Plantar fasciitis is a soft tissue injury characterized by inflammation of the plantar fascia. This syndrome can occur both acutely and chronically from overstretching of the plantar fascia or by overuse. There are a variety of methods to treat plantar fasciitis by controlling the inflammation. Ice massage is one traditional modality used to treat this condition, however, the current research both supports and refutes its use.
Research Supporting the Use of Ice Massage
· When applying ice
massage to an injury, many benefits may be expected. Ice massage is often
considered a primary treatment for plantar fasciitis because of its analgesic
effects. According to study conducted by Anaya-Terroba et al., Effects of
ice massage on pressure pain thresholds and electromyography activity
postexercise,
when tested on a specific muscle group,
the effects of ice massage have shown to increase a person’s pressure pain
threshold, which is the amount of pressure required
for sensation of pressure to change to pain. Additionally, surface EMG activity
has shown greater activity after ice massage treatment. Both effects of ice
massage can be considered highly desirable to a person hindered by plantar
fasciitis by allowing greater muscle recruitment and activity tolerance.
·
In the study, Intramuscular temperature responses in
the human leg to two forms of cryotherapy: Ice massage and ice bag by Zemke et al., the researchers compared muscle
temperature responses to two types of cryotherapy: ice massage and ice
bag. The results of the study
found that ice massage took about 18 minutes to achieve the lowest
intramuscular temperature, and the ice bag took considerably longer at 28
minutes. Although the study tested
the temperature of the calf musculature, these findings can be applied to
plantar fasciitis as well. In an
acute muscular injury, such as plantar fasciitis, ice massage can help cool the
injured tissue very rapidly. The beneficial
effects of rapid cooling include decreasing the injured cells’ need for oxygen
and reducing circulation to the site of injury which can help to lessen the
effects of the inflammatory response.
·
In an investigation by Middleton and Kolodin, Plantar
fasciitis-heel pain in athletes, the
researchers talk about six specific areas that need to be addressed for the
treatment of plantar fasciitis. One of the six areas consists of therapeutic
modalities. The researchers highlight ice massage or bagged ice as a good
treatment for acute plantar fasciitis because it controls swelling and
will help relieve the discomfort the patient feels from the inflammatory
process.
Research
refuting the use of ice massage to treat plantar fasciitis:
·
In Plantar fasciitis: Diagnosis and therapeutic considerations, the author, Roxas, talks about a variety of
treatment options for plantar fasciitis. Treating
plantar fasciitis typically involves conservative treatment of the condition by
using methods such as medication (NSAIDS), stretching, reduced weight
bearing, orthotic considerations, strengthening,
and ice massage. Ice massage has been concluded to only temporarily relieve
foot pain in a research based study, but combined with these methods, plantar
fasciitis typically resolves in 90% of cases.
·
The study, Treatment of plantar fasciitis in
recreational athletes: two different therapeutic protocols by
Karagounis et al., prescribes the
accompanying use of acupuncture along with conservative treatments, rather than
ice massage alone. The usage of acupuncture has been prescribed more often in
the treatment of acute and chronic pain, so why not plantar fasciitis? The
results of combining acupuncture with typical treatment resulted in a
statistical decrease in pain perception by the patient when compared to
traditional treatments alone. This indicates that acupuncture should be applied
or considered when treating plantar fasciitis along with traditional treatments
to decrease healing time.
·
The article The Use of Ice in the Treatment of Acute
Soft-Tissue Injury by Bleakley et al., is a
systematic review of randomized controlled trials assessing the evidence for
cryotherapy as a treatment modality for soft tissue injuries. Although ice has been found to decrease
pain in a number of soft tissue injuries, it is less effective in controlling
swelling based research of knee surgery rehabilitation. It has been found that a single
application of ice and compression had the same outcomes as no treatment in
reducing pain and swelling in subjects with an ankle sprain. At this time, a few studies have found
minimal support for the use of ice in treatment of soft tissue injuries,
however, a standardized mode and duration of treatment has not been
determined. Due to the lack of
evidence for cryotherapy, ice massage should be used with caution in the
treatment of soft tissue injuries including plantar fasciitis.
In conclusion, the literature supports the use of ice
massage as a modality in the treatment of plantar fasciitis to reduce the
inflammatory response and aid in pain relief. However, more research is needed to determine the most
effective use other conservative modalities used in combination with ice
massage. Additional research is
needed to validate studies of alternative medicine used in combination with
traditional treatments. Future
studies should also determine an optimal mode and duration for the use of ice
massage.
