Plantar fasciitis treatment: What is better, oral nonsteroidal anti-inflammatory agents or locally injectable steroid?

Author(s): Dr. Vaibhav Mittal, Dr. Nagakumar JS, Dr. Wayal Utkarsha Ashok and Dr. Arun HS

Abstract: Plantar fasciitis is the one of the most common causes of painful heel in adults. It is assumed to be caused by inflammation and is typically precipitated by biomechanical stress. Conservative management is the mainstream treatment option for plantar fasciitis like non steroidal anti-inflammatory drugs (NSAIDs), steroid injections, PRP injection, stretching exercises. There is no consensus on the efficacy of any particular conservative treatment regimen. This study was taken with objective to compare the efficacy of NSAID and local steroid injection in treating plantar fasciitis. Method: Sixty patients were randomized into 2 groups, group I patients were treat with oral NSAIDs and group II patients were treated with local steroid injection. Patients of both groups are given common supportive measures such as soft heel and advised same stretching exercises. The patients were evaluated using VAS score for pain assessment at pre-treatment stage, 1 week, 2 weeks, 4 weeks, 2 months and 3 months. Results: 60 patients were randomized into 2 groups, both groups had similar demographics. The VAS scores at pre treatment level in group I was 6.60±1.14 and in group II was 6.46±1.05. The VAS score reduced to 3.10±1.18 in group II after injection and in group I reduced to 4.9±1.33 after a starting oral NSAIDs. The VAS scores consistently reduced in both the groups till 4 weeks of follow up but group II VAS scores were always lower than group I (p-value < 0.001). After 4 weeks, a trend towards increase in VAS scores was noted in both groups, patients had complaints of relapse of pain or increase in intensity of it. Conclusion : With this study we concluded that as compared to NSAIDs the use of local injection of steroid gives better and more sustained pain relief with fewer complications and lesser recurrences of heel pain in cases of plantar fasciitis.

DOI: https://doi.org/10.22271/ortho.2018.v4.i1d.37