July 27, 2012 Patients with plantar fasciitis (painful bone heel spur) experience significantly less pain and improved quality of life following a standard dose of external beam radiation therapy, a common cancer treatment similar to receiving an X-ray, according to a randomized, cooperative group study that was published online July 25, 2012, in the International Journal of Radiation Oncology • Biology • Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO).
Approximately 8-10 percent of the population has severe bone heel spurs, with the most common treatments for alleviating the pain being ice, heat, and various anti-inflammatory agents. Steroids and local anesthetics can be injected, and oral analgesic medications may be prescribed, but most of these methods have only provided short-term pain relief. The results of this study demonstrated that up to 80 percent of standard dose patients experienced complete pain relief, and pain relief remained constant or even improved for up to 64 percent of the study participants during the follow-up period of 48 weeks post-treatment.
"Severe plantar fasciitis is a chronic health issue, and it can be extremely painful -- many of these men and women cannot walk or stand for a long time," said Marcus Niewald, MD, PhD, a radiation oncologist at Saarland University Medical Center in Homburg/Saar, Germany, and one of the study's authors. "Radiation therapy has been used for its anti-inflammatory effect for more than 60 years. We are extremely encouraged by the results of our research because evidence of improved quality of life for patients is clearly evident with the standard dose regimen."
This study was a prospective, randomized trial of a total of 66 patients, with evaluation every six weeks until 12-months post treatment. Four patients were secondarily excluded after the trial began; 29 patients received a standard dose regimen, and the remaining 33 patients received a low dose of radiation therapy. The standard dose patients were treated with a total dose of 6.0 Gy, applied in 6 single fractions of 1.0 Gy twice weekly on non-consecutive days. The low dose arm received 0.6 Gy, applied in 6 single fractions of 0.1 Gy twice weekly on non-consecutive days.
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- Marcus Niewald, M. Heinrich Seegenschmiedt, Oliver Micke, Stefan Graeber, Ralf Muecke, Vera Schaefer, Christine Scheid, Jochen Fleckenstein, Norbert Licht, Christian Ruebe. 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. International Journal of Radiation Oncology*Biology*Physics, 2012; DOI: 10.1016/j.ijrobp.2012.06.022
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