Effectiveness of using ultrasound therapy and manual therapy in the conservative treatment of calcaneal spur – pilot study

Abstract

Introduction: Calcaneal spur is a pathology of the fibrocartilage enthesis of the Achilles tendon and plantar fascia or a pathology of the mixed enthesis of the flexor digitorum brevis muscle. Ultrasound therapy is commonly applied in the conservative treatment of a calcaneal spur. Foot muscle strengthening exercises, stretching exercises and soft tissue therapy are indicated as effective methods of conservative treatment. The aim of the study was to compare and assess the effects of ultrasound therapy and selected techniques of manual therapy on pain level and functional state in patients with calcaneal spur. Material and methods: Twenty-two patients (14 females and 8 males) with calcaneal spur were included in the study. They were randomly assigned to two groups (A and B) with different therapies administered. Group A was treated with ultrasound therapy combined with soft tissue therapy, while group B was subjected to manual therapy only. Results: Significant pain reduction and an increase in functional capacity were noted in all patients from both groups. No statistically significant differences between the groups were found in pain intensity following the therapies. Conclusions: Our findings confirm the relevance of using ultrasound and soft tissue therapies in the conservative treatment of calcaneal spur and prove the need to carry out further research on a larger sample size. These therapies brought about significant pain reduction retained over a period of 3 weeks. A series of 10 therapy sessions is enough to improve pain and functional capacity outcomes; however, it will never result in complete pain relief. A greater number of interventions might contribute to an increase in therapy effectiveness.

Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial

“…All participants received up to eight treatment sessions at a frequency of once or twice per week over a 4-week period. Both groups received an impairment-based manual therapy approach directed to the lower limb,[ 6 , 13 , 26 , 28 , 58 ] an exercise program[ 7 , 12 , 13 , 29 , 42 , 43 ] including self-stretching of the plantar fascia and the Achilles tendon and strengthening exercises for the intrinsic muscles of the foot, and therapeutic ultrasound[ 6 , 30 , 50 ] (Sonicator, Mettler Electronics, Anaheim, CA; 3 MHz, 1.5 W/cm 2 , 20% duty cycle for 5 minutes to the most tender region of the proximal portion of the plantar fascia). Details regarding the manual therapies and exercise program are provided in S2 Table .…”

“…Among all outcomes included in the clinical trial registry, the primary outcome of the current trial was first-step pain[ 9 , 12 , 13 , 40 , 50 , 70 ] during the morning as measured by the Numeric Pain Rating Scale (NPRS). Patients were asked to indicate the average intensity of first-step pain when getting out of bed in the morning over the past week using an 11-point scale ranging from 0 (“no pain”) to 10 (“worst pain imaginable”) at baseline, 1 week, 4 weeks, and 3 months following the initial treatment session.…”

“…In the absence of high quality evidence for any one treatment modality,[ 23 ] it may still be possible to achieve a high success rate with a combination of the treatments for PF. [ 8 , 19 ] Electrical dry needling,[ 11 , 39 – 41 ] manual therapy,[ 6 , 28 , 42 ] exercise[ 29 , 43 ] and ultrasound,[ 30 , 50 ] when applied separately, have each been found to be effective for PF. However, no previous study has investigated the combination of the effectiveness of electrical dry needling in addition to manual therapy, exercise and ultrasound in patients with PF.…”

Chosen Conservative Treatments on the Symptoms of Calcaneal Spur: A Short Review

“…The study showed the reduction of the pain level at p < 0.001 in the phonophoresis treatment group, and the level of p < 0.01 in the US treatment group. Twarowska, Niemrzycka [13] compared the effects of 10 sessions of US and selected techniques of manuand mechanical properties of ultrasound waves. The heat produced in the tissues by electrotherapy leads to various changes typical of this energy: Congestion, increased metabolism, increased the extensibility of collagen fibers, increased enzyme activity, decreased muscle tone, changes in nerve conduction, pain relief, decreased joint stiffness [9].…”

The impact of shock wave therapy on reducing pain in patients with heel spurs

“…50% of patients with calcaneal spur also suffer from inflammation of plantar fasciitis. It is considered to be the most popular cause of foot pain in adults, since 10-15% population suffers from the condition, usually between 40-60 years of age [14,15]. Plantar fasciitis is diagnosed by clinical symptoms of pain, stiffness, edema, positive windlass test, and about 75% have no symptoms in patients with heel spurs.…”