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

NCT ID: NCT06917937

Last Updated: 2025-04-09

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-09-16
• Study Completion Date: 2019-05-05

Brief Summary

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.

Conditions

Plantar Fascitis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

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

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.

Group Type: EXPERIMENTAL

Exercise Program

Intervention Type: OTHER

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.

Corticosteroid injection

Intervention Type: OTHER

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.

After the application, he covered the area with a sterile cloth and said to remove it after 3 hours. He stated that patients could apply ice to the injected area if necessary for pain control, and advised patients to avoid all jogging and other high-impact activities on the day of injection. No additional treatments, including NSAIDs, orthoses, and night splints, were allowed during the study period.

Corticosteroid injection (Group II)

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.

Group Type: ACTIVE_COMPARATOR

Corticosteroid injection

Intervention Type: OTHER

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.

After the application, he covered the area with a sterile cloth and said to remove it after 3 hours. He stated that patients could apply ice to the injected area if necessary for pain control, and advised patients to avoid all jogging and other high-impact activities on the day of injection. No additional treatments, including NSAIDs, orthoses, and night splints, were allowed during the study period.

Interventions

Exercise Program

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.

Intervention Type: OTHER

Corticosteroid injection

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.

After the application, he covered the area with a sterile cloth and said to remove it after 3 hours. He stated that patients could apply ice to the injected area if necessary for pain control, and advised patients to avoid all jogging and other high-impact activities on the day of injection. No additional treatments, including NSAIDs, orthoses, and night splints, were allowed during the study period.

Intervention Type: OTHER

Eligibility Criteria

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.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Kutahya Health Sciences University

OTHER

Sponsor Role: lead

Responsible Party

Sevtap Cakir

Asst. Prof.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Kütahya Health Sciences University

Kütahya, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

KSBU-PF

Identifier Type: -

Identifier Source: org_study_id