Phonophoresis Plus Topical Nitroglycerin Versus Hydrocortisone for the Management of Plantar Fasciitis: A Randomized Controlled Trial
DOI:
https://doi.org/10.31661/gmj.v10i.2072Keywords:
Plantar Fasciitis; Phonophoresis; Nitroglycerin; HydrocortisoneAbstract
Background: Plantar fasciitis (PF), is the most common reason for inferior heel pain. Various approaches have been raised for the treatment of PF; however, none had substantial outcomes. The current study aims to assess and compare phonophoresis outcomes plus topical nitroglycerin versus phonophoresis plus topical hydrocortisone for PF management. Materials and Methods: The current randomized clinical trial was conducted on 65 patients with PF diagnosis, who underwent ten every-other-day treatment sessions with phonophoresis plus 20mg nitroglycerin (n=33) or 20mg hydrocortisone (n=32), respectively. The Modified Roles and Maudsley (RM) score and the visual analog scale (VAS) were compared between the two groups at baseline, three weeks, and two months after the interventions. Besides, the plantar fascia thickness was measured at baseline and two months after the intervention. Results: The baseline RM (P=0.067) and pain severity (P=0.057) was similar between the two groups, but other assessments revealed the superiority of phonophoresis plus topical nitroglycerin over topical hydrocortisone (P<0.05). The reduction in plantar fascia thickness was more in phonophoresis plus nitroglycerin-treated patients as compared to the latter group (P<0.001), but the requirement of additional doses of analgesia was remarkably more in hydrocortisone-treated patients (P<0.001). Conclusion: Based on the current study, phonophoresis plus topical nitroglycerin was superior to phonophoresis plus topical hydrocortisone in pain relief, improved quality of life, and decreased fascia thickness. However, further investigations are required to achieve the ultimate outcomes for a more extended period.
[GMJ.2021;10:e2072]
References
Ibrahim MI, Donatelli RA, Schmitz C, Hellman MA, Buxbaum F. Chronic plantar fasciitis treated with two sessions of radial extracorporeal shock wave therapy. Foot Ankle Int. 2010;31(5):391-7. https://doi.org/10.3113/FAI.2010.0391PMid:20460065 Gonnade N, Bajpayee A, Elhence A, Lokhande V, Mehta N, Mishra M, et al. Regenerative efficacy of therapeutic quality platelet-rich plasma injections versus phonophoresis with kinesiotaping for the treatment of chronic plantar fasciitis: A prospective randomized pilot study. Asian J Transfus Sci. 2018;12(2):105-11. https://doi.org/10.4103/ajts.AJTS_48_17PMid:30692793 PMCid:PMC6327765 Canyilmaz E, Canyilmaz F, Aynaci O, Colak F, Serdar L, Uslu GH, et al. Prospective randomized comparison of the effectiveness of radiation therapy and local steroid injection for the treatment of plantar fasciitis. Int J Radiat Oncol Biol Phys. 2015;92(3):659-66. https://doi.org/10.1016/j.ijrobp.2015.02.009PMid:25936814 Adi QA, Salman S, Resheed J. Topical Nitroglycerin in Treatment of Plantar Fasciitis. Iraqi J Sci. 2013;12(supplement):751-9. Tahririan MA, Motififard M, Tahmasebi MN, Siavashi B. Plantar fasciitis. Journal of research in medical sciences. J Res Med Sci. 2012;17(8):799-804. Chawla JS, Singh M, Ummat A, Goyal M, Kaur H, Verma V. Effectiveness of Calf Stretching Exercises Versus Plantar Fascia Stretching Exercises in Plantar Fasciitis: An Experimental Study. Indian J Public Health Res Dev. 2020;11(2):884-9. https://doi.org/10.37506/v11/i2/2020/ijphrd/194927 Trojian T, Tucker AK. Plantar fasciitis. Am Fam Physician. 2019;99(12):744-50. Ragab EM. A comparative study between endoscopic plantar fasciotomy and platelet-rich plasma for treatment of resistant plantar fasciitis. Egypt Orthop J. 2018;53(4):303-9. Chen C-M, Lee M, Lin C-H, Chang C-H, Lin C-H. Comparative efficacy of corticosteroid injection and non-invasive treatments for plantar fasciitis: a systematic review and meta-analysis. Sci Rep. 2018;8(1):1-9. https://doi.org/10.1038/s41598-018-22402-wPMid:29507320 PMCid:PMC5838257 Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Medicine (Baltimore). 2017;96(15):e6621. https://doi.org/10.1097/MD.0000000000006621PMid:28403111 PMCid:PMC5403108 Chellammal K. Effect of phonophoresis and myofascial release in plantar fasciitis: comparitive study: Cherraan's College of Physiotherapy, Coimbatore; 2012. Deshpande MM, Patil C. Heel pain and phonophoresis. J Indian Med Assoc. 