Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan.
School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Sci Rep. 2018 Mar 5;8(1):4033. doi: 10.1038/s41598-018-22402-w.
The first choice of treatment for patients with plantar fasciitis is non-invasive treatment, rather than corticosteroid injection (CSI). However, no comprehensive study has compared the effectiveness of CSI with non-invasive treatments for plantar fasciitis. We conducted a meta-analysis comparing CSI and non-invasive treatment effects on plantar fasciitis. The primary outcome was pain reduction. Nine randomized controlled trials comparing CSI with 4 non-invasive treatment types were included. A trend favoring CSI over non-invasive treatments was indicated regarding reduction in the visual analogue scale (VAS) score at 1-1.5 (mean difference (MD), 1.70; 95% confidence interval (CI) = 0.39-3.01; P = 0.01) and 2-3 months (MD, 1.67; 95% CI = 0.58-2.76; P = 0.003). At 1.5-month follow-up, CSI was associated with improved VAS score compared with physical therapy (PT) (MD, 2.5; 95% CI = 0.1-4.9; P = 0.04). No significant differences in the VAS score reduction were observed between CSI and shock wave therapy within 3 months. In summary, CSI tends to be more effective for pain reduction than non-invasive treatments within 3 months. Moreover, CSI provides significant pain relief at 1.5 months after treatment compared with PT. This study provides important clinical information for selecting therapeutics.
足底筋膜炎患者的首选治疗方法是非侵入性治疗，而不是皮质类固醇注射（CSI）。然而，目前还没有综合研究比较 CSI 与非侵入性治疗足底筋膜炎的效果。我们进行了一项荟萃分析，比较 CSI 与非侵入性治疗足底筋膜炎的效果。主要结局是疼痛减轻。共纳入 9 项比较 CSI 与 4 种非侵入性治疗类型的随机对照试验。结果显示 CSI 在减轻视觉模拟量表（VAS）评分方面优于非侵入性治疗，1-1.5 个月（MD，1.70；95%置信区间（CI）=0.39-3.01；P=0.01）和 2-3 个月（MD，1.67；95% CI=0.58-2.76；P=0.003）时更明显。在 1.5 个月随访时，CSI 与物理治疗（PT）相比，VAS 评分改善（MD，2.5；95% CI=0.1-4.9；P=0.04）。在 3 个月内，CSI 与冲击波治疗在减轻 VAS 评分方面无显著差异。总之，CSI 在 3 个月内对疼痛缓解的效果优于非侵入性治疗。此外，CSI 在治疗后 1.5 个月时与 PT 相比，能提供显著的疼痛缓解。本研究为治疗选择提供了重要的临床信息。
