EFFECTS OF ULTRASOUND THERAPY ON PLANTAR FASCIITIS

Abstract

Background: One of the most frequent cause of heel pain is plantar fasciitis. A lots of treatment option is available for the treatment of this condition like NSAIDs, foot wear modification, exercise, ADL etc.

Objective: To observe the efficacy of ultrasound therapy in the treatment of planter fasciitis

Methods: Data was collected from each sufferer after taking informed written consent.Past history of illness & any systemic disease will be inquired cautiously. Clinical examination will be done systematically; Base line investigation will be done e.g. CBC, ESR & Hb%, RBS, Serum creatinine, Urine for R/M/E, serum uric acid, SGPT & RA factor. X-ray of the affected heel B/V view will be also done. All reports will be properly recorded in the data sheet.

The selected patients were divided randomly into the following two groups by the way of lottery. Group A (case) will be treated with NSAID + ultrasound therapy and Group B (Control) will be treated with NSAID only.

Treatment will be delivered as per scheduled. Evaluations will be made before the treatment and every 14 days interval. There will be 3 visits and these evaluations will be always performed by the same examiner.  In each visit patients will be assessed by the following parameters: 

• Pain Score(0-4)
• Pain frequency score (1-5)
• visual analog scale (VAS)

4)50 feet walking time, seconds

Use of analgesics, NSAID: Tab. Naproxen 250 mg twice daily after meal for pain relieve with Cap. Omeprazole 20 mg coverage for six weeks.

Ultrasound therapy: Ultrasound therapy with 1 Mega Hz, 1 W/cm² for 7-8 minutes on the painful area of foot every alternate day for six weeks.                                       

RESULTS:                                                                                                                                         

From the 70 patients, mean age were 42.42(±12.25) minimum age was 22 and maximum age was 60. In 21-30 years 17.14% were in group-A and group-B, in 31-40 years 28.57% were in group-A and 31.43 % in group-B. In 41-50 years 40% were in group-A and 31.43% were in Group-B. In 51-60 years 14.29% were in group-A and 20.0% were in group-B. Mean age was 40.42(±9.94) in group A and 44.42(±14.06) in Group B, minimum age was 22 and maximum age was 60. In group-A 42.86% were male and 57.14% were female, in group-B 85.71% were male and 14.19% were female. In group- A majority of them 25.71% were house wife, followed by 40% were service holder,17.14% were  student and 8.57% were business man. In group –B   majority of them 37.14% were service holder, 17.14% were student and business man each. 14.29% were day labourers and 11.43% were farmers. In group –A majority of respondent come from middle class socioeconomic family and in group –B 54.29% were from middle class family. 71.43% come from middle socio-economic condition in group-A and group-B.  In this study mean pain score of pretreatment in group-A were 14.31(±2.33) and 13.40(±1.68) were in group-B, p value was (p>0.05) that was not statistically significant. Mean pain score in first follow up 10.80(±1.43) were in group-A and 10.48(±1.42) were in group-B. p value was (p>0.05) that was statistically not significant. That mean group-A is significantly better than group-B in first follow up but not different in pretreatment. Mean pain score of 2^nd follow up in group-A were 8.02(±1.31) and 8.65(±1.31) were in group-B, p value was (p<0.05) that was statistically significant. Mean pain score in 3^rd follow up 4.68(±1.58) were in group-A and 6.74(±1.89) were in group-B. P value was (p<0.05) that was statistically significant. That mean group-A is significantly better than group-B 2^nd and 3^rd follow up.

Conclusion: It may be concluded that from this study, ultrasound therapy is beneficial for plantar fasciitis.

Key Word: Plantar Fasciitis, Ultrasound, NSAIDs, Seronegetive arthropathy, VAS score.