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  • Return to More On Orthopaedic Medicine > Individual Prolotherapy Study Summaries > Plantar Fasciosis

    Whole Blood Kiter et al 2006 Whole blood vs Steroid vs repetitive needling

    Kiter E; Celikbas E; Akkaya S; Demirkan F; Kilic BA Comparison of injection modalities in the treatment of plantar heel pain: a randomized controlled trial. J Am Podiatr Med Assoc (United States), Jul-Aug 2006, 96(4) p293-6

    Dr. Reeves' Notes:   It is important to note that these were feet that had not been injected before. In feet without previous injection exposed to steroid X 1, blood X1, or traumatic needling with anesthetic only, each group as a whole did much better with one treatment at 6 months follow-up. Clinical experience has indicated that the first injection with steroid is usually helpful but subsequent injections are less so. Thus these results are not those expected from chronic feet pain that have failed injection. It is interesting to note that results were very similar between 15 or more traumatic redirections of an 18 gauge needle and a single injection of autologous blood with such trauma being required. Also notable was a severity of 6.4 in the needling group and 7.6 in the blood group, which may have been significant if the groups had been larger in size (15 in each group) 

    A copy of the abstract on Whole Blood Kiter is available here, with a copy of the content below.

    Summary: In a prospective randomized study of plantar heel pain, 44 patients were treated with injection of 1 mL of 2% prilocaine using the peppering technique, 1 mL of 2% prilocaine combined with 2 mL of autologous blood, or 1 mL of 2% prilocaine mixed with 40 mg of methylprednisolone acetate. At 6-month follow-up, clinical improvement was evaluated by using a 10-cm visual analog scale and the rearfoot score of the American Orthopaedic Foot and Ankle Society. Results were analyzed using sample t-tests within groups and repeated-measures analyses of variance between groups. Mean +/- SD visual analog scale scores in the peppering technique, autologous blood injection, and corticosteroid injection groups improved from 6.4 +/- 1.1, 7.6 +/- 1.3, and 7.28 +/- 1.2 to 2.0 +/- 2.2 (P < .001), 2.4 +/- 1.8 (P < .001), and 2.57 +/- 2.9 (P < .001), respectively. Mean +/- SD rearfoot scores in the same groups improved from 64.1 +/- 15.1, 71.6 +/- 1, and 65.7 +/- 12.7 to 78.2 +/- 12.4 (P = .018), 80.9 +/- 13.9 (P = .025), and 80.07 +/- 17.5 (P = .030), respectively. There were no statistically significant differences among the groups. Good outcomes have been documented using the peppering technique and autologous blood injection for the treatment of lateral epicondylitis. Although the curative mechanisms of both injection modalities are based on a hypothesis, they seem to be good alternatives to corticosteroid injection for the treatment of plantar heel pain.