eISSN: 2077-9135 / ISSN: 1681-5491
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Medical Channel Journal
2013, Volume 19, Issue 4 : 37-41
Research Article
Local steroid injection for treatment of planter fasciitis. Comparison between methylprednisolone and dexamethasone
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1
Department of Orthopedic Surgery and Traumatology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan
2
Sindh Services Hospital, Karachi, Pakistan
Abstract

Background: Plantar fasciitis causes medial heel pain which is severe with the first few steps in the morning and after long duration of rest.It affects about 10% of population and makes 15% of all foot complaints in adults. It is usually treated by conservative methods. These include, anti inflammatory medication, prefabricated foot orthosis, customized functional foot orthosis, corticosteroid injection, physical therapy, stretching exercises, and extracorporeal shock wave therapy. Despite the widespread use of corti-costeroid injection we have found very few studies comparing various types of steroids available. The aim of our study was to compare the effects of methylprednisolone acetate and dexamethasone in the treatment of planter fasciitis. Material & Methods: The inclusion criteria was adult patients of either sex having pain in heel for a minimum period of 12 weeks and were not satisfied with the treatment received during that period Patients were randomized in two groups, A and B. Patients in Group A were injected with a mixture of 1cc(40 mg) methylprednesolone and 1cc of 2% lignocain.Patients in Group B, were injected with a mixture of 1ml of 4mg/ml of dexamethasone phosphate and 1cc of 2% lignocain. Patients were called for follow up examination at 4,8, & 12 weeks. Pain was recorded on visual analog scale (VAS) with 0 as no pain, 1to 20 as mild, 21to40 as moderate, 41 to 60 as sever and 61 to 100 as very severe pain. The results were recorded as good if the patients has no pain at 4,8 and 12 weeks, fair if there is significant decrease in pain by 4to 8 weeks and no pain at 12 weeks, and poor if there is some relief at 4 and no relief at 8 and 12 weeks after injection. Results: A total of 60 patients were recruited in the study. Thirty four(56.66%) were male and 26(43.33%) female. Thirty patients were placed in each group. The age range was between 35 to 65 years, (mean 48.267+ 8.517). The results were assessed in terms of pain, adverse events, at 4,8, and 12 weeks. Twelve weeks after injection, 90% in group A and 26.66% in group B had no pain, 0% in group A and 43.33% in group B had mild pain, 0% in group A and 10% in group B had moderate pain, and 10% in group A and 20% in group B had severe pain. (VAN group A 5.33+16.344, group B 19.5000+19.08917. P value 0.010.)The results in group A were, Good in 24,fair in 3 and poor in 3 patients. In group B the results were good in 4, fair in 4 and poor in 22 patients. Conclusion: local methylprednisolone injection is superior to local dexamethasone injection, in providing short term pain relief to the patients with planter fasciitis.

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