***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Plantar fasciitis is one of the most common causes of foot pain in adults . In this prospect i ve study , the outcomes of local tenoxicam injection and corticosteroid therapy for the treatment of plantar fasciitis were compared . Patients were r and omly assigned to either the tenoxicam or corticosteroid group . The tenoxicam group ( n=31 ) was treated using a local injection of 1 mL of tenoxicam ( 20 mg/2 mL ) and 1 mL of 2 % lidocaine , whereas the steroid  group ( n=30 ) was treated with a local 1-mL injection containing 40 mg of methylprednisolone acetate and 1 mL of 2 % lidocaine . Clinical evaluations , which were performed before the injection and 6 and 12 months after the injection , consisted of patient-assessed pain using a visual analog scale . In addition , patient satisfaction was measured using the Roles and Maudsley score . Comparison of pre- and posttreatment visual analog scale scores demonstrated a statistically significant difference in both groups ( P<.05 ) . Furthermore , no significant difference was found between the steroid and tenoxicam groups in terms of visual analog scale scores measured 12 months after injection ( P>.05 ) . The tenoxicam injection was not significantly more effective than the corticosteroid injection . However , both methods were effective and successful in treating patients with plantar fasciitis .  Tenoxicam therapy appears to provide pain relief , but its effectiveness in the long term should be explored in additional studies Background The  Visual Analogue Scale ( VAS ) and the Foot Health Status Question naire ( FHSQ ) are two commonly used outcome measures for evaluating foot health . This study aim ed to calculate the Minimal Important Difference ( MID ) of the VAS and the FHSQ . Methods 184 participants with plantar heel pain were recruited from the general public to take part in two r and omised trials ( 92 participants in each trial ) that studied the effectiveness of two conservative interventions for plantar heel pain . Data from these participants were used to calculate the MIDs of the  VAS and the  FHSQ .  An anchor-based method was used to calculate the MIDs . Two distinct types of pain were investigated for the VAS : average pain and first-step pain . All four domains of the FHSQ were investigated : foot pain , foot function , footwear and general foot health . Results The MID for the VAS using the anchor-based approach was -8 mm ( 95 % CI : -12 to -4 ) for average pain and -19 mm ( 95 % CI : -25 to -13 ) for first-step pain on the 100 mm VAS . The MID for the FHSQ was 13 points ( 95 % CI : 6 to 19 ) for pain and 7 points ( 95 % CI : 1 to 13 ) for function . The MID for the footwear domain of the FHSQ was -2 points ( 95 % CI : -8 to 4 ) and 0 points ( 95 % CI : -7 to 6 ) for the general foot health domain of the FHSQ . Conclusion The results of this study provide additional evidence for MID values of the VAS and the FHSQ for plantar heel pain . This is important for clinicians and research ers as it provides a greater underst and ing of how much improvement is required by a patient before a minimal , worthwhile change is experienced . The calculated MIDs will also assist research ers with prospect i ve sample size calculations Plantar fasciitis is a common cause of heel pain . It is a disabling disease in its chronic form . It is a degenerative tissue condition of the plantar fascia rather than an inflammation . Various treatment options are available , including nonsteroidal anti-inflammatory drugs , corticosteroid injections , orthosis , and physiotherapy . This study compared the effects of local platelet-rich plasma , corticosteroid , and placebo injections in the treatment of chronic plantar fasciitis . In this double-blind study , patients were divided r and omly into 3 groups .  