Clinical outcomes of shockwave combined ultrasound drug introduction in patients with heel pain

  Background  Talalgia can lead to ankle dysfunction. Extracorporeal shock wave therapy can help patients recover to daily life within 1 to 2 days, but shockwave therapy also has the limitation of the short curative effect duration. Ultrasound drug delivery is an innovative drug delivery method in recent years, but it has not been applied to the treatment of talalgia.

  Objective  To observe the changes in pain intensity and ankle function before and after treatment in talalgia patients, and test whether ultrasound drug introduction combined with shockwave is a more effective therapy than shockwave alone.

  Methods  From September 2019 to September 2021, 60 patients with talalgia in the First Medical Center of Chinese PLA General Hospital were randomly divided into treatment group and control group. Patients in the two groups were both treated by shock wave treatment, with the duration of 15 min, 1 time per week. After shockwave treatment, the treatment group was given ultrasound drug introduction treatment (diclofenac diethylamine emulgel) for 15 min, 5 times per week for 2 weeks, while the control group had sham stimulation ultrasound drug introduction with the same method as the treatment group. Visual Analog Scale Score (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) were applied to evaluate the pain degree and ankle function before, at 1-and 2 weeks after treatment.

  Results  There was no significant difference in baseline data between the two groups. After treatment, the VAS score of the two groups decreased significantly over time, while the AOFAS score increased significantly. There was no significant difference in VAS and AOFAS scores between the two groups at 1 week after treatment, however, the differences were significant at 2 weeks after treatment (VAS: 3.36±1.00 vs 4.29±1.06; AOFAS: 80.22±8.73 vs 71.44±7.58; P＜0.05, respectively).

  Conclusion  Ultrasound drug delivery combined with shockwave can relieve the pain and improve the ankle function in patients with heel pain, which may be used as a comprehensive clinical treatment for talalgia patients, and the treatment cycle is suggested to be two weeks at least.