Ultrasound-guided pulsed radiofrequency stimulation of posterior tibial nerve: A potential novel intervention for recalcitrant plantar fasciitis

Publication date: Available online 14 February 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Yung-Tsan Wu, Chih-Ya Chang, Yu-Ching Chou, Chun-Chang Yeh, Tsung-Ying Li, Heng-Yi Chu, Liang-Cheng Chen
ObjectiveTo evaluate the therapeutic benefit of ultrasound-guided pulsed radiofrequency (PRF) stimulation at the posterior tibial nerve (PTN) in patients with recalcitrant plantar fasciitis (PF).DesignA prospective, randomized, double-blinded, placebo-controlled trial (12-week follow-up).SettingOutpatient of local medical center settings.ParticipantsThirty-six patients with recalcitrant PF were randomized and 36 participants were included in the final data analysis.InterventionsPatients were treated with one dose of ultrasound-guided PRF stimulation at the PTN in PRF group and control group received one dose of an ultrasound-guided 0.5 cc 2% lidocaine injection at the PTN.Main Outcome MeasuresThe outcome measurements, including the visual analog scale (VAS) (first-step and overall pain), American Orthopedic Foot-Ankle Society (AOFAS) Ankle-Hindfoot scale, and ultrasonographic thickness of the plantar fascia, were evaluated 1, 4, 8, and 12 weeks after treatment.ResultsThirty-six patients (20 feet per group) completed the study. The PRF group had a significantly larger improvement in first-step pain, overall pain, and AOFAS score (all p<0.001), as well as plantar fascia thickness (p<0.05) compared to those of the control group at all observed time-points.ConclusionsThis study shows that ultrasound-guided PRF stimulation at the PTN is effective for treating recalcitrant PF. This simple, reproducible method could be a novel strategy for managing recalcitrant PF.



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