Best Podiatrist In Pensacola Fl – Plantar Fasciitis is the most common cause of heel pain, accounting for 15% of all foot symptoms requiring medical attention in adults. MLS® laser therapy is safe and effective in the treatment of painful orthopedic conditions, although there are no randomized controlled trials evaluating its effectiveness in the treatment of chronic plantar fasciitis. The Effect of a Class IV Multifocal Locking System (MLS) Laser on Plantar Fasciitis J. Geldwert DPM R. Minara DPM Center for Podiatric Care and Sports Medicine 111 East 88th Street, New York, NY 10128 The most common cause of heel pain and its effect on 15 % of adults. Foot symptoms require medical attention. MLS laser therapy is safe and effective in the treatment of painful orthopedic conditions, although there are no randomized controlled trials evaluating its effectiveness in the treatment of chronic plantar fasciitis. The MLS laser is a class IV laser consisting of simultaneous continuous emission (808 nm) and pulsed emission (905 nm). This high-energy laser also has pain-relieving, anti-inflammatory and swelling-reducing properties. The aim of this study was to determine the effectiveness of MLS laser treatment in patients with plantar fasciitis. Twenty subjects with at least a 1-month history of plantar fasciitis were included in a randomized, non-placebo-controlled trial. Before treatment, the patient’s VAS pain level and fascia thickness (measured by ultrasound) were measured. Each patient used a multidiode arm at the same location at 700 Hz, 218.4 J 3 times a week for two weeks (6 treatments in total). Each treatment lasts 7 minutes. Patients were then evaluated at 4, 8, and 12 weeks post-treatment. At least 4 weeks after laser treatment, patients’ pain VAS decreased from a mean of 6.2 (range 3-10) to 2.6 (range 0-6). 16 out of 20 patients had reduced pain levels. Facial thickness decreased from 0.48 cm to 0.43 cm as measured by ultrasound. Although there was no significant reduction in fascial thickness, 80% of patients reported improvement in symptoms, with a mean VAS reduction of 3.6. Introduction One of the most common conditions treated by foot and ankle specialists is plantar fasciitis. Research shows that as the leading cause of heel pain, plantar fasciitis accounts for 15% of all foot symptoms requiring medical attention in adults (1). Older theories suggest that aging and sedentary populations are the hardest. However, we now know that it seems to affect many groups of patients regardless of age, gender, ethnicity, weight, activity level or foot shape. In some patients, symptoms usually resolve on their own within a year. However, many people seek treatment because of the severity or chronicity of the pain. Traditional conservative management of plantar fasciitis focuses on stretching, appropriate footwear and orthotics, and treatment of inflammation; Oral or topical NSAIDs, oral steroids, and usually injectable corticosteroids. Some patients ultimately choose surgical intervention because they do not respond to non-surgical treatments. The gold standard surgical procedure is fasciotomy, although other procedures, including radiofrequency ablation, have been shown to be effective. Advanced therapies, including extracorporeal shock wave therapy, have been shown to have a positive effect on reducing pain and functioning in patients (1). Laser therapy, especially class 3B low-level laser therapy (LLLT), has been widely used and studied in the medical literature since it was approved by the FDA in 1996. Bjordel et al conducted a systematic review of over 200 randomized controlled trials of LLLT (2). ). There is strong evidence that LLLT improves angiogenesis, modulates biochemical markers of inflammation, increases growth factor secretion, and enhances angiogenesis (2). However, due to some limitations, LLLT was not effective in many studies. Biological processes resulting from laser/radiation interactions are primarily photochemical and limited to surface biostimulation. LLLT requires longer treatment times and multiple treatments. The therapeutic effect is obtained only at the end of the treatment period, and the treatment is effective only for wounds of a certain tissue depth. The MLS therapy laser is a class IV device consisting of simultaneous continuous transmission (808 nm) and pulsed radiation (905 nm). This combination, with high energy output, has been shown to be analgesic, anti-inflammatory and anti-edema, and to treat a variety