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Achilles tendinopathy
Plantar fasciosis

Dextrose: Ryan et al 2009 Dextrose injection for chronic pain of Plantar fasciosis
Ryan MB, Wong AD, Gillies JH, Wong J, Traunton JE Sonographically guided intratendinous injections of hyperosmolar dextrose/lidocaine: a pilot study for the treatment of chronic plantar fasciitis. Br J Sports Med 2009;43 :303–306.

The is an article about injection of 25% dextrose in 20 consecutive patients with pain in the feet imitated by prssure over the plantar fascia. Injections were given under ultrasound guidance. These were chronic cases with pain from 7 to 228 months (mean 21 months). Follow-up was for 6-20 months (mean 11.8) months from the final treatment. Three to 12 sessions (mean 3) were given at 2 week intervals. 16 out of 20 had good to excellent results.

My impression is that there were apparently no dropouts which is somewhat unusual in a study with foot injection every 2 weeks. This speaks well of the technique of the authors. However, the every 2 week frequency may have not allowed enough time in between to really determine the number of treatments needed with full healing intervals. There is always that balance between desire to move treatment along in an athlete and the desire to keep the number of treatments minimal. It is notable that, although ultrasound was used for injection there were no post treatment ultrasound results reported. Therefore there were no objective post treatment measures. There also was not a group comparing blind injections to ultrasound guided.

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