The Effects of Pain Neuroscience Education with Conventional Physical Therapy on Chronic Plantar Fasciitis: A Case Study

Background and Purpose: Plantar Fasciitis (PF) is a condition that affects the foot and causes complaints such as pain and stiffness. The most common symptom of this condition is pain. There are many treatment options to deal with this condition, such as conservative therapy, medications, and surgical interventions in rare cases. This case study aims to investigate the potential impact of pain neuroscience education (PNE), combined with a conventional Physical Therapy (PT) program on a 37-year-old-patient with chronic plantar fasciitis. Case description: A 37-year-old male health care professional presented to an outpatient physical therapy clinic with a diagnosis of chronic PF for around two years. The participant had tried several treatment options with no improvement of his symptoms. After undergoing a physical therapy evaluation, he was given a plan of care for twelve sessions by a skilled physical therapist for a six-week period, with each session consisting of 30 minutes of conventional PT, followed by 5 to 15 minutes of PNE. Results: After completing the prescribed plan of care, the patient reported a reduction in subjective symptoms via the Visual Analog Scale (VAS). He also reported improvement with symptoms and functional independence via the Foot Function Index (FFI). The patient reported no change in the quality of sleep via Pittsburg Sleep Quality Index (PSQI). Lastly, he demonstrated no objective improvement in foot pressure with the Navicular Drop Test. Discussion: This case report indicates that PNE, combined with conventional PT for PF can have a positive impact on subjective pain and foot function. PNE should involve many topics about the physiology of pain and the nervous system and should be administered by a certified therapeutic pain specialist. Further studies are recommended to investigate the impact of this intervention in combination with traditional PT for PF in larger populations.

Research progress of extracorporeal shock wave therapy for plantar fasciitis

Plantar fasciitis is a common and frequently occurring disease in clinic.It is a kind of local aseptic inflammation caused by chronic strain.In severe cases,pain is unbearable,which affects the quality of life of patients.Extracorporeal shock wave(ESW)is a new non-invasive treatment for bone and muscle diseases.It can significantly relieve the pain and other symptoms of patients with plantar fasciitis,and promote the functional recovery of patients.In order to provide reference for the clinical treatment of plantar fasciitis,this paper reviews the literature of extracorporeal shock wave treatment of plantar fasciitis at home and abroad.

Use of orthotics with orthotic sandals versus the sole use of orthotics for plantar fasciitis:Randomised controlled trial

BACKGROUND Plantar fasciitis(PF)affects around 10%of the population.Prefabricated orthotics with arch support has been shown to provide symptom relief in PF by decreasing the repetitive stress sustained by the plantar fascia.However,prefabricated orthotics are only effective when shoes are worn,meaning the foot may be left unsupported when it is impractical to wear shoes.Using orthotic sandals in conjunction with prefabricated orthotics may increase PF symptom relief,as they can be worn inside the home,extending the period in which the foot is supported.AIM To compare the combined use of prefabricated orthotics and orthotic sandals vs the sole use of prefabricated orthotics in the treatment of PF.METHODS 98 participants with PF were randomised into two groups.The intervention group received the Aetrex L420 Compete orthotics and the Aetrex L3000 Maui Flips(orthotic sandals),whilst the control group received the Aetrex L420 Compete orthotics only.Foot pain was assessed both by the numerical rating scale(NRS)and the pain sub-scale of the foot health status questionnaire(FHSQ).Foot functionality was measured using the function sub-scale of the FHSQ.Symptom change was measured using the global rating of change scale(GROC).RESULTS Foot pain scores measured both by NRS and FHSQ pain sub-scale showed statistically significant reductions in foot pain in both groups(P<0.05)at six months.Both groups also reported statistically significant improvements(P<0.05)in function as measured by the FHSQ function subscale and improvement of symptoms as measured by the GROC scale.Between-group analysis showed that the intervention group with the combined use of orthotics and orthotic sandals scored better on all four outcome measures as compared to the control group with the sole use of orthotics.However,the between-group analysis only reached statistical significance on the NRS pain score(P<0.05).CONCLUSION Combined use of prefabricated orthotics and orthotic sandals provides a greater decrease in foot pain and improvement in foot function in PF compared to using prefabricated orthotics alone.

