Treatment of plantar fasciitis by low-Dye taping and iontophoresis - short-term results of a double blinded, randomised, placebo controlled clinical trial of dexamethasone and acetic acid

Hamish R Osborne ^1* and Garry T Allison ¹

¹ The University of Western Australia, Australia

^* To whom correspondence should be addressed. E-mail: hamish.osborne{at}bigpond.com.

Accepted 9 February 2006

Abstract

Objectives: To determine if in the short term acetic acid and dexamethasone iontophoresis combined with low-Dye taping, are effective in treating the symptoms of plantar fasciitis.

Methods: A double blinded randomised placebo controlled trial of 31 patients with medial calcaneal origin plantar fasciitis recruited from three Sports Medicine clinics. All subjects received six treatments of iontophoresis to the site of maximum tenderness on the plantar aspect of the foot over a period of two weeks, continuous low-Dye taping during this time and instructions on stretching exercises for the gastrocnemius/soleus. They received dexamethasone 0.4%, Placebo (0.9% NaCl) or acetic acid 5%. Stiffness and pain outcomes were recorded at the initial session, the end of 6 treatments and the follow-up at 4 weeks.

Results: Data for forty two feet from thirty one subjects were used in the study. At the conclusion of the treatment phase all groups showed statistically significant improvements in morning pain, average pain and morning stiffness. However for morning pain, the acetic acid/taping group demonstrated a statistically greater improvement than the dexamethasone/taping intervention. At the follow up the treatment effect of acetic acid/taping and dexamethasone/taping remained statistically significant for symptoms of pain. In contrast only acetic acid maintained treatment effect for stiffness symptoms compared with placebo (p=0.031) and dexamethasone.

Conclusions: This study found that 6 treatments of acetic acid iontophoresis combined with taping gives the greatest relief of the stiffness symptoms and equivalent relief from pain symptoms as treatment with dexamethasone/taping. For the best clinical results at 4 weeks this study demonstrated that taping combined with acetic acid is the preferred treatment option when compared to taping combined with dexamethasone or saline iontophoresis.

Key Words: Iontophoresis, Plantar Fasciitis, Randomised controlled trial, low-Dye

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