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Due to top ranking in SUCRA analysis and significant pain
reduction, ESWT might be the most efficacious treatment over other therapies in
the management of plantar fasciitis.
As per recent analysis published in the Journal of cellular physiology, the extracorporeal shockwave therapy, BTX-A and PRP were considered as favorable treatment approaches to manage plantar fasciitis. Plantar fasciitis is the inflammation of the plantar fascia; a band of tissues connects heel bone to toes. It causes severe pain in the heel area of the foot.
Haibo Li and colleagues conducted a meta-analysis to evaluate the effect of eight approaches in eradicate foot pain due to plantar fasciitis. The eight procedures used in the study were corticosteroid injections (Css), ultrasound therapy (US), dry needling (DN), nonsteroidal anti-inflammatory drugs (NSAIDs), platelet rich plasma (PRP), extracorporeal shockwave therapy (ESWT), autologous whole blood and botulinum toxin A (BTX A). The Embase, CNKI and PubMed were used to extract interventions related to randomized controlled trials (RCTs) and prospective studies. Multi-aspect comparisons were determined by using 95% credible intervals (CrIs) and mean difference (MD) of visual analogue scale (VAS). Further, the surface under the cumulative ranking curve (SUCRA) and Node splitting plots were used to achieve ranking results and uniformity among direct & indirect evidence, respectively. Publication bias was examined by performing funnel plots and Egger's test.
A total of 41 trials comprised 2,889 cases were involved. As per VAS, only ESWT (MD = −3.3; CrI: −5.3, −1.1) exhibited better efficacy than placebo at first month. At 2-month VAS, no statistically notable difference was noticed among pain-wise comparisons. At 3-month VAS, ESWT again showed great efficacy (MD = −2.7; CrI: −4.2, −1.3) along with Css (MD = −2.1; CrI: −4.1, −0.19). The ESWT also exhibited better MD (−3.0) and CrI (−5.0) as compared to placebo (CrI: −0.51). The PRP and BTX A exhibited sub-optimal outcomes. Further, on the report of SUCRA, out of all eight treatments, ESWT ranked first and is the appropriate approach to reduce foot pain.
J Cell Physiol
Comparison of efficacy of eight treatments for plantar fasciitis: A network meta-analysis
Haibo Li et al.
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