lead

Responsible Party

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Erdem Sahin

Medical Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Kars Harakani State Hospital

Kars, Merkez, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Erden T, Toker B, Cengiz O, Ince B, Asci S, Toprak A. Outcome of Corticosteroid Injections, Extracorporeal Shock Wave Therapy, and Radiofrequency Thermal Lesioning for Chronic Plantar Fasciitis. Foot Ankle Int. 2021 Jan;42(1):69-75. doi: 10.1177/1071100720949469. Epub 2020 Sep 3.

Reference Type BACKGROUND
PMID: 32880199 (View on PubMed)

Liden B, Simmons M, Landsman AS. A retrospective analysis of 22 patients treated with percutaneous radiofrequency nerve ablation for prolonged moderate to severe heel pain associated with plantar fasciitis. J Foot Ankle Surg. 2009 Nov-Dec;48(6):642-7. doi: 10.1053/j.jfas.2009.05.013. Epub 2009 Jul 5.

Reference Type BACKGROUND
PMID: 19857819 (View on PubMed)

Alshami AM, Souvlis T, Coppieters MW. A review of plantar heel pain of neural origin: differential diagnosis and management. Man Ther. 2008 May;13(2):103-11. doi: 10.1016/j.math.2007.01.014. Epub 2007 Mar 30.

Reference Type BACKGROUND
PMID: 17400020 (View on PubMed)

Wu PT, Lee JS, Wu KC, Wu TT, Shao CJ, Liang FW, Chern TC, Su FC, Jou IM. Ultrasound-Guided Percutaneous Radiofrequency Lesioning When Treating Recalcitrant Plantar Fasciitis: Clinical Results. Ultraschall Med. 2016 Feb;37(1):56-62. doi: 10.1055/s-0034-1385466. Epub 2014 Nov 12.

Reference Type BACKGROUND
PMID: 25389914 (View on PubMed)

Rompe JD, Furia J, Weil L, Maffulli N. Shock wave therapy for chronic plantar fasciopathy. Br Med Bull. 2007;81-82:183-208. doi: 10.1093/bmb/ldm005. Epub 2007 Apr 24.

Reference Type BACKGROUND
PMID: 17456546 (View on PubMed)

Other Identifiers

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27093

Identifier Type: -

Identifier Source: org_study_id