แนวทางการรักษาโรครองช้ำ

Abstract

Plantar fasciitis does not know the exact cause.  Many studies suggested that gastro soleus complex, Achilles and gastro soleus muscle, and more rigid plantar fascia and the weight gain might play some part in heel pain. The leading symptom is the heel pain after waking up in the morning or not moving for a long period of time. It will be very painful when moving the first step after that the pain will be alleviated. Most patients feel pain at the medial aspect of heel at approximately 70-75%. At present, non-surgical procedures are more effective to cure the symptoms at approximately 80% and these symptoms will gradually improve at 6 months.  With a variety of treatments, the question is which treatment will yield a better result and also being worthwhile. This article reviewed the extant literature on the treatment of plantar fasciitis in different ways. The current results demonstrated that most patients respond well to the non-surgical treatment, that is, the non-steroidal anti-inflammatory drugs are effective in 80% of the patients, while the steroid injection at a specific pain area could provide immediate pain relief but side effects should be carefully considered including tear ligaments or atrophy of fat layer under the feet, which will cause chronic pain. The use of Platelet- Rich Plasma (PRP) to reduce pain was effective at 3 months. High frequency of Extracorporeal Shock Wave Therapy (ESWT) could achieve good results in 50 - 94% at 24 months follow-up period. Foot support instruments had a benefit in the midterm (7-12 weeks), with pain relief and functional efficacy, however,  the long-term data were not significantly different from a control group. The taping method for seven day in 92 patients showed improvements in pain but it did not achieve a significant difference from a control group (p=0.08)

                 In conclusion, the current treatments for plantar fasciitis indicated that non-surgical treatment resulted in an effective therapeutic outcome for more than 80%. Although there are many types of treatments available, the key of successful plantar fasciitis treatments are stretching the Achilles tendon and plantar fascia, using shoes with foot-arch support, avoiding the high-heeled shoes wearing, and avoiding over-exercising training.