Anaya-Terroba, L., Arroyo-Morales, M., Fernández-de-Las-Peñas, C., Díaz-Rodríguez, L., & Cleland, J. a. (n.d.). Effects of ice massage on pressure pain thresholds and electromyography activity postexercise: a randomized controlled crossover study. Journal of manipulative and physiological therapeutics, 33(3), 212-9.
Zemke, J. E., Andersen, J. C., Guion, W. K., McMillan, J., & Joyner, A. B. (1998). Intramuscular temperature responses in the human leg to two forms of cryotherapy: ice massage and ice bag. The Journal of orthopaedic and sports physical therapy, 27(4), 301-7. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9549714
Middleton, J.A., and E.L. Kolodin. "Plantar fasciitis-heel pain in athletes." Journal of athletic training. 27.1 (1992): 70-5. Web. 19 Jan. 2012.
Karagounis, P., Tsironi, M., Prionas, G., Tsiganos, G., & Baltopoulos, P. (2011). Treatment of plantar fasciitis in recreational athletes: two different therapeutic protocols. Foot & ankle specialist, 4(4), 226-34. doi:10.1177/1938640011407320
Bleakley, C., McDonough, S., & MacAuley, D.
(Jan 2004). The use of ice in the treatment of acute soft-tissue injury: a
systematic review of randomized controlled trials. The American journal of
sports medicine,
32(1),
251-61. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14754753
Roxas, Mario. "Alternative Medicine
Review." Plantar Fasciitis: Diagnosis and Therapeutic Considerations. 10.2 (2005): 83-93.
Web. 20 Jan. 2012.
Hajiamini Z, Masoud SN, Ebadi A, Mahboubh A, Matin AA. Comparing the effects of ice massage and acupressure on labor pain reduction. Complement Ther Clin Pract. 2012 Aug;18(3):169-72. doi: 10.1016/j.ctcp.2012.05.003. Epub 2012 Jun 29.
ReplyDeleteMany articles have reviewed the usefulness of ice massage as a modality to reduce inflammation and pain and found it to be effective (i.e. plantar fasciitis). The current article under review is titled "Comparing the effects of ice massage and acupressure on labor pain reduction".
The study wished to study pain management of women during childbirth. The authors "aimed to compare the effects of ice massage, acupressure, and placebo in reducing the intensity of labor pain in pregnant women from selected hospitals in Tehran, Iran."
The study completed was quasi-experimental. There were 90 pregnant women that had a mean age of 27.8 years. These women were randomly allocated to three groups: ice massage, acupressure, or placebo. The intervention was placed at the Hegu point on the hand (a common acupunture point located on the dorsum of the hand between the first and second metacarpal bones, at the midpoint of the second metacarpal bone and close to its radial border). The ice massage was performed with the researcher placing ice balls (2 cm in diameter) inside a wet thin gauze into the hand and massaging rotationally for 10 min (2 min pressure and 15 min break). Pain intensity via a visual analogue scale (VAS) was monitored prior to the intervention, 30 min after, and 1 hour post intervention. The results showed that pain intensity among the ice massage group showed the greatest decrease in pain. It was concluded that both ice massage and acupressure techniques reduced pain during labor with ice massage providing greater relief. It was suggested that "in the active phase of the labor, the interventions should be repeated every 30 min."
This article presents supportive evidence in using ice massage as a modality to decrease pain in women during labor.
[Reviewed by Ryan Barragree and Christian Busch]
DeleteRehabilitation Interventions for Pain and Disability in Osteoarthritis: A review of interventions including exercise, manual techniques, and assistive devices. Maura Daly Iverson. Orthopaedic Nursing. March/April 2012, Volume 31, Number 2.
ReplyDeleteOsteoarthritis is a progressive destruction of a joint, that includes both bone and cartilage damage. The current literature suggests that exercise and a variety of modalities and manual techniques can be used to reduce the debilitating effects of OA. These interventions can be used to help reduce the disability of the patient, and help improve their function. In this literature review, a meta-analysis was performed on three RCTs of 179 OA patients who received cold or ice packs, with or without ice massage, hot packs, or no treatment. The outcomes for these study included pain relief, decreased swelling, improved ROM, and better function. One study’s findings included the benefits of ice massage specifically. 20 minutes of ice massage five days/week for three weeks compared to no treatment, resulted in an increase in quadriceps strength (29% difference) and resulted in an increase in functional status (11% difference). The study qualities for these were not particularly high, but results showed improvements in those treated with ice massage in ROM, knee strength and function as well as a decrease in swelling.
[The above two studies were reviewed and summarized by Ryan Barragree and Christian Busch]
Thanks for the blog post buddy! Keep them coming...
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