Abstract
Amaç: Halluks valgus, ayağın yaygın bir deformitesi olup önemli ağrı ve fonksiyonel bozukluğa neden olabilir. Bu çalışmanın amacı hafif ve orta dereceli halluks valgus ağrısının tedavisinde proloterapi ve kuru iğnelemenin etkinliğini karşılaştırmaktır.
Gereç ve Yöntemler: Ortez ve analjezik tedavi sonrası dirençli ağrı yaşayan halluks valgus deformitesi olan ve proloterapi (52 hasta, 68 ayak) veya kuru iğneleme (49 hasta, 57 ayak) ile tedavi edilen hastalar çalışmaya dahil edildi. Her grup 3 haftalık aralıklarla üç tedavi seansı aldı. Görsel analog skala (visual analog scale, VAS) ve Amerikan Ortopedik Ayak ve Ayak Bileği Derneği (American Orthopedic Foot and Ankle Society, AOFAS) skorları kullanılarak klinik değerlendirmeler başlangıçta, üçüncü ayda ve on ikinci ayda yapıldı.
Bulgular: Her iki grup da tedavi sonrası VAS ve AOFAS skorlarında anlamlı iyileşme gösterdi (p<0,001). Proloterapi grubunda, VAS skoru tedavi öncesi 6’dan (aralık, 4-8) hem üç ve hem de on ikinci aylarda 2’ye (aralık, 1-5) düştü (p<0,001). Kuru iğneleme grubunda, VAS skoru tedavi öncesi 6’dan (aralık, 4-7) hem üç ve hem de on ikinci aylarda 4’e (aralık, 2-7) düştü (p<0,001). AOFAS skorları, proloterapi grubunda, üçüncü ayda 75’e (aralık, 63-85) ve on ikinci ayda 76’ya (aralık, 60-80) yükselirken (p<0,001), kuru iğneleme grubunda üçüncü ayda 56’ya (aralık, 44-75) ve on ikinci ayda 50’ye (aralık, 36-75) yükseldi (p<0,001).
Sonuç: Hem proloterapi hem de kuru iğneleme halluks valgus ağrısını etkili bir şekilde tedavi eder ve ayak fonksiyonunu iyileştirir, ancak proloterapi daha üstün sonuçlar gösterir.
References
- AlMeshari A, AlShehri Y, Anderson L, Willegger M, Younger A, Veljkovic A. Inconsistency in the reporting terminology of adverse events and complications in hallux valgus reconstruction: A systematic review. Foot Ankle Spec. 2024;[Epub ahead of print]. doi: 10.1177/19386400241256215.
- Cano DP, Lagos MA, Baduell A, González JTA, Torre CM, Rios J. Immediate effect of hallux valgus surgery on the biomechanical behavior of the first ray. Foot Ankle Surg. 2024;[Epub ahead of print]. doi: 10.1016/j.fas.2024.04.001.
- Zirngibl B, Grifka J, Baier C, Götz J. Hallux valgus: Etiology, diagnosis, and therapeutic principles. Orthopade. 2017;46(3):283-96. German.
- Schmeichel S, Krähenbühl N. Treatment of hallux valgus. Ther Umsch. 2022;79(7):343-7. German.
- Park SH, Choi YR, Lee J, Doh CH, Lee HS. Joint-preserving surgery for hallux valgus deformity in rheumatoid arthritis. Clin Orthop Surg. 2024;16(3):461-9.
- Uludağ V, Büker N. Effect of dry needling in chronic musculoskeletal pain. Int J Tradit Complement Med Res. 2022;3(2):109-16.
- Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A systematic review of dextrose prolotherapy for chronic musculoskeletal pain. Clin Med Insights Arthritis Musculoskelet Disord. 2016;9:139-59.
- Lew J, Kim J, Nair P. Comparison of dry needling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: a systematic review and meta-analysis. J Man Manip Ther. 2021;29(3):136-46.
- Trigger point dry needling. J Orthop Sports Phys Ther. 2017;47(3):150.
- Valera-Calero JA, Fernández-de-Las-Peñas C, Navarro-Santana MJ, Plaza-Manzano G. Efficacy of dry needling and acupuncture in patients with fibromyalgia: a systematic review and meta-analysis. Int J Environ Res Public Health. 2022;19(16):9904.