of ailments deeper into the tissues. Biological interactions and therapeutic effects of MLS lasers include photochemical, photothermal and photomechanical effects. Photochemistry at 808 nm increases the activity of the mitochondrial respiratory chain, allowing it to enter the second absorption peak of cytochrome oxidase. The wavelength of 905 nm increases the activity of complexes I, II, III and IV of the mitochondrial respiratory chain and succinate dehydrogenase. This overall increase in mitochondrial activation increases ATP synthesis, potentially accelerating the healing process (3). The photothermal effect increases the rate of biochemical reactions and tissue metabolism, and reduces vasodilation and fluid viscosity. This leads to increased blood flow, decreased tissue stiffness, and activates the inflammatory healing process while having an overall calming, pain-relieving effect (4). Laser and photothermal effects induce optomechanical effects, resulting in forces that affect the cellular and extracellular matrix (ECM) components of various tissues. These non-destructive mechanical effects occur through reversible deformation of the ECM. These forces contribute to cell growth and differentiation, protein synthesis, and ECM production. These actions help maintain the homeostasis of structural functional tissues such as connective tissue, muscle, bone and cartilage, essentially helping to regulate tissue healing processes. (5) MLS laser therapy is safe and effective in the treatment of painful musculoskeletal disorders, such as research by Dr. However, no studies have evaluated its effectiveness in the treatment of chronic plantar fasciitis. The aim of this study was to determine the effectiveness of MLS laser treatment in patients with plantar fasciitis. Materials and Methods Twenty patients from one office were included in the study. 11 women and 9 men aged 32-80 participated, with an average age of 42.5 years. Patients with a positive physical examination based on typical findings of plantar fasciitis, including medial colonic nodules at the origin of the fascia and/or tenderness on palpation of the medial aspect of the plantar fascia, and palpation of the proximal third of the fascial band were included. . Pain and suffering. Usually after a break. Patients must have a history of plantar fasciitis for at least one month. Previous treatments excluded patients from the study unless they received steroid injections or anti-inflammatory drugs within one month of starting laser treatment. Other exclusion criteria include pregnancy, epilepsy, and patients with pacemakers. All patients were treated with the same protocol using the same MLS Mphi5 laser in the same office by the same physician. Each patient was treated for 7 minutes (700 Hz, 218.4 J) per session, with manual diodes in the area of the chief complaint and the typical trigger point. Tendonitis is treated. Patients received treatment twice a week for three weeks for a total of six sessions. Before starting treatment, pain was assessed by VAS. The patient’s plantar fascia was also measured using ultrasound. The mean pretreatment VAS score was 6.2 (range 3–10), and the mean ultrasound measurement of the plantar fascia was 0.48 cm (range 0.19–0.71 cm). Results After completing the treatment regimen, patients were evaluated at 4, 8, and 12 weeks post-treatment. All patients were evaluated 4 weeks after treatment, but only 8 were evaluated at 8 weeks and 6 at 12 weeks. At each post-treatment visit, the patient’s pain level was determined by VAS and a new ultrasound measurement of the fascia was performed. The mean VAS after treatment was 2.6 (range 0–6), with a mean decrease of 3.6 (Figure 1). Eighty percent of subjects (16/20) reported a reduction in symptoms. The average fascial ultrasound measurement decreased from a minimum mean of 0.48 mm to a mean of 0.43 mm (Figure 2). Discussion 80% of study patients reported symptom relief after 4 weeks of treatment. Although the total thickness of the fascial penetration was also reduced, the mean reduction was only 0.5 mm. However, this study has some limitations. Ideally, patients have no prior medical history to better consider MLS laser therapy as a stand-alone first-line treatment for plantar fasciitis. The patients in this study underwent multiple treatments, and although they were weaned from the use of medications (such as injectable or oral medications) in the past month, many continued to use custom or prefabricated orthoses.