Local injections of platelet-rich plasma , corticosteroid , or normal saline were given . Patients were assessed with the visual analog scale for pain and with the American Orthopaedic Foot and Ankle Society ( AOFAS ) Ankle and Hindfoot score before injection , at 3 weeks , and at 3-month follow-up . Mean visual analog scale score in the platelet-rich plasma and corticosteroid groups decreased from 7.44 and 7.72 preinjection to 2.52 and 3.64 at final follow-up , respectively . Mean AOFAS score in the platelet-rich plasma and corticosteroid groups improved from 51.56 and 55.72 preinjection to 88.24 and 81.32 at final follow-up , respectively . There was a significant improvement in visual analog scale score and AOFAS score in the platelet-rich plasma and corticosteroid groups at 3 weeks and at 3-month follow-up . There was no significant improvement in visual analog scale score or AOFAS score in the placebo group at any stage of the study . The authors concluded that local injection of platelet-rich plasma or corticosteroid is an effective treatment option for chronic plantar fasciitis . Platelet-rich plasma injection is as effective as or more effective than corticosteroid injection in treating chronic plantar fasciitis Objective The aim of this study was to investigate the effectiveness of device-assisted ultrasound-guided steroid injection for treating plantar fasciitis . Design An ultrasound-guided injection device design ed with space for securing a transducer and syringe was used to guide steroid injection . Patients with unilateral plantar fasciitis were enrolled and r and omly divided into device-assisted ultrasound-guided and palpation-guided groups . Pain intensity was measured using a visual analog scale and tenderness threshold . Ultrasound and pain intensity evaluations were performed before injection and at 3 wks and at 3 mos postinjection . Betamethasone ( 7 mg ) and 1 % lidocaine ( 0.5 ml ) were injected into the inflamed plantar fascia . Results Thirty-three patients who received either device-assisted ultrasound-guided or palpation-guided injection had significantly lower visual analog scale scores ( P < 0.001 ) and higher tenderness threshold ( P < 0.01 ) postinjection . However , the device-assisted group had higher tenderness threshold ( 9.02 ± 1.38 vs. 7.18 ± 2.11 kg/cm2 ; P = 0.007 ) , lower visual analog scale score ( 1.88 ± 2.13 vs. 3.63 ± 2.60 ; P = 0.046 ) , and lower hypoechogenicity incidence in the plantar fascia ( 3/16 vs. 9/16 ; P = 0.033 ) than the palpation-guided group did at 3 mos postinjection . The heel pad was significantly thin ( P = 0.004 ) in the palpation-guided group postinjection . Conclusions Device-assisted ultrasound-guided injection for treating plantar fasciitis results in better therapeutic outcomes than palpation-guided injection does Purpose The aim of this study was to assess the reliability of perifascial oedema as a sonographic criterion for selecting the most appropriate treatment ( ultrasoundguided corticosteroid injection or ultrasound-guided extracorporeal shock wave therapy ) of idiopathic plantar fasciitis ( IPF ) . Material s and methods Sixty-four patients with a clinical diagnosis of unilateral refractory IPF , treated conservatively for at least 8 weeks , were studied with highresolution ultrasound ( HRUS ) .  Pain intensity was evaluated with a visual analogue scale ( VAS ) . HRUS was used to confirm IPF and identify the presence of perifascial oedema . Patients with an HRUS diagnosis of IPF were grouped according to the presence ( A ) or absence ( B ) of perifascial oedema and then r and omly allocated to treatment with corticosteroid injection ( 1 ) or extracorporeal shock wave therapy ( 2 ) . Clinical and HRUS follow-up was performed 6 weeks after treatment . Results HRUS confirmed IPF in 68,97 % of patients and identified perifascial oedema in 53.33 % . Clinical and sonographic improvements were observed in 87.5 % and 37.5 % of patients in subgroups A1 and A2 , respectively , and in 35.71 % and 92.85 % of those in subgroups B1 and B2 , respectively . Conclusions The presence of perifascial oedema may represent an effective criterion for guiding treatment decisions towards HRUS-guided corticosteroid injection . RiassuntoObiettivoValutare l’affidabilità del criterio ecografico nell’individuazione dell’edema perifasciale nella scelta della terapia mini-invasiva ( iniezione di corticosteroidi o onde d’urto , ESWT ) con guida dell’ecografia ad alta risoluzione ( HRUS ) nel trattamento della fascite plantare idiopatica ( FPI ) . Material i e metodiSessantaquattro pazienti con diagnosi clinica di FPI monolaterale , recalcitrante , trattata conservativamente per almeno 8 settimane , sono stati sottoposti ad