Ultrasound-Guided Pulsed Radiofrequency Stimulation of Posterior Tibial Nerve: A Potential Novel Intervention for Recalcitrant Plantar Fasciitis

Arch Phys Med Rehabil. 2017 May;98(5):964-970. doi: 10.1016/j.apmr.2017.01.016. Epub 2017 Feb 14.

Abstract

Objective: To evaluate the therapeutic benefit of ultrasound-guided pulsed radiofrequency (PRF) stimulation at the posterior tibial nerve (PTN) in patients with recalcitrant plantar fasciitis (PF).

Design: A prospective, randomized, double-blinded, placebo-controlled trial (12-wk follow-up).

Setting: Outpatient local medical center settings.

Participants: Patients (N=36) with recalcitrant PF underwent randomization, and all were included in the final data analysis.

Interventions: Patients in the PRF group were treated with 1 dose of ultrasound-guided PRF stimulation at the PTN, and those in the control group received 1 dose of 2% lidocaine, 0.5mL, injected at the PTN under ultrasound guidance.

Main outcome measures: The visual analog scale (first-step and overall pain), American Orthopedic Foot-Ankle Society (AOFAS) ankle-hindfoot scale, and ultrasonographic thickness of the plantar fascia were evaluated at 1, 4, 8, and 12 weeks after treatment.

Results: Thirty-six patients (20 feet per group) completed the study. The PRF group had a significantly larger improvement in first-step pain, overall pain, and AOFAS score (all P<.001), as well as plantar fascia thickness (P<.05), compared with those of the control group at all observed time points.

Conclusions: This study shows that ultrasound-guided PRF stimulation at the PTN is effective for treating recalcitrant PF. This simple, reproducible method could be a novel strategy for managing recalcitrant PF.

Keywords: Fasciitis, plantar; Pulsed radiofrequency treatment; Rehabilitation; Tibial nerve.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anesthetics, Local / therapeutic use
  • Double-Blind Method
  • Fasciitis, Plantar / rehabilitation*
  • Female
  • Humans
  • Lidocaine / therapeutic use
  • Male
  • Middle Aged
  • Pain Measurement
  • Prospective Studies
  • Pulsed Radiofrequency Treatment / methods*
  • Tibial Nerve*
  • Ultrasonography, Interventional / methods

Substances

  • Anesthetics, Local
  • Lidocaine