Bahrami Mohammad Hassan, Raeissadat Seyed Ahmad, Barchinejad Mahboobeh, Elyaspour Dariush, Rahimi-Dehgolan Shahram
Physical Medicine and Rehabilitation Department and Research Center, School of Medicine, Shohada-e-tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clinical Development Research Center of Shahid Modarres Hospital, Physical Medicine and Rehabilitation Department and Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Pain Res. 2019 Jul 24;12:2251-2259. doi: 10.2147/JPR.S202045. eCollection 2019.
To compare the efficacy of local ozone injection versus corticosteroid in plantar fasciopathy treatment.
This double-blinded randomized trial was performed on 44 adult patients with plantar fasciopathy. One group (23 patients) received local injection of 40 mg methylprednisolone, while a local injection of 3 cc oxygen-ozone solution was performed for the other group (21 subjects). Severity of pain, functional level, and pressure-pain threshold (PPT) were measured before treatment and 1, 4, and 12 weeks after injection using VAS, Foot and Ankle Ability Measure (FAAM) questionnaire, and algometer for PPT, respectively.
The majority (65.9%) of the total 44 patients analyzed, were women. Both treatments efficiently relieved patients' pain and improved their functions at 1 and 3 months follow-up time-points. But one week after injection, the improvement in VAS (<0.001) and FAAM (<0.001) was significant only in the corticosteroid group. During the first month, VAS (=0.35) and PPT (=0.003) were still better in the corticosteroid group. However, FAAM revealed no remarkable difference between the two groups (=0.083). Eventually, at the third month of follow-up, there was no remarkable preference between the treatments regarding any of the outcome measures (>0.05). Nevertheless, both methods efficiently improved patients' symptoms, ie, over the 50% of pain reduction and 30% improvement in functional status.
The present results showed no remarkable superiority between the two groups. In other words, although ozone injection showed a slower efficacy than methylprednisolone, it could be used in plantar fasciitis management as an appropriate alternative.
比较局部注射臭氧与皮质类固醇治疗足底筋膜炎的疗效。
对44例成年足底筋膜炎患者进行了这项双盲随机试验。一组(23例患者)接受局部注射40mg甲泼尼龙,另一组(21例受试者)接受局部注射3cc氧-臭氧溶液。分别在治疗前以及注射后1周、4周和12周,使用视觉模拟评分法(VAS)、足踝能力测量(FAAM)问卷以及压力痛阈(PPT)测量仪测量疼痛严重程度、功能水平和压力痛阈。
在分析的44例患者中,大多数(65.9%)为女性。在1个月和3个月的随访时间点,两种治疗方法均能有效缓解患者疼痛并改善其功能。但注射后1周,仅皮质类固醇组的VAS(<0.001)和FAAM(<0.001)改善显著。在第一个月,皮质类固醇组的VAS(=0.35)和PPT(=0.003)仍更好。然而,FAAM显示两组之间无显著差异(=0.083)。最终,在随访的第三个月,在任何一项结局指标方面,两种治疗方法之间均无显著偏好(>0.05)。尽管如此,两种方法均能有效改善患者症状,即疼痛减轻超过50%,功能状态改善30%。
目前的结果显示两组之间无显著优势。换句话说,虽然臭氧注射的疗效比甲泼尼龙慢,但它可作为足底筋膜炎治疗的一种合适替代方法。