低能量電波對腳底筋膜炎的治療有好處

這種治療可以緩解疼痛,使手術的必要性降低

  2002年4月15日報導──據Journal of Bone and Joint Surgery雜誌3月份一期中報導的一項前瞻性的隨機臨床試驗的結果顯示,體外電波治療方法可以幫助那些患有腳底筋膜炎的患者緩解走路時的疼痛感。

  德國美因茲the Johannes Gutenberg大學醫學院的Jan D. Rompe醫師,和他的同事們寫道:「利用1000衝量的低能量電波進行3次治療,對腳底筋膜炎的治療似乎有效,患者還可以不必因為頑固性的足跟痛而進行手術治療,相比之下,10個衝量的3次治療對症狀的改善沒有實質上的作用。」

  有112名患有腳底筋膜炎的患者,接受了為期12個月的隨訪,與只接受10個衝量單位治療的患者相比,那些每次接受1000個單位電波治療的患者的治療結局的優秀率提高了47%(p<0.0001)。他們由於人工壓力所導致的疼痛的目視近似刻度得分,平均的從77分將到了19分,但是與那些每次接受10個衝量單位治療的患者相比,並沒有顯著的差別。接受1000個衝量單位治療的患者中,超過半數的人(25/49)在治療的第六個月走路時不伴有疼痛,而每次治療接受10個單位衝量治療的患者,沒有一人在治療的第六個月走路時不會有疼痛(p<0.0001)。

  在治療的第五年,接受1000單位衝量治療的38名患者中,有5人(13%)接受了後跟手術,相比之下,每次接受10個單位衝量治療的40名患者中,有23人(58%)進行了手術治療(p<0.0001)。

  儘管大多數患者認為電波治療並不舒服,但沒有一人因為疼痛而終止治療,而且也沒有副作用。

  儘管FDA已經批准電波裝置用於治療足跟痛,但作者認為在沒有進行進一步的研究之前,不推薦低能量電波作為腳底筋膜炎的一線治療方法。

Low-Energy Shock Waves Benefit Plantar Fasciitis

Treatment Relieves Pain, Reduces Need for Surgery

By Laurie Barclay, MD
WebMD Medical News

Reviewed by Gary D. Vogin, MD

April 15, 2002 -- Extracorporeal shock-wave treatments may help patients with plantar fasciitis walk without pain, according to results of a prospective randomized trial reported in the March issue of the Journal of Bone and Joint Surgery.

"Three treatments with 1000 impulses of low-energy shock waves appear to be an effective therapy for plantar fasciitis and may help the patient to avoid surgery for recalcitrant heel pain," write Jan D. Rompe, MD, and colleagues from the Johannes Gutenberg University School of Medicine in Mainz, Germany. "In contrast, three applications of 10 impulses did not improve symptoms substantially."

At six months' follow-up of 112 patients with plantar fasciitis, those treated with 1000 impulses per treatment had 47% more good and excellent outcomes than did those treated with only 10 impulses (p<0.0001). On average, their visual analog scale score for pain caused by manual pressure decreased to 19 points from 77 points before treatment, whereas the score did not change significantly in the group receiving only 10 impulses per treatment. More than half (25/49) of patients receiving 1000 impulses but none of 48 patients receiving 10 impulses per treatment could walk completely without pain at six months (p<0.0001).

At five years, five of 38 patients (13%) treated with 1000 impulses had undergone heel surgery, compared with 23 of 40 patients (58%) who received 10 impulses per treatment (p<0.0001).

Although most patients found the shock-wave treatment unpleasant, none stopped because of pain, and there were no side effects.

Pending additional studies, the authors do not recommend low-energy shock waves as a first-line therapy for plantar fasciitis, even though the FDA has approved a shock-wave device for treating heel pain.

© 2002 WebMD Inc. All rights reserved.

    



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