Injection therapies for plantar fasciopathy (‘plantar fasciitis’): a systematic review and network meta-analysis of 22 randomised controlled trials

Tsikopoulos, Konstantinos; Vasiliadis, Haris S.; Mavridis, Dimitris

doi:10.1136/bjsports-2015-095437

Cited by 33 publications

(34 citation statements)

References 75 publications

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“…As the current NMA is the first to examine the comparative effectiveness of the most common treatments for PHP, it is difficult to directly compare the findings of the present study with those of previous NMAs which examined a limited number of treatments,58 or compared dosage/technique for specific treatment options 59. Previous reviews collectively indicate that exercise and foot orthoses are promising interventions for short-term and medium-term improvements in pain and function 60 61.…”

Section: Discussionmentioning

confidence: 92%

Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis

et al. 2018

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ObjectiveTo evaluate the comparative effectiveness of current treatment options for plantar heel pain (PHP).DesignSystematic review and network meta-analysis (NMA).Data sourcesMedline, EMBASE, CINAHL, AMED, PEDro, Cochrane Database, Web of Science and WHO Clinical Trials Platform were searched from their inception until January 2018.Study selectionRandomised controlled trials (RCTs) of adults with PHP investigating common treatments (ie, corticosteroid injection, non-steroidal anti-inflammatory drugs, therapeutic exercise, orthoses and/or extracorporeal shockwave therapy (ESWT)) compared with each other or a no treatment, placebo/sham control.Data extraction and analysisData were extracted and checked for accuracy and completeness by pairs of reviewers. Primary outcomes were pain and function. Comparative treatment effects were analysed by random effects NMA in the short term, medium term and long term. Relative ranking of treatments was assessed by surface under the cumulative ranking probabilities (0–100 scale).ResultsThirty-one RCTs (total n=2450 patients) were included. There was no evidence of inconsistency detected between direct and indirect treatment comparisons in the networks, but sparse data led to frequently wide CIs. Available evidence does not suggest that any of the commonly used treatments for the management of PHP are better than any other, although corticosteroid injections, alone or in combination with exercise, and ESWT were ranked most likely to be effective for the management of short-term, medium-term and long-term pain or function; placebo/sham/control appeared least likely to be effective; and exercise appeared to only be beneficial for long-term pain or function.ConclusionsCurrent evidence is equivocal regarding which treatment is the most effective for the management of PHP. Given limited understanding of long-term effects, there is need for large, methodologically robust multicentre RCTs investigating and directly comparing commonly used treatments for the management of PHP.PROSPERO registration numberCRD42016046963.

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Section: Discussionmentioning

confidence: 92%

Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis

et al. 2018

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“…Albeit reported the short-term positive effect of this treatment 31 , it is also well documented that corticosteroid injections are correlated to the risk of the plantar fascia rupture 31,59 . However, a recent review and meta-analysis study has not showed this major adverse effect 29 .…”

Section: Details Of the Included Articlesmentioning

confidence: 99%

“…Autologous whole blood, botulinum toxin, dehydrated amniotic membrane injections were also considered [28][29][30] . Surgical intervention is performed when PF symptoms persist after different and repetitive conservative treatments.…”

Section: Blood Analysismentioning

confidence: 99%

“…With respect to other injection modalities, botulinum toxin injections appear better than corticosteroid injections and corticosteroid injections are better than autologous blood ones [29][30][31] . Worthy of note is the effect of dehydrated amniotic membrane injection in the shortterm pain relief, with respect to other injection therapies 29 . However, it is necessary to take into consideration that the number of studies regarding these emerging treatments are very limited.…”

Section: Blood Analysismentioning

confidence: 99%

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Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review

Petraglia

Ramazzina

Cipolla

2017

MLTJ

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SummaryBackground: Plantar fasciitis (PF) is reported in different sports mainly in running and soccer athletes. Purpose of this study is to conduct a systematic review of published literature concerning the diagnosis and treatment of PF in both recreational and élite athletes. The review was conducted and reported in accordance with the PRIS-MA statement. Methods: The following electronic databases were searched: PubMed, Cochrane Library and Scopus. As far as PF diagnosis, we investigated the electronic databases from January 2006 to June 2016, whereas in considering treatments all data in literature were investigated. Results: For both diagnosis and treatment, 17 studies matched inclusion criteria. The results have highlighted that the most frequently used diagnostic techniques were Ultrasonography and Magnetic Resonance Imaging. Conventional, complementary, and alternative treatment approaches were assessed. Conclusions: In reviewing literature, we were unable to find any specific diagnostic algorithm for PF in athletes, due to the fact that no different diagnostic strategies were used for athletes and non-athletes. As for treatment, a few literature data are available and it makes difficult to suggest practice guidelines. Specific studies are necessary to define the best treatment algorithm for both recreational and élite athletes. Level of evidence: Ib.

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“…They include networks that compare exercise versus drug treatments for mortality in various conditions,22 different physical activity and other interventions for osteoarthritis,23 24 and different interventions for knee arthroplasty25 lateral elbow tendinopathy and epicondylalgia26 27 and plantar fasciitis 28. Network meta-analyses are still susceptible to reporting biases and the other biases that traditional pairwise meta-analyses may suffer from.…”

Section: Prospective Meta-analysismentioning

confidence: 99%

Next-generation systematic reviews: prospective meta-analysis, individual-level data, networks and umbrella reviews

2017

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Injection therapies for plantar fasciopathy (‘plantar fasciitis’): a systematic review and network meta-analysis of 22 randomised controlled trials

Abstract: CRD42015017353.

Cited by 33 publications

References 75 publications

Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis

Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis

Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review

Next-generation systematic reviews: prospective meta-analysis, individual-level data, networks and umbrella reviews

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