Jul 30 2012
By Helen Albert, Senior MedWire Reporter
Research shows that external beam radiation therapy, similar to that used in treating cancer, provides effective pain relief for patients with plantar fasciitis.
The researchers compared standard- (n=29; total dose 6.0 Gy) with low- (n=33; total dose 0.1 Gy) dose therapy in 62 patients with the condition. They found that 80% of those who received standard-dose therapy experienced complete pain relief, 64% of whom maintained this relief for up to 48 weeks.
"Severe plantar fasciitis is a chronic health issue, and it can be extremely painful - many of these men and women cannot walk or stand for a long time," said lead author Marcus Niewald (Saarland University Medical Center, Homburg/Saar, Germany) in a press statement.
"We are extremely encouraged by the results of our research because evidence of improved quality of life for patients is clearly evident with the standard dose regimen."
The patients in the standard-dose group had therapy applied in six fractions of 1.0 Gy twice weekly and those in the low-dose group in six fractions of 0.1 Gy twice weekly with follow up continuing for 1 year. Lateral opposing 4- to 6-MV photon beams were used for all patients.
After 3 months of follow up, patients in the standard-dose group had significantly better scores than the low-dose group on the visual analog scale (VAS; 0=no pain, 100=maximum pain), Calcaneodynia score (100=symptom free, 0=very intense symptoms), and the Short Form (SF)-12 health survey (high values correspond to good quality of life).
More specifically, the between group difference at 3 months was 23.39 for the VAS, 10.82 for the Calcaneodynia score, and ranged from 1.04 to 5.11 for the different sections of the SF-12. Many standard-dose patients who had good results at 3 months maintained pain relief at 12 months.
Notably, significantly fewer patients in the standard- versus the low-dose arm had to undergo re-irradiation due to the initial therapy being ineffective.
No acute or long-term side effects of the therapy were observed.
The authors concede that their results are somewhat limited by the small size of their study and suggest that further research is warranted. However, they conclude that "on the basis of the results of our trial, the effect of radiation therapy on painful heel spur could be proven at a high level of evidence."
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