- Hsu C, Vu K, Borg-Stein J. Prolotherapy: A narrative review of mechanisms, techniques, and protocols, and evidence for common musculoskeletal conditions. Phys Med Rehabil Clin N Am. 2023;34(1):165-80.
- Hecht PJ, Lin TJ. Hallux valgus. Med Clin North Am. 2014;98(2):227-32.
- Perera AM, Mason L, Stephens MM. The pathogenesis of hallux valgus. J Bone Joint Surg Am. 2011;93(17):1650-61.
- Park CH, Chang MC. Forefoot disorders and conservative treatment. Yeungnam Univ J Med. 2019;36(2):92-8.
- Rabago D, Reeves KD, Doherty MP, Fleck M. Prolotherapy for musculoskeletal pain and disability in low- and middle-income countries. Phys Med Rehabil Clin N Am. 2019;30(4):775-86.
- Hauser RA, Matias D, Woznica D, Rawlings B, Woldin BA. Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review. J Back Musculoskelet Rehabil. 2022;35(4):701-12.
- Wee TC, Neo EJR, Tan YL. Dextrose prolotherapy in knee osteoarthritis: A systematic review and meta-analysis. J Clin Orthop Trauma. 2021;19:108-17.
- Lara-Palomo IC, Gil-Martínez E, Antequera-Soler E, Castro-Sánchez AM, Fernández-Sánchez M, García-López H. Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Trials. 2022;23(1):238.
- López-González L, Falla D, Lázaro-Navas I, Lorenzo-Sánchez-Aguilera C, Rodríguez-Costa I, Pecos-Martín D, et al. Effects of dry needling on neuromuscular control of ankle stabilizer muscles and center of pressure displacement in basketball players with chronic ankle instability: a single-blinded randomized controlled trial. Int J Environ Res Public Health. 2021;18(4):2092.
- Kazempour Mofrad M, Rezasoltani Z, Dadarkhah A, Hamidi Panah S, Tabatabaee SM, Azarakhsh A. Neurofascial dextrose prolotherapy for managing chronic ankle ligament injury. Anesth Pain Med. 2022;12(1):e118317.
- Uğurlar M, Sönmez MM, Uğurlar ÖY, Adıyeke L, Yıldırım H, Eren OT. Effectiveness of four different treatment modalities in the treatment of chronic plantar fasciitis during a 36-month follow-up period: a randomized controlled trial. J Foot Ankle Surg. 2018;57(5):913-8.
- Mullins JF, Nitz AJ, Hoch MC. Dry needling equilibration theory: A mechanistic explanation for enhancing sensorimotor function in individuals with chronic ankle instability. Physiother Theory Pract. 2021;37(6):672-81.
- Abbasi L, Panahi F, Zarei-Kurdshooli Z, Yazdi Yahya-Abadi F. The effect of perturbation training with and without applying the dry needling on leg muscles in patients with chronic ankle sprain. J Bodyw Mov Ther. 2023;35:233-7.
Abstract
Aim: Hallux valgus is a common foot deformity that causes significant pain and functional impairment. This study aimed to compare the effectiveness of prolotherapy and dry needling in treating mild to moderate hallux valgus pain.
Material and Methods: Patients with hallux valgus deformity experiencing refractory pain after orthotic and analgesic treatment, and treated with prolotherapy (52 patients, 68 feet) or dry needling (49 patients, 57 feet) methods were included in the study. Each group received three treatment sessions at 3-week intervals. Clinical assessments were performed using the visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) scores at baseline, in the third month, and twelfth month.
Results: Both groups showed significant improvement in VAS and AOFAS scores after treatment (p<0.001). In the prolotherapy group, the VAS score decreased from 6 (range, 4-8) in the pre-treatment period to 2 (range, 1-5) both in the third and twelfth months (p<0.001). In the dry needling group, the VAS score decreased from 6 (range, 4-7) in the pre-treatment period to 4 (range, 2-7) both in the third and twelfth months (p<0.001). While the AOFAS scores improved to 75 (range, 63-85) in the third month and 76 (range, 60-80) in the twelfth month in the prolotherapy group (p<0.001), improved to 56 (range, 44-75) in the third month and 50 (range, 36-75) in the twelfth month in the dry needling group (p<0.001).