Minimally invasive treatment of the KobyGard system for plantar fasciitis： a retrospective study

Background Calcodynia is a persistent condition that podiatric surgeons frequently see among their patients, and plantar fasciitis is the main reason for pain. When systematic conservative treatments fail to alleviate these conditions, it requires surgical intervention, mainly plantar fascia release surgery, which used to be an open heel release surgery. This study aimed to investigate whether minimally invasive treatment of the KobyGard system is more safe and effective for plantar fasciitis. Methods From May 2009 to May 2012, a total of nine patients, three males and six females with plantar fasciitis, were treated in the Peking University People＇s Hospital with minimally invasive instruments, the KobyGard system, for the release of plantar fascia. Three patients, experiencing bilateral calcaneodynia, underwent bilateral surgery. One patient had bilateral calcaneodynia with enthesiopathy of Achilles tendon, and underwent Achilles tendon surgery. Preoperative and postoperative Visual Analogue Scale （VAS）, American Orthopaedic Foot and Ankle Society （AOFAS） ankle and hindfoot scores, Roles and Maudsley scores and SF-36 questionnaires were evaluated. Results The nine patients were successfully followed up. The average postoperative follow-up time was 13.2 months and it varied from 2.0 months to 21.0 months. Pre- and postoperative average scores of VAS was 9.3 and 1.9 （P 〈0.001）, respectively. Pre- and postoperative average scores of AOFAS hind foot was 36.0 and 82.0 （P 〈0.001）, respectively. There was also a statistically significant amelioration in SF-36 scores and the Roles and Maudlesy scores. Eight patients were satisfied with the surgery outcome. Conclusion Minimally invasive surgery treatment of the KobyGard system for plantar fasciitis has the advantages of shorter operation time, ease of operation, and similar satisfaction rates with open surgery, but with smaller surgical incision.

Ultrasound-Guided Plantar Fascia Release with Needle: A Novel Surgical Technique

The purpose of this study was to assess the effectiveness of a new procedure, ultrasound-guided partial plantar fasciotomy with needle for plantar fasciosis. Methods: This study was carried out on 16 patients, 9 men and 7 women, with average age 47.5, diagnosed with plantar fasciosis, who were treated through ultrasound-guided partial plantar fasciotomy using multiple perforations. Clinical assessments and ultrasounds of all patients were carried out before treatment, after a week, then after 1, 3 and 12 months. For the clinical assessment the Visual Analogue Scale (VAS) and the Foot and Ankle Disability Index (FADI) were used. Results: There was significant progress at 95% (Greenhouse-Geisser p < 0.001) of the VAS and the FADI during the study. We had no nerve or other complications: paraesthesia of the entry portal or vascular lesions. Conclusion: Ultrasound- guided partial plantar fasciotomy using multiple perforations is a safe technique, with very satisfactory preliminary results, reducing recovery times and time off work. The technique can be performed in the specialist’s consultation room with local anaesthesia, without the need for stitches and with very fast recovery, thus reducing costs. It can be performed on patients with underlying pathology such as diabetes mild to moderate, vascular insufficiency, heart disease or other comorbidities, so this technique could be an improvement on other open plantar fasciotomy surgical techniques.

Effects and mechanism of platelet-rich plasma on military drill injury: A review

Military drill injury is a significant part of military medical research.The increase of training intensity and changes in training methods lead to differences in injury types.The ideal therapeutic modality should allow rapid healing at a reasonable cost and minimize impact on patients’life.Platelet-rich plasma(PRP),a platelet concentrate,is rich in a variety of growth factors and widely used clinically as a minimally invasive treatment.It plays an important role in injury repair and rehabilitation.In this article,we review the therapeutic role of PRP in military drill injury and its possible underlying mechanisms,with a focus on plantar fasciitis,stress fractures and other common injuries,in order to provide basic support for military reserve.