Local ozone (O2–O3) versus corticosteroid injection efficacy in plantar fasciitis treatment: a double-blinded RCT
Received 24 January 2019
Accepted for publication 27 June 2019
Published 24 July 2019 Volume 2019:12 Pages 2251—2259
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Melinda Thomas
Peer reviewer comments 2
Editor who approved publication: Dr E Alfonso Romero-Sandoval
Mohammad Hassan Bahrami,1 Seyed Ahmad Raeissadat,2 Mahboobeh Barchinejad,2 Dariush Elyaspour,2 Shahram Rahimi-Dehgolan3
1Physical Medicine and Rehabilitation Department and Research Center, School of Medicine, Shohada-e-tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Clinical Development Research Center of Shahid Modarres Hospital, Physical Medicine and Rehabilitation Department and Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Physical Medicine and Rehabilitation Department, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran
Purpose: To compare the efficacy of local ozone injection versus corticosteroid in plantar fasciopathy treatment.
Patients and methods: This double-blinded randomized trial was performed on 44 adult patients with plantar fasciopathy. One group (23 patients) received local injection of 40 mg methylprednisolone, while a local injection of 3 cc oxygen-ozone solution was performed for the other group (21 subjects). Severity of pain, functional level, and pressure-pain threshold (PPT) were measured before treatment and 1, 4, and 12 weeks after injection using VAS, Foot and Ankle Ability Measure (FAAM) questionnaire, and algometer for PPT, respectively.
Results: The majority (65.9%) of the total 44 patients analyzed, were women. Both treatments efficiently relieved patients’ pain and improved their functions at 1 and 3 months follow-up time-points. But one week after injection, the improvement in VAS (p<0.001) and FAAM (p<0.001) was significant only in the corticosteroid group. During the first month, VAS (p=0.35) and PPT (p=0.003) were still better in the corticosteroid group. However, FAAM revealed no remarkable difference between the two groups (p=0.083). Eventually, at the third month of follow-up, there was no remarkable preference between the treatments regarding any of the outcome measures (p>0.05). Nevertheless, both methods efficiently improved patients’ symptoms, ie, over the 50% of pain reduction and 30% improvement in functional status.
Conclusion: The present results showed no remarkable superiority between the two groups. In other words, although ozone injection showed a slower efficacy than methylprednisolone, it could be used in plantar fasciitis management as an appropriate alternative.
Keywords: plantar fasciopathy, ozone, steroids, heel
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