Salvioli Stefano, Guidi Maddalena, Marcotulli Giulia
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Infantile Sciences, University of Genoa, Italy.
Bologna, Italy.
Foot (Edinb). 2017 Dec;33:57-67. doi: 10.1016/j.foot.2017.05.004. Epub 2017 Jun 15.
Plantar heel pain is one of the most common causes of pain and musculoskeletal pathologies of the foot. The aim of this systematic review was to identify the most effective, conservative and non-pharmacological treatments regarding pain in patients with plantar heel pain. The authors searched 5 databases and included only randomized control trials which investigated the efficacy of a conservative non-pharmacological treatment compared to the placebo, for the outcome of pain. Study selection, data collection and risk of bias assessment were conducted independently by two authors, and consensus was reached with a third author. Results were quantitatively summarized in meta-analyses, by separating homogeneous subgroups of trials by type of intervention. A total of 20 studies that investigated the efficacy of 9 different types of interventions were included, with a total of 4 meta-analyses carried out. The interventions: shock waves, laser therapy, orthoses, pulsed radiofrequency, dry-needling, and calcaneal taping resulted in being effective treatments for the outcome pain in patients with plantar heel pain when compared to the placebo. However, considering that the improvements were very small, and the quality of evidence was mostly low or moderate for many of the interventions, it was not possible to give definitive conclusions for clinical practice.
足跟痛是足部疼痛和肌肉骨骼疾病最常见的原因之一。本系统评价的目的是确定针对足跟痛患者疼痛的最有效、保守且非药物治疗方法。作者检索了5个数据库，仅纳入了随机对照试验，这些试验研究了与安慰剂相比保守非药物治疗对疼痛结局的疗效。研究选择、数据收集和偏倚风险评估由两位作者独立进行，并与第三位作者达成共识。通过按干预类型分离试验的同质亚组，在荟萃分析中对结果进行了定量总结。共纳入了20项研究，这些研究调查了9种不同类型干预措施的疗效，共进行了4项荟萃分析。与安慰剂相比，冲击波、激光治疗、矫形器、脉冲射频、干针疗法和跟骨贴扎等干预措施对足跟痛患者的疼痛结局是有效的治疗方法。然而，考虑到改善非常小，且许多干预措施的证据质量大多为低或中等，因此无法为临床实践给出明确结论。
