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Which Treatment Method Is Better in the Treatment of Chronic Plantar Fasciitis: Corticosteroid Injection, Extracorporeal Shock Wave Therapy, or Radiofrequency Thermal Lesioning?

Furkan Yapici Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey.

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Volkan Gur Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey.

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Ilker Fatih Sari Department of Physical Medicine and Rehabilitation, Giresun University Faculty of Medicine, Giresun, Turkey.

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Resit Karakose Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey.

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Ismail Tardus Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey.

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Hanifi Ucpunar Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey.

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Background: Chronic plantar fasciitis (CPF) is a common disease that has various treatment options. This study aimed to compare the effectiveness of three of these options: corticosteroid injection (CSI), extracorporeal shock wave therapy (ESWT), and radiofrequency thermal lesioning (RTL).

Methods: The records of 229 patients treated with CSI (n = 81), ESWT (n = 76), or RTL (n = 72) were retrospectively analyzed. Visual analog scale scores, patient satisfaction–related success rates, repeated treatment rates, and initial treatment change rates were compared.

Results: Mean ± SD follow-up was 19.0 ± 4.5 months. Baseline clinical characteristics, mean visual analog scale scores (before treatment and at months 3, 6, and 12), patient satisfaction and success rates (at months 6 and 12), and repeated treatment and initial treatment change rates were similar between treatment groups. No complications were observed after the treatments.

Conclusions: All three options—CSI, ESWT, and RTL—were found to be safe and effective in treating CPF, with similar outcomes up to 1 year. Use of CSIs is advantageous because it is more accessible than the other treatments. Similarly, the noninvasive nature of ESWT is glaring among other minimally invasive options. Therefore, the first-line treatment modality of CPF can be CSI or ESWT, depending on the patient's and physician's joint preference; RTL treatment should be tried in patients who do not respond to these treatments.

Corresponding author: Furkan Yapici, MD, Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan Universitesi Basbaglar Mahallesi 24030, Erzincan, Turkey. (E-mail: furkanyapici@hotmail.com)
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