Effectiveness of extracorporeal shock wave therapy in the treatment of epin calcanei

Year 2021, , 140 - 144, 30.06.2021

Nihan Cüzdan Deniz Evcik Saime Ay

https://doi.org/10.15321/GenelTipDer.2021.301

Abstract

Objective: Epin calcanei is a common clinical problem with chronic plantar heel pain. ‘Extracorporeal Shock Wave Therapy (ESWT)’ is a non-surgical method administered to patients along with a variety of other options such as corticosteroid injections, non-steroidal antiinflammatory drugs and physical therapy modalities. The aim of this prospective controlled study is to investigate the efficacy of ESWT in patients with clinical and radiological diagnosis of epin calcanei.

Materials-Methods: The study included 49 patients diagnosed with epin calcanei according to the clinical and radiological criteria. Patients were randomly divided into two groups. Group 1 (n=25) received ESWT treatment as 1000 shots in each session at a frequency of 8 Hz, 3 sessions in total with intervals of four days. Group 2 (n=24) was accepted as the control group and used silicone insoles alone. The severity of pain was evaluated using the pain Visual Analog Scale (VAS) as pain at night, pain in the morning, on the first step, pain on motion, pain at rest, pain on uneven ground and pain at the end of the day. The functional level of activity of the foot was evaluated by the Foot Ankle Outcome Score (FAOS) index. Measurements were taken before treatment and after 4 weeks of follow-up.

Results: After treatment, both groups showed statistically significant improvement in all parameters (p<0.05). Post-treatment VAS scores showed significant improvements in pain at night and pain in the morning on the first step (p<0.05) in ESWT group. However there was no significant difference in other parameters between the two groups (p>0.05).

Conclusion: The results of this study support that ESWT application seems to be effective in the treatment of epin calcanei; and ESWT application may be an effective alternative to other conservative methods.

Keywords

ESWT, epin calcanei, plantar pain

Topuk dikeni tedavisinde ekstrakorporeal şok dalga tedavisinin etkinliği

Abstract

Amaç: Topuk dikeni klinikte sıkça karşılaşılan, kronik plantar topuk ağrısına neden olan klinik bir tablodur. Hastalara uygulanan kortikosteroid enjeksiyonu, steroid olmayan antiinflamatuvar ilaçlar ve çeşitli fizik tedavi modaliteleri gibi seçeneklerin yanında, ‘Extracorporeal Shock Wave Therapy’ (ESWT) cerrahi olmayan yöntemler arasında yerini almıştır. Bu prospektif kontrollü çalışmanın amacı klinik ve radyolojik olarak topuk dikeni tanısı alan hastalarda ESWT tedavisinin etkinliğini araştırmaktır.

Gereç-Yöntem: Çalışmaya klinik ve radyolojik olarak topuk dikeni tanısı konan 49 hasta alındı. Hastalar randomize olarak iki gruba ayrıldı. Grup 1 (n=25) dört gün aralıkla 3 seans boyunca 8 Hz frekans ile her seans 1000 atım olacak şekilde ESWT tedavisi aldı. Grup 2 (n=24) ise kontrol grubu olarak kabul edildi ve sadece silikon tabanlık kullandı. Ağrı şiddeti gece ağrısı, sabah ilk basma sırasındaki ağrı, hareket ile ağrı, istirahat ağrısı, engebeli zeminde ağrı ve gün sonunda ağrı olmak üzere Görsel Analog Skala (GAS) ile ve ayak aktiviteleri ile ilgili fonksiyonel düzey ise Foot Ankle Outcome Score (FAOS) indeksi ile değerlendirildi. Ölçümler hastalar tedaviye alınmadan önce ve 4 haftalık izlem sonrasında yapıldı.

Bulgular: Tedavi sonrasında her iki grupta tüm parametrelerde istatistiksel olarak anlamlı iyileşme saptandı (p<0,05). Gruplar arası değerlendirmede ise tedavi sonrasında GAS ile hesaplanan gece ağrısı ve sabah ilk basma sırasındaki ağrıda (p<0,05) ESWT grubu lehine olacak şekilde anlamlı düzelme olduğu gözlemlendi. Diğer parametrelerde ise her iki grup arasında anlamlı fark bulunmadı (p>0,05).

Sonuç: Çalışmamızın sonuçları; ESWT uygulamasının topuk dikeni tedavisinde etkili olduğunu ve diğer konservatif yöntemler arasında etkin bir seçenek olabileceğini desteklemektedir.

Keywords

ESWT, epin kalkanei, topuk ağrısı

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