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A study explores a possible new treatment for a common cause of foot pain. Bangmaha Art/EyeEm/Getty Images
  • Plantar fasciitis is one of the most common causes of foot pain.
  • Current treatments for persistent plantar fasciitis include steroid injections or surgery, which can have side effects.
  • A small study found that fat injections into the ball of the foot decrease pain and improve function.
  • Plans are in place for large-scale studies to verify these promising findings.

Many people experience foot and heel pain in their lifetime. And for about 80% of them, plantar fasciitis is the cause.

Plantar fasciitis is caused by inflammation or damage to connective tissue — the plantar fascia – which runs along the sole of the foot. women, the elderly and obese people or overweight are most likely to suffer from the disease. However, it can also affect people who regularly engage in high-impact exercise, such as running.

“Plantar fasciitis is probably the most common foot condition in adults in the United States. Although there are a number of potential therapies that have been successful, none are universally successful.

– Dr. David G. Armstrong, Ph.D., podiatric surgeon, speaking to Medical News Today.

For most people, exercises, braces, and night splints will fix the problem within a year. However, for some it can become a chronic condition, known as plantar fasciosis. The plantar fascia thickens and the collagen deteriorates.

People may have surgery to release tension in the plantar fascia or steroid injections. Both treatments provide pain relief but can have side effects, as body performance and injury specialist Dr. Rami Hashish, Ph.D., said. DTM:

“Steroid injections tend to provide only temporary relief and also have the potential side effect of weakening the plantar fascia, exposing it to a greater likelihood of rupture. And it goes without saying that there are There are also a multitude of side effects associated with the surgery, so the prospect of a safe alternative is quite exciting.

Now, a team from the University of Pittsburgh, PA, has developed just such a treatment for chronic plantar fasciitis. The study, which appears in the Journal of the American Society of Plastic Surgeonssuggests that fat injections into the ball of the foot can relieve pain and improve function.

In this small study, researchers injected fat, under local anesthesia, into the sole of the participant’s foot. They took fat from the person’s belly or elsewhere in their body.

They used a blunt needle to puncture the fascia in several places, injecting 0.1 milliliters (ml) of the person’s fat when the needle was withdrawn. Most participants were injected with just over 3ml of fat in total.

The researchers divided the 14 participants into two groups for the 12-month study. One group received the fat injections at the start of the study, and the other used night splints and arch supports for 6 months before receiving the fat injections.

After the injections, researchers told participants to limit weight-bearing exercises to 10 minutes per hour, use night splints for at least 1 hour each day, and wear supportive shoes without any accessories or arches. .
Support.

Both groups reported less pain after treatment. The group that received the treatment at the start of the study had a greater reduction in pain than those treated after 6 months.

The researchers measured the thickness of the plantar fascia after treatment. They saw a decrease in thickness at 6 months, and this improvement continued until the 12-month stage.

Several aspects of the treatment can contribute to the positive effect. Using a blunt needle, the researchers caused a small wound that stimulates healing. The fat contains stem cells and growth factors that help bring in blood supply to promote healing.

“We developed this procedure to harness the regenerative properties of fat,” says lead researcher Dr. Jeffrey Gusenoff, professor of plastic surgery at the University of Pittsburgh School of Medicine. “In this proof-of-concept study, we showed that fat injections into the foot reduced heel pain, helped patients return to sports and activities, and improved quality of life.”

The study had several limitations. The sample size was small and 13 of the 14 participants were female. The participants did not all have the same number of injections in the sole of the foot. And the researchers were unable to quantify participants’ compliance with recovery instructions.

While acknowledging the study’s limitations, Dr. Hashish praised the results: “[W]We should be reluctant to crown fat injections as the primary approach until further large sample studies are conducted. Nonetheless, the results are encouraging, so much so that I wouldn’t be surprised if fat injections were to become a mainstream approach to treating plantar fasciitis in the next few years.

And Dr Armstrong agreed: “The results of this study suggest that fat pad injections may hold promise in helping to improve outcomes in this common and costly condition. For my part, I am cautiously optimistic.

Dr. Gusenoff and his team are planning a large-scale clinical study to validate their findings.

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