Choice of treatment for «hard-to-treat» cases of plantar fasciitis

Objective: to develop an algorithm for choosing a treatment method for "difficult" cases of plantar fasciitis. Materials and methods. The clinical research included 40 patients with plantar fasciitis. These patients had so-called «hard-to-treat» cases of plantar fasciitis. These are: patients previously treated with local hormone injections or FSWT. There was no effect from the treatment. Depends on the clinical picture, the patients were divided into 3 groups: the main group (n=20) - patients with «hard-to-treat» cases, who underwent combined focused(FSWT) and radial shock wave therapy(RSWT); compare group (n=10) - patients who received only FSWT; control group(n=10) - patients who underwent local injection of hormones. Results. It was found that that the complex treatment of plantar fasciitis with radial and focused shock wave therapy in patients in «difficult cases» allows obtaining satisfactory results in 97% of patients 4 weeks after the end of treatment. This is significantly higher than with treatment with only focused shock wave and local hormone therapy (p<0.05). Moreover, hormone therapy was effective only in 4 (40%) patients who had previously received shock wave therapy. In patients with previous local injection of hormones, it was ineffective. Only focused shock wave therapy relieved pain syndrome in 6 (60%) patients. Conclusion. The study of the results of the treatment of «difficult» cases of plantar fasciitis by the method of radial and focused shock waves in combination, as well as only by the method of focused shock wave therapy and local injection with hormones will allow us to form an algorithm for the treatment of such patients to increase the number of satisfactory results.

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