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New Twist on Treatment of Foot Pain
Date:12/1/2008

can lead to swelling, bruising, and numbness, however. The next option is surgery.

Searching for an alternative treatment, Sconfienza and his colleagues focused on 44 plantar fasciitis patients who had proven "unresponsive to medical therapy." Radiologists first applied a local anesthetic to the patients' affected heel area, and then repeatedly poked the region with a solid needle -- a procedure known as dry-needling -- to provoke more blood flow to the area.

A small amount of steroids was then injected into the same area, with ultrasound guidance used to improve accuracy and to avoid injecting the steroids into the plantar fascia, which could rupture the tissue. Following a single 15-minute treatment, orthotics were inserted into each patient's footwear to take pressure off the rear part of the foot.

The result: 42 of the 44 patients were cured of their symptoms within two to three weeks of treatment, the researchers said.

"As it is conceived, our procedure is new," said Sconfienza. "To our best knowledge, the combination of dry-needling and steroid has never been described. We think that this combination is the strength of the therapy, and being so simple and cheap, the procedure can be performed anywhere and by anyone who underwent a basic training in interventional ultrasound."

Dr. Johanna Youner, a New York City podiatrist and a member of the American Podiatric Medical Association, said that while the combination of steroids and dry-needling may be novel, the use of steroids itself is not.

"But what is interesting," she added, "is the notion of using dry-needling -- that is poking at the inflamed area repeatedly. This would increase the trauma to the area a little, and by doing that increase blood flow. That is not a traditional treatment. And it might seem counterintuitive. But when you increase inflammation and blood flow to an area you can help it heal faster. And the fascia itself is a ligament t
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