Pain Clinical Trial
Official title:
Comparison of the Different Conservative Therapy Interventions in Plantar Fasciitis
Plantar fasciitis is seen common in clinics and responsible from most of foot related pain problems. There are many treatment modalities in the literature as well as there is no golden standard to treat plantar fasciitis in non-surgical ways. The aim of this study is to compare intensive physiotherapy program, home based exercise program and control group decide the most effective rehabilitation program in plantar fasciitis.
Plantar fasciitis is frequently seen in adult population as a pain related problem of the
foot. Pain, as a most prominent symptom, is caused from repetitive microtraumas and
inflammation where plantar fascia attaches to the calcaneus. Pain starts from heel pad or
medial tubercule of the calcaneus and spreads through plantar fascia and medial longitudinal
arch.
Obesity, increased foot pronation, difference in extremity length, long standing duration and
Achilles tendon tightness are some of the factors which stress plantar fascia and sometimes
cause degenerative changes on it. Weakness of intrinsic muscle is also another factor which
is thought to be related with plantar fasciitis.
Diagnosis is mostly depends on history and physical examination. First steps in the morning,
walking after long rest, and palpation of medial tubercule of calcaneus are painful.
According to the literature, non-surgical treatment modalities relieve symptoms of patients
successfully. Orthotics, night splints, manipulation interventions with conventional methods
are effective to decrease pain and improve function. There are various physiotherapy
treatment approaches in plantar fasciitis but there is no consensus about most effective
treatment program. Stretching of plantar flexor muscles and plantar fascia is one of the core
elements of the treatment plan. Strengthening exercises together with stretching were shown
more effective than only stretching. Foot orthoses are thought to prevent increased pronation
and relieving stress on plantar fascia in patients with plantar fasciitis. Usage of insoles
with night splints is found more effective. Taping is also helpful to acute pain control.
Short foot exercises as isolated intrinsic foot muscles strengthening helps to providing
subtalar foot position and supports plantar fascia and foot arches. Manual techniques improve
lower extremity joint mobility and decreases related pain. Extracorporeal Shock Wave Therapy
is suggested to try after at least six month ineffective conservative treatments. If symptoms
resist more than six months and non-conservative treatments are found ineffective, invasive
approaches as steroid injections are applicable.
Treatment of this common problem in population is important to ensure patients returning in
earliest period to daily life with full physical capacity. There are many conservative
options to treat plantar fasciitis but best treatment program combination was not clear The
aim of this study is to compare intensive physiotherapy program, home based exercise program
and control group decide the most effective rehabilitation program in plantar fasciitis.
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