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European Journal of Physical and Rehabilitation Medicine 2014 February;50(1):39-47

Copyright © 2014 EDIZIONI MINERVA MEDICA

lingua: Inglese

Cryoultrasound therapy in the treatment of chronic plantar fasciitis with heel spurs. A randomized controlled clinical study

Costantino C. 1, Vulpiani M. C. 2, Romiti D. 1, Vetrano M. 2, Saraceni V. M. 2

1 Rehabilitation Medicine, Department of Clinical and Experimental Medicine, Parma University Hospital, Parma, Italy; 2 Physical Medicine and Rehabilitation Unit, La Sapienza University of Rome, Sant’Andrea Hospital, Rome, Italy


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Background: Plantar fasciitis is one of the most common causes of pain in the inferior heel and is very frequent in some running sports. It affects up to 10% of general population and accounts for 11% to 15% of all foot pain symptomatology. Several treatments have been suggested, but there is no evidence supporting a specific conservative management strategy.
Aim: Evaluation of the efficacy of combined cryoultrasound therapy on chronic plantar fasciitis with heel spurs resistant to pharmacological and instrumental therapies.
Design: Single-blind randomized clinical trial.
Population: 102 consecutive patients affected by chronic plantar fasciitis with painful symptomatology for at least 6 months, intensity of pain higher than 5 on the VAS score, presence of heel spurs, use of plantar orthoses and ineffectiveness of previous therapies.
Methods: The patients were randomized into two groups: Group A treated with cryoultrasound therapy and Group B with cryotherapy. Our protocol was based on 10 daily treatments, lasting 20 minutes. Each participant was evaluated using VAS score before (T0) the treatment and 3 months (T1), 12 months (T2) and 18 months (T3) after. Effectiveness index was calculated from T1 to T3.
Results: Both treatments have been found effective. The difference in pain intensity on the VAS scale between the two groups at T2 was 4.35 points in favor of Group A (IC 95% 3.75; 4.95; P<0.001), reaching the primary end point. The difference in pain intensity on the VAS scale between the two groups at T1, T2 and T3 was 3.00, 4.35 and 4.81 respectively, showing a statistically significant difference between VAS average scores at all follow-ups in favor of Group A. Scores of at least 66% at the effectiveness index were only achieved in Group A (P values <0.001).
Conclusion: Cryoultrasound therapy could be an efficient treatment option for chronic plantar fasciitis.
Clinical Rehabilitation Impact: Cryoultrasound therapy promises an effective and long-lasting clinical improvement in patients with chronic plantar fasciitis, granted its high therapeutic efficiency, patients’ satisfaction, its limited cost and its short and repeatable protocol of use.

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