mobiflex and Fasciitis--Plantar

For active individuals, plantar fasciitis (PF) is one of the most clinically diagnosed causes of heel pain. When conservative treatment fails, one of the next most commonly used treatments includes corticosteroid injections. Although PF has been identified as a degenerative condition, rather than inflammatory, corticosteroid injection is still commonly prescribed. However, the literature has not been examined to determine the effect of corticosteroid injection on PF. Focused Clinical Question: Are corticosteroid injections more effective than other interventions (placebo, platelet-rich plasma, and tenoxicam injections) in the short- and long-term treatment of PF? Summary of Key Findings: Corticosteroid injections are not more effective in the long-term treatment of PF pain than other treatments (platelet-rich plasma, tenoxicam). Clinical Bottom Line: The level 2 and 3 evidence shows that corticosteroids are more effective than placebo injections but are no more effective than tenoxicam injections and perhaps less effective than platelet-rich plasma treatment.. Level 2 and 3 evidence suggests that corticosteroid injections are not more effective in the long-term treatment of PF than platelet-rich plasma or tenoxicam.

Topics: Adrenal Cortex Hormones; Anti-Inflammatory Agents; Fasciitis, Plantar; Humans; Injections; Piroxicam; Platelet-Rich Plasma; Treatment Outcome

Plantar fasciitis is one of the most common causes of foot pain in adults. In this prospective study, the outcomes of local tenoxicam injection and corticosteroid therapy for the treatment of plantar fasciitis were compared. Patients were randomly assigned to either the tenoxicam or corticosteroid group. The tenoxicam group (n=31) was treated using a local injection of 1 mL of tenoxicam (20 mg/2 mL) and 1 mL of 2% lidocaine, whereas the steroid group (n=30) was treated with a local 1-mL injection containing 40 mg of methylprednisolone acetate and 1 mL of 2% lidocaine. Clinical evaluations, which were performed before the injection and 6 and 12 months after the injection, consisted of patient-assessed pain using a visual analog scale. In addition, patient satisfaction was measured using the Roles and Maudsley score. Comparison of pre- and posttreatment visual analog scale scores demonstrated a statistically significant difference in both groups (P<.05). Furthermore, no significant difference was found between the steroid and tenoxicam groups in terms of visual analog scale scores measured 12 months after injection (P>.05). The tenoxicam injection was not significantly more effective than the corticosteroid injection. However, both methods were effective and successful in treating patients with plantar fasciitis. Tenoxicam therapy appears to provide pain relief, but its effectiveness in the long term should be explored in additional studies.

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents, Non-Steroidal; Fasciitis, Plantar; Female; Humans; Injections, Intralesional; Male; Middle Aged; Piroxicam; Prospective Studies; Young Adult