The Effect of Extracorporeal Shock Wave Therapy in Plantar Fasciitis

OBJECTIVE: To evaluate the effect of extracorporeal shock wave therapy (ESWT) in plantar fasciitis with visual analog scale score and thickness of fascia by ultrasonography. METHOD: The subjects consisted of 32 feet (24 patients) with established diagnosis of chronic plantar fasciitis, including 17 feet in the ESWT group and 15 feet in the control group. In the ESWT group, three session of ESWT (0.24 mJ/mm2 FED, 1,200 impulse, weekly) were performed. The visual analog scale (VAS) score and thickness of the plantar fascia were measured by ultrasound before therapy and at the 6-week and 6-month follow-up. Patients in the control group were treated with medication, orthotics, physical therapy and exercise program. VAS and thickness of plantar fascia was evaluated at the same time as ESWT group. RESULTS: In the ESWT group, thickness of plantar fascia decreased significantly at 6-week follow-up (p 0.05). Visual analog scale score showed no significantly difference at 6-week follow-up (>0.05), but decreased at 6-month follow-up. On the other hand, in the control group, thickness of plantar fascia did not change significantly at 6-week follow-up (>0.05) and 6-month follow-up (>0.05). VAS score was not significant different at the 6-week follow-up (>0.05), but decreased at the 6-month follow-up (p <0.05). CONCLUSION: ESWT in plantar fasciitis is effective in relieving subjective pain and reducing thickness of plantar fascia at 6-month follow-up.

Comparison of Blind and Ultasonography Guided Approach of Suprascapular Nerve Block

OBJECTIVE: To compare ultrasonography guided versus blind approach in a randomized trial examining the efficacy of suprascapular nerve block in patients with non-specific shoulder pain. METHOD: A total of 20 patients with shoulder pain lasting for more than 1 month were included in this study. After 1:1 randomization, patients were included either in the blind group (n=10) or in the ultrasonography guided group (n=10) of suprascapular nerve block. All patients were evaluated before and after treatment, in terms of shoulder pain and disability index (SPADI) and nerve conduction study. RESULTS: Significant improvements were seen in all pain scores and disability after both types of nerve block, with no significant difference in the improvement of pain and disability between the two approaches. However, amplitude changes of nerve conduction study were larger in ultrasonography guided approach than blind approach. CONCLUSION: This study suggests ultrasonography guided approach of suprascapular nerve block could place the needle closer to the nerve compared to blind approach.

Comparison of the Effects between Growth Hormone and Hyaluronic Acid on Degenerative Cartilage of Knee in Rabbit

OBJECTIVE: To explore whether the growth hormone is effective in the treatment of degenerative cartilage of knee in rabbits. METHOD: Thirty New Zealand white rabbits were administered intra-articular injection with monosodium iodoacetate (Sigma, St. Louis, USA) 2.5 mg and divided into 3 groups. Each group was administered with hyaluronic acid (Hyruan plus(R), LG life science, Seoul, Korea)(group A) 0.6 ml, growth hormone (Declage(R), LG life science, Seoul, Korea) (group B) or saline (group C) 0.6 ml intra-articulary once a week for 4 weeks, beginning 4 weeks after the degeneration induction. All rabbits were killed 9 weeks after degeneration induction. The histologic morphology was observed by optical microscope with knee cartilage. RESULTS: Mankin score was 2.4+/-1.3 in group A, 3.9+/-1.7 in group B, 7.4+/-0.8 in group C. Yoshimi score was 1.5+/-0.7 in group A, 2.2+/-0.9 in group B, 4.4+/-0.6 in group C. Gross and microscopic morphologic findings showed that group C represented the more severe than group A & B (p<0.01), also group A was better than group B (p<0.05). CONCLUSION: Growth hormone is effective on degenerative knee cartilage in rabbit model, but less than the hyaluronic acid.