As per a study that was presented at the annual meeting of the Radiological Society of North America (RSNA), the combination of an ultrasound-guided technique with steroid injection is 95 percent effective to relieve plantar fasciitis, a common and painful foot problem.

Luca M. Sconfienza, M.D., from Italy’s University of Genoa and lead author of the study, remarked that there is an absence of a widely accepted therapy when first-line treatments fail to relieve the pain of plantar fasciitis.

From News-Medical.Net:

For this study, Dr. Sconfienza and colleagues used a new ultrasound-guided technique, along with steroid injection, on 44 patients with plantar fasciitis that was unresponsive to conservative treatments.

After injection of a small amount of anesthesia, the anesthetic needle is used to repeatedly puncture the site where the patient feels the pain. This technique is known as dry-needling. Dry-needling creates a small amount of local bleeding that helps to heal the fasciitis. Lastly, a steroid is injected around the fascia to eliminate the inflammation and pain. The technique is performed with ultrasound guidance to improve accuracy and to avoid injecting the steroids directly into the plantar fascia, which could result in rupture.

After the 15-minute procedure, symptoms disappeared for 42 of the study’s 44 patients (95 percent) within three weeks.

Plantar fasciitis, the most common cause of heel pain, affects approximately one million people on a yearly basis in the United States alone.

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As per a study that was presented at the annual meeting of the Radiological Society of North America (RSNA), the combination of an ultrasound-guided technique with a steroid injection can prove to be effective by as much as 95 percent to offer relief to patients suffering from plantar fasciitis.

This technique is expected to stand up as an effective and one-time outpatient procedure as per study’s lead author, Luca M. Sconfienza, M.D., from Italy’s University of Genoa.

Plantar fasciitis, which is the most common cause of heel pain, is an inflammation of the plantar fascia (connective tissue) that affects one million people annually in the U.S. alone.

From News-Medical.Net:

For this study, Dr. Sconfienza and colleagues used a new ultrasound-guided technique, along with steroid injection, on 44 patients with plantar fasciitis that was unresponsive to conservative treatments.

After injection of a small amount of anesthesia, the anesthetic needle is used to repeatedly puncture the site where the patient feels the pain. This technique is known as dry-needling. Dry-needling creates a small amount of local bleeding that helps to heal the fasciitis. Lastly, a steroid is injected around the fascia to eliminate the inflammation and pain. The technique is performed with ultrasound guidance to improve accuracy and to avoid injecting the steroids directly into the plantar fascia, which could result in rupture.

After the 15-minute procedure, symptoms disappeared for 42 of the study’s 44 patients (95 percent) within three weeks.

Dr. Sconfienza said that when pain associated with plantar fasciitis becomes annoying then dry-needling with steroid injection proves to be a viable option.

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Patients with Plantar Fasciitis now have a choice above surgery as per Luca M. Sconfienza, M.D., of the University of Genoa.

Sconfienza in the Radiological Society of North America meeting remarked that dry needling can prove to be one of the most effective treatment options when it comes to reducing inflammation in patients with Plantar Fasciitis.

This treatment option can be exercised by inducing local bleeding in an area where the steroids are expected to be administered via injection into the perifascial soft tissue rather than injecting directly into the fascia. It was revealed during the study that dry needling along with steroid injections can help patients who have almost lost the hope fighting against Plantar Fasciitis.

From Medpagetoday.com:

“It’s a very good [method] because we allow nature to work for us,” Dr. Sconfienza said. When bleeding is induced around the fascia, platelets respond, helping the tissue to heal spontaneously.

He said the combination treatment could be a good alternative to other remedies that have met with varying degrees of success for treating plantar fasciitis,

No widely accepted therapy for the disease has been established, the researchers said. Shockwaves, which send sound waves through the heel, is expensive and painful, Dr. Sconfienza said, and its long-term efficacy has not been established.

Other more conservative treatments, such as stretching in the morning, weight loss, and NSAIDS, are frequently used as well. Surgery is a last resort.

It was suggested that tissues can be expected to heal spontaneously through respond of platelets when bleeding is induced around the fascia. It is further believed that this treatment can also be used to treat tennis elbow. It was remarked in the meeting that further research will help the involved researchers in exploring more treatment options by comparing options such as dry needling alone, no treatment, and dry needling with steroids.

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Patients suffering from plantar fasciitis now have a choice to choose above surgery. The new method developed by an Italian Team of researchers used dry-needling to combine it with a steroid injection.

Dry needling is done to reduce inflammation by causing local bleeding in the area where a steroid can be injected to the perifascial soft tissue, which helps in healing the fascia.

Till date, no proper treatment was established for this disease though stretching in the morning, weight loss, and NSAIDS were few things that were advised to the concerned patients. But after a number of clinical trials, researchers have come out with a conclusion that steroids help in reducing pain to a considerable extent.

From medpage today:

For patients with plantar fasciitis, a notoriously difficult condition to treat, an Italian Team has come up with a novel approach that uses dry-needling combined with a steroid injection, researchers said here.

The study, however, had no control group, and Dr. Sconfienza said further research is needed, possibly comparing three groups: dry-needling alone, dry-needling with steroids, and no treatment.

“It’s an interesting approach, but they should still try to try to repeat the study [with a control group],” commented Philip O. Alderson, M.D., of Saint Louis University, who moderated the session at which the study was presented and was not involved in the research. “However, there is still such a good amount of pain relief [shown in this study] and it should be looked at further.”

The efficiencies of dry needling and steroids were assessed by researchers as they conducted a study of 44 patients in the age group of 35-80 years (who were unresponsive to previous therapies). The entire procedures took about 15 minutes. Patients were given local anesthesia guided by dry needling that was then pulled back to the perifascial soft tissues and 1 mL of triamcinolone acetonide 40 mg/mL was injected to reduce inflammation, Luca M. Sconfienza, M.D., of the University of Genoa, said.

This study has been seen as a progressive therapy for reduction of pain and associated symptoms. It is also believed that this is a novel method of treatment to cure even tennis elbow.

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Plantar fasciitis is the most common cause of heel pain. This happens when the long fibrous plantar fascia ligament along the bottom of the foot develops tears or very tiny cuts in the tissue resulting in pain and inflammation. This condition can now be treated with dry needling accompanied by steroid injection.

In the procedure, dry needling creates small amount of local bleeding and then an injection of steroids will be administered into the perifascial soft tissue.

From Medpage today:

For patients with plantar fasciitis, a notoriously difficult condition to treat, an Italian team has come up with a novel approach that uses dry-needling combined with a steroid injection, researchers said here.

Dry needling creates a small amount of local bleeding that helps to heal the fascia, and the accompanying steroid injected into the perifascial soft tissue, rather than directly into the fascia, reduces inflammation, Luca M. Sconfienza, M.D., of the University of Genoa, said at the Radiological Society of North America meeting.

To assess the efficacy of dry needling and steroids, the researchers conducted a study of 44 patients ages 35 to 80 who were unresponsive to previous therapy.

Of the 44 patients, who were followed for four to six months, 39 had a complete response two to three weeks after the treatment, Dr. Sconfienza said.

In the study of,Dr. Luca M. Sconfienza, of the University of Genoa, each patient was given local anesthetic before dry-needling guided by ultrasound perforemed. Dry-needling was done on the insertional portion of the plantar fascia and the periosteum to induce hyperemia. They then pulled the needle back into the perifascial soft tissues and injected 1 mL of triamcinolone acetonide 40 mg/mL to reduce inflammation.

According to Dr. Luca M. Sconfienza after about three weeks 39 had a complete response two to the treatment and only two patients didn’t respond to therapy.

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