Tuesday 3 March 2015

Ultrasound Treatment May Be Option for Plantar Fasciitis

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Most patients found relief from foot pain in short study, but longer trials are needed, experts say


WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

SUNDAY, March 1, 2015 (HealthDay News) -- An ultrasound technique is showing early promise as a quick and minimally invasive treatment for the common and painful foot condition known as plantar fasciitis.

The finding is based on a short-term study involving just 65 patients, the researchers noted.

"While the long-term outcome studies are in progress, the results we have seen to date are very promising," said study lead author Dr. Rahul Razdan, an interventional radiologist with Advanced Medical Imaging in Lincoln, Neb.

The American Orthopaedic Foot and Ankle Society describes plantar fasciitis as essentially an "overuse injury" resulting from inflammation of a band of tissue in the sole of the foot that links the heel bone to the base of the toes.

According to Razdan, standard treatment includes painkillers, cortisone shots, icing, heating, massage, silicone arch supports, and physical therapy centered on the benefits of controlled stretching. For some patients, invasive surgery is another option.

Dr. Raymond Monto is an orthopedic surgeon at Nantucket Cottage Hospital in Nantucket, Mass. He said that about 85 percent of patients will recover from plantar fasciitis with sufficient rest and standard treatment. However, the remaining 15 percent are so-called "problem patients" for whom typical treatments fail to provide relief.

"So when you're looking at chronic cases of disabling morning pain lasting three or four months or more, then absolutely it is warranted to explore new treatment options," said Monto, "because the treatments we currently have are just not that great for these kind of stubborn cases."

Razdan said the new ultrasound therapy is an entirely "novel approach" that uses ultrasonic energy to cut and remove damaged, pain-generating tissue while sparing healthy foot tissue.

In the study, Razdan's team tested the procedure on 65 patients who sought care at an interventional radiology clinic in 2013 and 2014.

All had chronic plantar fasciitis, and all had failed to respond to standard treatments.

During the ultrasound therapy, doctors guided a hollow needle tip into an area of "problem" tissue by means of ultrasound guidance. Once in position, the tip targeted a combination of high frequency/low amplitude sound to the damaged foot region. That broke up the pain-generating tissue, which was then extracted out of the foot.



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