Promising Ultrasound-Guided Perineural Dextrose Injection for Plantar Fasciitis: A Case Report with Up to Seven Months Follow Up

Guntur Darmawan, King Hei Stanley Lam

Oman Medical Journal. DOI 10.5001/omj.2030.05

Abstract

Plantar fasciitis is a common source of heel pain, and treatment effects are often temporary. We reported 2 cases of ultrasound-guided perineural tibial nerve dextrose 5% water (D5W) injection in treating plantar fasciitis and subsequent three, five and seven-months follow up. Two middle-aged female patients with comorbidities, presented with chronic right heel pain despite of previous oral analgesics, steroid injections treatment. Physical examination, plain radiography, and musculoskeletal ultrasound confirmed the presence of plantar fasciitis. They sought for safe, effective, less painful, and more durable treatment options. After consented, two sessions a week apart of three-milliliters out-of-plane ultrasound-guided perineural tibial nerve D5W injection were performed, resulting in significant pain reduction. Three, five and seven-months evaluation revealed no recurrence of pain without any additional analgesics. Both patients reported greater satisfaction with this method and no worsening of their comorbidities. Ultrasound-guided perineural tibial nerve D5W injection serve as promising treatment option in treating plantar fasciitis. Larger studies are warranted to strongly establish the safety and effectiveness of this technique 

Keywords: Plantar Fasciitis; Heel Pain; Dextrose 5% Water; Ultrasound-Guided Perineural Injection; Tibial Nerve. Tibial Nerve.

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