HRUS . Il dolore è stato quantizzato con una visual analogue scale ( VAS ) . La FPI è stata verificata all’HRUS ed è stata valutata la presenza di edema perifasciale . I pazienti con diagnosi HRUS di FPI sono stati suddivisi in ( A ) presenza e ( B ) assenza di edema perifasciale e poi suddivisi r and om in trattati con ( 1 ) infiltrazione di corticosteroidi e ( 2 ) ESWT . Le rivalutazioni clinica e HRUS sono state eseguite a 6 settimane . RisultatiNel 68,97 % dei pazienti l’HRUS ha evidenziato una FPI con edema perifasciale nel 53,33 % . Nei pazienti dei sottogruppi A1 e A2 è stato evidenziato un miglioramento clinico-strumentale nel 87,5 % e nel 37,5 % dei casi , mentre nei pazienti dei sottogruppi B1 e B2 questo è stato evidenziato nel 35,71 % e nel 92,85 % dei casi . Conclusion iLa presenza dell’edema perifasciale potrebbe essere un efficace criterio nell’indirizzare la terapia verso le iniezioni di corticosteroidi con guida HRUS Objective : To investigate the effectiveness of a physiotherapy-based exercise program versus dexamethasone injection for chronic plantar fasciopathy in workers st and ing for prolonged periods of time . Design : A parallel group nonblinded r and omized controlled trial with 12-week follow-up . Setting : An outpatient sports medicine clinic in Vancouver , British Columbia , Canada . Participants : Fifty-six workers required to st and for greater than 5 h/d with chronic plantar fasciopathy took part . Diagnosis from a physiotherapist must include signs of structural changes to the plantar fascia seen on ultrasound . Interventions : The PHYSIO group included 7 physiotherapy-led exercises performed daily over a 12-week period . The INJECTION group received 1 palpation-guided dexamethasone injection followed by a daily routine of calf stretching . Main Outcome Measures : The Foot and Ankle Disability Index ( FADI ) scores 12-weeks postintervention and ultrasound-based measures of ligament appearance . Results : At follow-up , both groups reported significant improvements in FADI and visual analog scales for pain at work and with activities of daily living at 6 and 12 weeks compared with baseline scores ( P < 0.001 ) . There were no significant between-group differences . There were no significant changes to plantar fascia thickness reported at the 6- and 12-week follow-up point . Both the number of cases with focal anechoic areas and the size of these anechoic areas improved significantly in the PHYSIO ( P = 0.003 ) and INJECTION ( P < 0.001 ) groups at 12-week follow-up . Conclusions : Workers st and ing for prolonged periods experienced the same short-term therapeutic effectiveness with a physiotherapy-led exercise program compared with an injection of corticosteroid with stretching PURPOSE To compare the effectiveness of sonographically guided and palpation-guided steroid injection for the treatment of proximal plantar fasciitis . PATIENTS AND METHODS Twenty-five consecutive patients with unilateral proximal plantar fasciitis were recruited and r and omly divided into a sonographically guided group ( n = 12 ) and palpation-guided group ( n = 13 ) . Proximal plantar fascia was assessed with a 5- to 12-MHz linear-array transducer .  Pain intensity was quantified using a " tenderness threshold " ( TT ) and a visual analog scale ( VAS ) . Injection of 7 mg ( 1 ml ) of betamethasone and 0.5 ml of 1 % lidocaine into the inflamed proximal plantar fascia was performed under the guidance of sonography or palpation . Patients were evaluated clinical ly and sonographically before injection and at 2 weeks , 2 months , and 1 year after injection . VAS- and TT-measured pain intensity , thickness , and echogenicity of the proximal plantar fascia , as well as the recurrence of heel pain , were assessed . RESULTS Both VAS- and TT-measured levels of pain improved significantly after steroid injection in both groups ( p < 0.001 ) . Also 
    Output:
    
There was very low quality evidence for fewer treatment failures ( defined variously as persistent heel pain at 8 weeks , steroid injection at 12 weeks , and unrelieved pain at 6 months ) after steroid injection .
We found low quality evidence that local steroid injections compared with placebo or no treatment may slightly reduce heel pain up to one month but not subsequently .