2010;108(6):365. Cardoso TB, Pizzari T, Kinsella R, Hope D, Cook JL. Current trends in tendinopathy management. Best Pract Res Clin Rheumatol. 2019;33(1):122-40. https://doi.org/10.1016/j.berh.2019.02.001PMid:31431267 Challoumas D, Kirwan PD, Borysov D, Clifford C, McLean M, Millar NL. Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review. BMJ Open Sport Exerc Med. 2019;53(4):251-62. https://doi.org/10.1136/bjsports-2018-099552PMid:30301735 PMCid:PMC6362607 Londeen M. Therapeutic Ultrasound: The Effectiveness of Ultrasound and the Importance of Parameter Settings.North Dakota State University of Agriculture and Applied Science. 2013. Sreeraj S, Bellare B, Ray I. A Review on Ultrasound Parameters and Methods of Application in Transdermal Drug Delivery. Int J Health Sci Res. 2015;5(5):476-85. Cardoso L, Pinto N, Nobre M, Silva M, Pires G, Lopes M, et al. Anti-inflammatory and antinociceptive effects of phonophoresis in animal models: a randomized experimental study. Braz J Med Biol Res. 2019;52(2):e7773. https://doi.org/10.1590/1414-431x20187773PMid:30698227 PMCid:PMC6345359 Tabatabaiee A, Ebrahimi-Takamjani I, Ahmadi A, Sarrafzadeh J, Emrani A. Comparison of pressure release, phonophoresis and dry needling in treatment of latent myofascial trigger point of upper trapezius muscle. J Back Musculoskelet Rehabil. 2019;32(4):587-94. https://doi.org/10.3233/BMR-181302PMid:30584120 Ch S. Effect of Pressure Release and Positional Release with Phonophoresis in Management of Myofascial Trigger Point of Trapezius. Int J Clin Ski. 2020;14(2):306-11. Shingala M, Gill MA. Effectiveness of Iontophoresis and Phonophoresis on Pain in Patients with Lateral Epicondylitis: A Comparative Study. Indian J Physiother Occup Ther. 2018;12(3):33-7. https://doi.org/10.5958/0973-5674.2018.00052.7 Meshali M, Abdel-Aleem H, Sakr F, Nazzal S, El-Malah Y. Effect of gel composition and phonophoresis on the transdermal delivery of ibuprofen: in vitro and in vivo evaluation. Pharm Dev Technol. 2011;16(2):93-101. https://doi.org/10.3109/10837450903499358PMid:20100032 Macri EM, Hart HF, Thwaites D, Barton CJ, Crossley KM, Bierma-Zeinstra S, et al. Medical Interventions for Patellofemoral Pain and Patellofemoral Osteoarthritis: A Systematic Review. J Clin Med. 2020;9(11):3397. https://doi.org/10.3390/jcm9113397PMid:33114034 PMCid:PMC7690719 Waked IS, Nagib SH, Ashm HN. Triamcinolone Acetonide Phonophoresis versus Transcutanous Electrical Nerve Stimulation in the Treatment of Post-burn Pruritus-A Randomised Controlled Study. Indian J Physiother Occup Ther. 2013;7(2):87-92. https://doi.org/10.5958/j.0973-5674.7.2.019 Bokhari AR, Murrell GA. The role of nitric oxide in tendon healing. JSES Int. 2012;21(2):238-44. https://doi.org/10.1016/j.jse.2011.11.001PMid:22244067 Jun D, Meng L, Xijing H, Jie Q, Junkui X, Zhijian C, et al. Five-year practical experience on treatment of spinal cord injury: A review of literature. Am J Neuroprot Neuroregen. 2013;5(1):4-16. https://doi.org/10.1166/ajnn.2013.1062 Baktir S, Ozdincler AR, Mutlu EK, Bilsel K. The short-term effectiveness of low-level laser, phonophoresis, and iontophoresis in patients with lateral epicondylosis. J Hand Ther. 2019;32(4):417-25. https://doi.org/10.1016/j.jht.2018.01.002PMid:29452929 Ahmed MAS, Saweeres ESB, Abdelkader NA, Abdelmajeed SF, Fares AR. Improved pain and function in knee osteoarthritis with dexamethasone phonophoresis: A randomized controlled trial. Indian J Orthop. 2019;53(6):700-7. https://doi.org/10.4103/ortho.IJOrtho_639_18PMid:31673169 PMCid:PMC6804376 Frizziero A, Causero A, Bernasconi S, Papalia R, Longo M, Sessa V, et al. efficacy of betamethasone valerate medicated plaster on painful chronic elbow tendinopathy: a double-blind, randomized, placebo-controlled trial. Muscles Ligaments Tendons J. 2016;6(1):131-9. https://doi.org/10.32098/mltj.01.2016.16PMid:27331041 PMCid:PMC4915452 Dean BJ, Lostis E, Oakley T, Rombach I, Morrey ME, Carr AJ. The risks and benefits of glucocorticoid treatment for tendinopathy: a systematic review of the effects of local glucocorticoid on tendon. Semin Arthritis Rheum. 2014;43(4):570-6. https://doi.org/10.1016/j.semarthrit.2013.08.006PMid:24074644
