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Glucosamine In Treatment Of Plantar Fasciitis: A Pilot Study
MSSE Volume 38(5) Supplement, May 2006, p S87
Overuse injuries are common conditions which can be therapeutic challenges. Plantar fasciitis can be a degenerative chronic tendonopathy. Physiologically, micro-tears of the bone-tendon union composed of proteoglycans may be the root cause. Healing this union more efficiently may speed recovery, resulting in earlier return to activity. Glucosamine is a nutraceutical that potentially accelerates healing by stimulating proteoglycans biosynthesis. We hypothesized that glucosamine supplementation may have a beneficial effect on the healing process in overuse injuries.
PURPOSE: To investigate the effectiveness of glucosamine in the treatment of plantar fasciitis.
METHODS: We initiated an IRB approved prospective, randomized double blinded, placebo-controlled trial comparing the addition of glucosamine (500mg TID) to the standard treatment for plantar fasciitis. A convenience sample of 29 patients (male=1 5; female=14; age=29.7±1.5y) from primary care clinics with a new diagnosis of plantar fasciitis were collected. Diagnostic criteria included heel pain less than 60 days, pain worse with first morning step, and with activity. Exclusion criteria included prior use of glucosamine, traumatic injury, pregnancy or lactation. All subjects received standard of care treatment for plantar fasciitis; Ibuprofen 800mg TID, relative rest, and stretching exercises. Subjects were randomly assigned to receive either glucosamine (500mg TID) or placebo. Treatment continued for 8 weeks or until pain free. The primary endpoint was return to unrestricted activity based on a 10 point Likert pain scale and objective clinical assessments conducted every 2 weeks. Means±SD and survival analysis are reported.
RESULTS: The severity of initial pain was similar (P=0.41) in each group at rest (3.2±0.48) and with activity (7.5±0.38) measured on a Likert scale with 1=lowest pain and 10=highest pain. Six of 15 subjects taking glucosamine were pain free by 31±11.6d compared to only one of 14 subjects taking placebo (15d). Survival analysis showed that the glucosamine group demonstrated a trend (P <0.15) to achieving pain free status sooner than placebo.
CONCLUSIONS: This pilot study shows a trend to a reduction in the number of days to return to unrestricted activity for patients receiving glucosamine in addition to standard treatment for plantar fasciitis. Although not statistically significant, this trend to a more rapid resolution of pain and return to activity in the glucosamine group warrants further investigation.
What mechanism of action is proposed here?.....we could see if meat pies help too...or chicken soup, bound to help. Glucosamine is a I believe a bit of an anit-coagulant.....maybe helps in peripheral flow.....???? some studies just aren't worth the paper they are written on....is this one of those?
not particularly, research has got a certain criterion that it has to satisfy, and certainly this article has done just that. and to test the null hypothesis that glucosamine supplement over above what the patient is on can be more effective than placebo, standard medical care available for plantar fasciitis.
take for a example a neurologically induced plantar fasciitis due to baxter's nerve compression, treatment with vitamin B12 complex and folic acid as a nerve enhencement therapy manages to treat the condition. i think this is a good study, well thought off and planned and executed, this is the stuff research is all about and podiatry can do more especially for stubborn conditions such as plantar fasciitis. I think diet will have to be the next step and we will have to treat plantar fasciitis along this line.........whose foot is it anyway