Reumatología Clínica Reumatología Clínica
Reumatol Clin 2007;3:159-65 - Vol. 3 Núm.4 DOI: 10.1016/S1699-258X(07)73614-8
Originales
Fascitis plantar: revisión del tratamiento basado en la evidencia
Plantar Fascitis: Evidence-Based Review of Treatment
Ana Lafuente Guijosa, , Isabel O’mullony Muñoz, Maruxa Escribá de La Fuente, Paula Cura-Ituarte
Unidad de Rehabilitación. Fundación Hospital Alcorcón. Alcorcón. Madrid. España
Recibido 28 diciembre 2006, Aceptado 22 marzo 2007
Resumen
Objetivos

Analizar la eficacia de los tratamientos utilizados en la fascitis plantar.

Material y método

Se ha consultado los principales buscadores y bases de datos biomédicas: MEDLINE, Evidence Based Medicine, Cochrane Database of Systematic Reviews, Cochrane Register of Controlled Trials, EMBASE y PEDRO (Physiotherapy Evidence Database). Se seleccionó los estudios de mayor calidad científica: metaanálisis, revisiones sistemáticas, revisiones y ensayos clínicos controlados y/o aleatorizados de una o varias intervenciones para tratar el dolor plantar del talón.

Resultados

Tras realizar una revisión bibliográfica actualizada sobre el tratamiento de las fascitis plantar, se encontró que existen múltiples opciones terapéuticas, pero su eficacia es variable y no hay evidencia fuerte del beneficio de ninguna modalidad de tratamiento.

Únicamente se encontró limitada evidencia de beneficio con la utilización de taloneras blandas, junto con la realización de cinesiterapia, principalmente ejercicios específicos de estiramiento de la fascia plantar. Con las infiltraciones y la iontoforesis con corticoides también se ha demostrado beneficio, aunque limitado y a corto plazo. Con el resto de los tratamientos no se ha hallado suficiente evidencia de beneficio.

Conclusiones

Según el análisis de la evidencia científica, ante una fascitis plantar debemos recomendar primero la utilización de medidas conservadoras, sencillas y de bajo coste, como taloneras blandas y ejercicios específicos de estiramiento de la fascia plantar. Si lo anterior no es eficaz, se puede administrar corticoides locales mediante infiltraciones o iontoforesis, aunque su efecto es transitorio.

Resumen
Objetive

To analyze the effectiveness of the interventions in the management of plantar fasciitis.

Material and method

The main medical and biomedical databases have been used: MedLine, Evidence Based Medicine, Cochrane Database of Systematic Review, Cochrane Register of Controlled Trials, EMBASE and PEDRO (Physiotherapy Evidence Database). Meta-analysis, systematic reviews, reviews, and controlled or randomized clinical trials of interventions for heel pain have been selected.

Results

After an updated review of the treatment of plantar fascitis, we have found several therapy options to treat this problem, but their efficacy is variable, and none show strong evidence of benefit. The use of plantar insoles and stretching exercises focused on plantar fascia have demonstrated limited evidence of benefit. Corticosteroid injections and iontophoresis with steroids have also demonstrated evidence of benefit, although limited and during a short time. The rest of interventions have not demonstrated enough evidence of benefit.

Conclusions

An evidence-based review of treatments of plantar fasciitis suggests that we must first recommend the use of conservative measures, easy to perform and of low cost, such as plantar soft insoles, plus specific stretching plantar fascia exercises. Limited evidence suggest that steroid injection or iontophoresis may be useful, but of transient effect, when conservative options fail.

Palabras clave
Fascitis plantar, Dolor en la parte inferior del talón, Talalgia, Revisión, Tratamiento, Ensayo clínico
Key words
Plantar fasciitis, Heel pain, Painful heel syndrome, Review, Treatment, Clinical trial
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Correspondencia: Dra. A. Lafuente Guijosa. Baños de Montemayor, 5 portal 2-7.° A. 28005 Madrid. España.
Copyright © 2007. Elsevier España S.L Barcelona
Reumatol Clin 2007;3:159-65 - Vol. 3 Núm.4 DOI: 10.1016/S1699-258X(07)73614-8