Investigación clínica sobre pie y tobillo

Abstracto

Evidence Based use of Heat, Cold and NSAIDS for Plantar Fasciitis

Jerrold S. Petrofsky, Michael S. Laymon, Faris Alshammari and Iman Akef Khowailed

Plantar Fasciitis is a possible complication in runners and even people who walk a lot. There have been numerous proposed therapies to treat this disorder but the independent effect of heat, cold and NSAIDS have not been examined without the concomitant use of other modalities. Here we examined the effect of heat, cold and Advil independently of other therapies on plantar fasciitis.

Objective: Subjects with plantar fasciitis either had no intervention, cold applied 20 min at night before bed, or 20 min in the morning upon wakening or either moist heat at night or in the morning (1 h) or dry heat (4 h) at night for 1 day or 3 days with and without Advil. Plantar fascia swelling, tenderness and pain were evaluated.

Methods: Visual analog pain scale, plantar facial thickness was measured by ultrasound as a measure of inflammation, the pressure tolerated by force on the plantar fascia from an algometer were measured first thing in the morning. An activity of Daily Living Subscale of the Foot and Ankle Ability Measure (FAAM-ADL) questionnaire was used for assessing disability. There were 99 subjects in 9 groups. All post intervention measurements were taken first thing in the morning before activity.

Results: The greatest relief of symptoms was with the application of cold used at bedtime the night before the measurements, cold used in the morning was not as effective as was heat. Cold use reduced the thickness of the plantar fascia and pain. Cold plus Ibuprofen were significantly better at reducing plantar fascia symptoms than cold alone. Conclusion: Cold applied for 20 min prior bedtime was the most effective treatment for reduced symptomology caused by plantar fascia inflammation. Advil further reduces pain when used with cold.