Value of dexamethasoneiontophopresis vs. local injection of dexamethasone in the treatment of plantar fasciitis

ABSTRACT

To evaluate the effect of dexamethasone [DXM] iontophoresis in treating plantar fasciitis compared to the effect of local DXM injection. The study was performed on 21 patients [26 feet] complaining of plantar fasciitis of at least 2 months duration. Patients were selected on the basis of their clinical presentation and confirmed by plain Xray and diagnostic ultrasonography. Patients were classified into 2 groups Group I [11 patients] received 10 sessions of iontophoresis using solution of 0.4% DXM on alternating days, while Group Ii [10 patients] received one local steroid injection of DXM into the area of maximum tenderness. Reassessment of the patients of both groups was done 3 weeks after starting their treatment program by assessment of pain intensity using numerical visual analogue scale [VAS], assessment of tenderness using Heel Tenderness Index [HTI] and ultrasonography examination. There was high statistical significant improvement of in all patients of group I, and in 7 patients of group II. Two feet had steroid flare in group II. No difference of statistical significance between the 2 groups was detected regarding change in HTJ, or change in ultrasound findings. However, there was a statistical significance difference regarding decrease in pain intensity with higher improvement in group I. Dexamethasone is an effective anti-inflammatory drug in treating plantar fasciitis whether applied by iontophoresis or by local injection. However, lontophoresis has the advantages of painless application with no risk of infection or fascial rupture