SUMMARY
Pressure algometry was used for the objective diagnosis and quantitative outcome documentation in patients with plantar fasciitis. The efficacy of needling and infiltration [N&I] with 1% lidocaine of myofascial trigger points [MTrPs] and tender spots [TSs] followed by physical medicine procedures was assessed by algometry in up to two years follow-up.
Materials and Methods: The diagnostic procedure included search for TrPs and TSs, confirmed and quantified by pressure algometry. Needling and slow infiltration with 1% lidocaine of the tender areas were performed where maximum intensity of pain was detected, during each consultation, usually at a week intervals. It was followed by heat, electric stimulation, stretching and relaxation exercises. Statistical analysis was performed by the Wilcoxon test with significant level of 5%.
Results: Functional recovery and return to previous activities in the conventionally treated group of 9 patients took a mean of 21.1 ± 19.5 weeks [range 6–64 weeks]. The 20 patients treated with myofascial trigger point injections achieved the same level of recovery on VAS and algometry in 3.4 ± 2.2 weeks [range 1–8 weeks]. This represents a reduction of treatment time by 83.9%. The improvements still persisted 2 years after the treatment.
Conclusions: The inactivation of TrPs and TSs by a special technique of N&I is effective for the treatment of the myofascial pain component of the painful conditions associated with or resulting from plantar fasciitis. Pressure algometry documented quantitatively the improvement, that corresponded to relief of pain. Such correlation between the pain reduction and improvement in pressure pain threshold can be achieved only if the tender areas measured are the cause of the patient's complaints, i.e., pressure upon them reproduces patient's symptoms.