Comparison of a physiotherapy program versus dexamethasone injections for plantar fasciopathy in prolonged standing workers

The plantar fascia ligament is a connective tissue band providing support for the longitudinal arch of the foot during weight bearing. Plantar fasciopathy is common in people who have to stand for long hours on the job, with chronic disease characterized by focal tenderness over the medial plantar arch and heel. The study authors performed a nonblinded, randomized trial to determine effectiveness of physiotherapy vs corticosteroid injection for treatment of chronic plantar fasciopathy. 

56 workers with chronic plantar fasciopathy who stood for over 5 hrs/day were recruited. Ultrasound was used to confirm the diagnosis of plantar fasciopathy. The physiotherapy group were taught 7 exercises; karaoke, balance walking, forefoot extension, 1-legged standing, ankle inversion/eversion, gastrocnemius/soleus stretch and plantar fascia stretch. The injection group received a steroid injection and then did a daily calf stretching program. Outcome was measured using the Foot and Ankle Disability Index (FADI) and visual analog pain scale (VAS). 

There was no difference in FADI or VAS in either group, suggesting that a multielement physiotherapy program may be equally effective to steroid injection in treatment of chronic plantar fasciopathy. > From: Ryan et al., Clin J Sport Med 24 (2014) 211-217. All rights reserved to Lippincott William & Wilkins.

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