<p>Local ozone (O<sub>2</sub>–O<sub>3</sub>) versus corticosteroid injection efficacy in plantar fasciitis treatment: a double-blinded RCT</p>

Abstract

Purpose: To compare the efficacy of local ozone injection versus corticosteroid in plantar fasciopathy treatment. Patients and methods: This double-blinded randomized trial was performed on 44 adult patients with plantar fasciopathy. One group (23 patients) received local injection of 40 mg methylprednisolone, while a local injection of 3 cc oxygen-ozone solution was performed for the other group (21 subjects). Severity of pain, functional level, and pressure-pain threshold (PPT) were measured before treatment and 1, 4, and 12 weeks after injection using VAS, Foot and Ankle Ability Measure (FAAM) questionnaire, and algometer for PPT, respectively. Results: The majority (65.9%) of the total 44 patients analyzed, were women. Both treatments efficiently relieved patients’ pain and improved their functions at 1 and 3 months follow-up time-points. But one week after injection, the improvement in VAS ( p <0.001) and FAAM ( p <0.001) was significant only in the corticosteroid group. During the first month, VAS ( p =0.35) and PPT ( p =0.003) were still better in the corticosteroid group. However, FAAM revealed no remarkable difference between the two groups ( p =0.083). Eventually, at the third month of follow-up, there was no remarkable preference between the treatments regarding any of the outcome measures ( p >0.05). Nevertheless, both methods efficiently improved patients’ symptoms, ie, over the 50% of pain reduction and 30% improvement in functional status. Conclusion: The present results showed no remarkable superiority between the two groups. In other words, although ozone injection showed a slower efficacy than methylprednisolone, it could be used in plantar fasciitis management as an appropriate alternative. Keywords: plantar fasciopathy, ozone, steroids, heel