J Korean Foot Ankle Soc.  2021 Dec;25(4):171-176. 10.14193/jkfas.2021.25.4.171.

A Prospective Study Comparing Steroid Injection and Needle Fenestration for the Treatment of Chronic Plantar Fasciitis

• Lee J
• Chung JW

• KMID: 2523298
• DOI: http://doi.org/10.14193/jkfas.2021.25.4.171

Abstract

Purpose
This study sought to compare needle fenestration with a corticosteroid injection for the treatment of chronic plantar fasciitis. We hypothesized that needle fenestration would be as effective as a corticosteroid injection while avoiding the potential adverse effects of the corticosteroid.
Materials and Methods
Forty female patients with unilateral chronic plantar fasciitis who did not respond to a minimum of 6 months of various conservative treatments were prospectively randomized to receive either a corticosteroid injection or needle fenestration. Visual analogue scale and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used for all patients before treatment and at 3-, 6-, and 12-month following treatment.
Results
The corticosteroid injection group had a before-treatment average AOFAS Ankle-Hindfoot score of 56.4, which increased to 87.3 at 3 months and 78.2 at 6 months after treatment but decreased to 62.4 at 12 months. The needle fenestration group had a before treatment average AOFAS ankle-hindfoot score of 49.5, which increased to 77.8 at 3 months and 92.1 at 6 months after treatment and remained at a high score of 89.4 at 12 months. There were no complications in either group.
Conclusion
In the treatment of chronic plantar fasciitis, needle fenestration is as effective at 3- and 6-month post-treatment as a corticosteroid injection. Also, unlike a corticosteroid, its effect remains until 12 months post-treatment.

Keyword

Corticosteroid; Dry needling; Injections; Plantar fasciitis

Figure

• 

  Figure. 1 Photographs of steroid injection shows the 21-gauge needle is positioned in plane, along the axis of the plantar fascia, parallel to the transducer.

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  Figure. 2 Photograph (A) and ultrasound image (B) show the 18-gauge needle is positioned over the long axis of the plantar fascia and the tip fenestrated the plantar facia at the insertion site to the calcaneus (arrow).

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  Figure. 3 Visual analogue scale and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score over the follow-up period.

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