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The Efficacy of Oral Nonsteroidal Anti-Inflammatory Medication (NSAID) in the Treatment of Plantar Fasciitis: A Randomized, Prospective, Placebo-Controlled Study. Foot Ankle Int. 2007 Jan;28(1):20-3Donley BG, Moore T, Sferra J, Gozdanovic J, Smith R
Quote:
BACKGROUND: Plantar fasciitis frequently responds to a broad range of conservative therapies, and there is no single universally accepted way of treating this condition. Modalities commonly used include rest, ice massage, stretching of the Achilles tendon and plantar fascia, nonsteroidal anti-inflammatory medications (NSAIDs), corticosteroid injections, foot padding, taping, shoe modifications (steel shank and anterior rocker bottom), arch supports, heel cups, custom foot orthoses, night splints, ultrasound, and casting. To our knowledge, no prospective, randomized, placebo controlled double-blind study has evaluated the efficacy of oral NSAIDs in the treatment of plantar fasciitis.
METHODS: Twenty-nine patients with the diagnosis of plantar fasciitis were treated with a conservative regimen that included heel-cord stretching, viscoelastic heel cups, and night splinting. They were randomly assigned to either a placebo group or an NSAID group. In the NSAID group, celecoxib was added to the treatment regimen.
RESULTS: Pain and disability mean scores improved significantly over time in both groups, although there was no statistical significance between the placebo and NSAID groups at 1, 2, or 6 months. There was a trend towards improved pain relief and disability in the NSAID group, especially in the interval between the 2 and 6-month followup. Pain improved from baseline to 6 months by a factor of 5.2 and disability by 3.8 in the NSASID group compared to 3.6 and 3.5, respectively, in the placebo group. Even though at baseline the pain and disability scores were higher in the NSAID group, the final pain and disability scores were subjectively lower in the NSAID group than in the placebo group (1.43 for pain and 1.16 for disability in the NSAID group, compared to 1.86 and 1.49, respectively, in the placebo group).
CONCLUSIONS: These results provide some evidence that the use of an NSAID may increase pain relief and decrease disability in patients with plantar fasciitis when used with a conservative treatment regimen.
Didn't we have a discussion a while back on NSAID's and plantar fasciitis? As it was not really and "itis" and more a "fasciosis" then NSAID's should not work, at least not because of their antiinflammatory effect.
Didn't we have a discussion a while back on NSAID's and plantar fasciitis? As it was not really and "itis" and more a "fasciosis" then NSAID's should not work, at least not because of their antiinflammatory effect.
The Efficacy of Oral Nonsteroidal Anti-Inflammatory Medication (NSAID) in the Treatment of Plantar Fasciitis: A Randomized, Prospective, Placebo-Controlled Study. Foot Ankle Int. 2007 Jan;28(1):20-3Donley BG, Moore T, Sferra J, Gozdanovic J, Smith R
Dear All
The sample size is very small and unlikely to have power.
I like the last line, it says the drug MAY help.
Remember in many people these NSAIDS have an analgesic effect and most likely you are getting this.
Remember the drug companies say the NSAIDS fight inflammation and thus the pain goes. QED
If they said it was an analgesic effect, they would have to find the central site in the brain where this occurs. any peripheral sites, analyze the method of action, is it a drug of addiction etc. etc.
This is estimated at about 200 million US to satisfy the Food and Drug mob.
So it is easy to say the inflammation is the cause and we fight this.
Remember if the patient gets relief of their symptoms within three tabs, the serum levels are not high enough to cause an antiinflamm effect so the only thing left is analgesia.
This study needs at leat 200 people in it to prove it one way or another.
I am doing a review on best evidence based practice for the use of NSAIDs and ice etc for intervention and treatment of chronic plantar fasciitis. I currently have had little luck finding sufficient evidence as to why everyone uses it in there treatment program.
If anyone knows any articles with such reference, study or clinical trial that would be of great help. There is lots of information on other physical modalities besides anti-inflammatories :(
In my opinion the use of NSAIDs should be keep to a minimum because the drugs are undermining the body's ability to heal itself, ie stating the obvious inflammation is how the body repairs damage regardless of cause.
What is very important is to find out what has caused the inflammatory response and eliminate that, then the pain usually goes and it is frequently the pain which prompts action to be taken in the first place.
Often the request is for a quick fix rather than addressing what is the fundamental problem.
There are numerous causes of what is labeled 'plantar fasciitis'. What all of them have in common is a biomechanical element (which leads to an overload of soft tissue structures).
Good luck with your review of best evidence based practice.
I would interested to know what your conclusions are.
Personally I believe it is important to treat the person not the condition.
NSAID's for plantar fasciitis
NSAIDs in Plantar Fasciitis
Linear Mode
