An Extended Literature Review Of The Efficacy Of Corticosteroid Injection In The Treatment Of Plantar Fascitiis Whether Given Under Ultrasound Guidance Or By Palpation, Followed By A Research Protocol.

Plantar fasciitis is a traction periostitis of the proximal plantar fascia that involves both inflammatory and degenerative processes. Its aetiology is uncertain but may involve altered mechanics, autoimmune disease and raised BMI. Review of the literature reveals that steroid injections are helpful in reducing pain in the short to medium term. Only chronic cases of PF that have failed to respond to other treatments have hitherto been studied. A gap in current knowledge exists as no studies were found that treat PF at the point of initial presentation and before other treatments have been used. It is hypothesised that steroid injection given at early presentation will reduce pain and may shorten the often protracted course of PF by halting the initial inflammatory response thus avoiding chronic degenerative processes. The aim of the proposed trial is to reduce pain in PF sufferers by administering CSI in the early stages of the condition and compare this to a placebo (LA) and control (simple insole). Method- 120 participants will be recruited by referral from primary care health professionals and allocated randomly using SNOSE (numbered ,opaque, sealed, envelopes) to one of three groups with 40 participants in each. Group 1 will receive a CSI with lidocaine, group 2 will receive a LA injection (placebo) and group 3 will be supplied with a 3mm poron insole (control). The outcome measure will be VAS 100mm and this measure will be taken pre-treatment and at intervals of 1 month, 3 months, 6 months and 12 months. Data will be stored electronically and analysed using EXCEL. Unpaired, and paired t-tests will be used and the null hypothesis will be tested using p-value with a confidence of 0.05.msc_podsurunpub1527_ethesesunpu