Donley Brian G, Moore Tim, Sferra James, Gozdanovic Jon, Smith Richard
Orthopaedic Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk A40, Cleveland, OH 44195, USA.
Foot Ankle Int. 2007 Jan;28(1):20-3. doi: 10.3113/FAI.2007.0004.
Plantar fasciitis frequently responds to a broad range of conservative therapies, and there is no single universally accepted way of treating this condition. Modalities commonly used include rest, ice massage, stretching of the Achilles tendon and plantar fascia, nonsteroidal anti-inflammatory medications (NSAIDs), corticosteroid injections, foot padding, taping, shoe modifications (steel shank and anterior rocker bottom), arch supports, heel cups, custom foot orthoses, night splints, ultrasound, and casting. To our knowledge, no prospective, randomized, placebo controlled double-blind study has evaluated the efficacy of oral NSAIDs in the treatment of plantar fasciitis.
Twenty-nine patients with the diagnosis of plantar fasciitis were treated with a conservative regimen that included heel-cord stretching, viscoelastic heel cups, and night splinting. They were randomly assigned to either a placebo group or an NSAID group. In the NSAID group, celecoxib was added to the treatment regimen.
Pain and disability mean scores improved significantly over time in both groups, although there was no statistical significance between the placebo and NSAID groups at 1, 2, or 6 months. There was a trend towards improved pain relief and disability in the NSAID group, especially in the interval between the 2 and 6-month followup. Pain improved from baseline to 6 months by a factor of 5.2 and disability by 3.8 in the NSAID group compared to 3.6 and 3.5, respectively, in the placebo group. Even though at baseline the pain and disability scores were higher in the NSAID group, the final pain and disability scores were subjectively lower in the NSAID group than in the placebo group (1.43 for pain and 1.16 for disability in the NSAID group, compared to 1.86 and 1.49, respectively, in the placebo group).
These results provide some evidence that the use of an NSAID may increase pain relief and decrease disability in patients with plantar fasciitis when used with a conservative treatment regimen.
足底筋膜炎通常对多种保守治疗方法有反应，且尚无一种被普遍接受的治疗该病症的方法。常用的治疗方式包括休息、冰敷按摩、跟腱和足底筋膜拉伸、非甾体类抗炎药（NSAIDs）、皮质类固醇注射、足部衬垫、贴扎、鞋类改良（钢条和前足摇摆底）、足弓支撑、足跟垫、定制足部矫形器、夜间夹板、超声以及石膏固定。据我们所知，尚无前瞻性、随机、安慰剂对照双盲研究评估口服NSAIDs治疗足底筋膜炎的疗效。
29例诊断为足底筋膜炎的患者接受了包括跟腱拉伸、粘弹性足跟垫和夜间夹板的保守治疗方案。他们被随机分为安慰剂组或NSAID组。在NSAID组中，塞来昔布被添加到治疗方案中。
两组的疼痛和功能障碍平均评分随时间均有显著改善，尽管在1个月、2个月或6个月时，安慰剂组和NSAID组之间无统计学差异。NSAID组有疼痛缓解和功能障碍改善的趋势，尤其是在2个月至6个月的随访期间。与安慰剂组分别为3.6和3.5相比，NSAID组从基线到6个月时疼痛改善了5.2倍，功能障碍改善了3.8倍。尽管在基线时NSAID组的疼痛和功能障碍评分较高，但NSAID组最终的疼痛和功能障碍评分主观上低于安慰剂组（NSAID组疼痛评分为1.43，功能障碍评分为1.16，而安慰剂组分别为1.86和1.49）。
这些结果提供了一些证据，表明在采用保守治疗方案时，使用NSAID可能会增加足底筋膜炎患者的疼痛缓解并减少功能障碍。
