Thursday, 4 October 2012

Radiotherapy for plantar fasciitis

So today I am looking at another paper and it is not yet the Dupuytren's and genetics one as I am yet to have full access to that but I do have another interesting paper that came to my attention through a conversation that I am having with Dr Shaffer.

 He was saying how there is a new paper out that shows that radiotherapy can help with the treatment of plantar fasciitis. I had a look at the paper and noticed that it was in Hamburg and that of course meant that one of the authors on the list was Prof S. Dr Shaffer is so impressed with the results that he is considering starting to offer treatment to patients at his facilities. Although this is slightly off of what I normally cover I thought seeing as it is the use of radiotherapy in a condition in the foot there was no harm in looking at the data and seeing what it said and besides this is likely to be another case that the treatment is going to not be received by many patients due to lack of awareness much like radiotherapy for Ledderhose disease and maybe my post will help raise a little bit of awareness. Of course I will not go into my usual detail as I don't imagine too many people here are interested in reading too much about the exact science and risk factors of plantar fasciitis so here goes.  

This paper is available through pubmed for free so have a look if you think it sounds interesting: 

Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months’ Follow-Up. Niewald et al, published in the International Journal of Radiation Oncology. 

In simple terms I think that this condition is basically chronic inflammation which in time results in the formation of a heel spur. This can then be extremely painful and much like ledderhose disease surgery will be performed once conservative methods have failed. 

66 patients were randomised to get radiation therapy with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly or with a total dose of 0.6 Gy in 6 fractions of 0.1 Gy twice weekly. In the patients that had the higher dose the results after 3 months were much better than those that had had the lower dose. After a year those patients who had had the higher dose showed good results and those who had had the lower dose and then required the higher dose showed the same results as those that had the higher dose to start with. 

To be honest there is not much else to say from this paper other than it looks like radiotherapy also helps to give pain relief to this condition and with lower doses than those used to treat Ledderhose and related conditions. Surely it can only be a good thing to have more option available to treat any condition so that you have the choice of what you want to get. 

I hope that everyone found this interesting.