Patients can expect continued improvement over a 2-year period.
In a randomized trial published in 2003, investigators compared a
non-weight-bearing plantar fascia–stretching exercise with an
Achilles tendon–stretching exercise in 82 patients who had had
plantar fasciitis for at least 10 months (Journal
Watch Jul 29 2003). At 8 weeks, the plantar fascia–stretching
group had significantly less pain than the comparison group. At that
point, the trial was stopped and the plantar fascia–stretching
exercises were taught to patients in the comparison group.
In the current report, the same researchers present 2-year follow-up
data. During this period, both groups continued to improve such that
pain scores no longer differed significantly between groups. At 2
years, "worst pain" scores on a 100-point visual analog scale
were about 30 in both groups (compared with scores of about 70 at
baseline). During follow-up, only 18% of patients sought additional
treatment by a physician. The authors do not mention how many
patients were still doing the plantar fascia–stretching exercises
at follow-up.
Comment: This report suggests that patients with chronic plantar fasciitis
can expect continued improvement over a 2-year period after an
initial course of plantar fascia–stretching exercises. The exercise
probably contributed at least somewhat to the improvement, since all
patients had been chronically symptomatic and had tried numerous
other treatments prior to entering the original study. The exercise
is described and depicted in a
recent review article.
— Allan S. Brett, MD
Published in Journal Watch September 21, 2006
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