Conclusion: Both prolotherapy and dry needling effectively treat hallux valgus pain and improve foot function, with prolotherapy showing superior effectiveness.
References
- AlMeshari A, AlShehri Y, Anderson L, Willegger M, Younger A, Veljkovic A. Inconsistency in the reporting terminology of adverse events and complications in hallux valgus reconstruction: A systematic review. Foot Ankle Spec. 2024;[Epub ahead of print]. doi: 10.1177/19386400241256215.
- Cano DP, Lagos MA, Baduell A, González JTA, Torre CM, Rios J. Immediate effect of hallux valgus surgery on the biomechanical behavior of the first ray. Foot Ankle Surg. 2024;[Epub ahead of print]. doi: 10.1016/j.fas.2024.04.001.
- Zirngibl B, Grifka J, Baier C, Götz J. Hallux valgus: Etiology, diagnosis, and therapeutic principles. Orthopade. 2017;46(3):283-96. German.
- Schmeichel S, Krähenbühl N. Treatment of hallux valgus. Ther Umsch. 2022;79(7):343-7. German.
- Park SH, Choi YR, Lee J, Doh CH, Lee HS. Joint-preserving surgery for hallux valgus deformity in rheumatoid arthritis. Clin Orthop Surg. 2024;16(3):461-9.
- Uludağ V, Büker N. Effect of dry needling in chronic musculoskeletal pain. Int J Tradit Complement Med Res. 2022;3(2):109-16.
- Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A systematic review of dextrose prolotherapy for chronic musculoskeletal pain. Clin Med Insights Arthritis Musculoskelet Disord. 2016;9:139-59.
- Lew J, Kim J, Nair P. Comparison of dry needling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: a systematic review and meta-analysis. J Man Manip Ther. 2021;29(3):136-46.
- Trigger point dry needling. J Orthop Sports Phys Ther. 2017;47(3):150.
- Valera-Calero JA, Fernández-de-Las-Peñas C, Navarro-Santana MJ, Plaza-Manzano G. Efficacy of dry needling and acupuncture in patients with fibromyalgia: a systematic review and meta-analysis. Int J Environ Res Public Health. 2022;19(16):9904.
- Hsu C, Vu K, Borg-Stein J. Prolotherapy: A narrative review of mechanisms, techniques, and protocols, and evidence for common musculoskeletal conditions. Phys Med Rehabil Clin N Am. 2023;34(1):165-80.
- Hecht PJ, Lin TJ. Hallux valgus. Med Clin North Am. 2014;98(2):227-32.
- Perera AM, Mason L, Stephens MM. The pathogenesis of hallux valgus. J Bone Joint Surg Am. 2011;93(17):1650-61.
- Park CH, Chang MC. Forefoot disorders and conservative treatment. Yeungnam Univ J Med. 2019;36(2):92-8.
- Rabago D, Reeves KD, Doherty MP, Fleck M. Prolotherapy for musculoskeletal pain and disability in low- and middle-income countries. Phys Med Rehabil Clin N Am. 2019;30(4):775-86.
- Hauser RA, Matias D, Woznica D, Rawlings B, Woldin BA. Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review. J Back Musculoskelet Rehabil. 2022;35(4):701-12.
- Wee TC, Neo EJR, Tan YL. Dextrose prolotherapy in knee osteoarthritis: A systematic review and meta-analysis. J Clin Orthop Trauma. 2021;19:108-17.
- Lara-Palomo IC, Gil-Martínez E, Antequera-Soler E, Castro-Sánchez AM, Fernández-Sánchez M, García-López H. Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Trials. 2022;23(1):238.
- López-González L, Falla D, Lázaro-Navas I, Lorenzo-Sánchez-Aguilera C, Rodríguez-Costa I, Pecos-Martín D, et al. Effects of dry needling on neuromuscular control of ankle stabilizer muscles and center of pressure displacement in basketball players with chronic ankle instability: a single-blinded randomized controlled trial. Int J Environ Res Public Health. 2021;18(4):2092.
- Kazempour Mofrad M, Rezasoltani Z, Dadarkhah A, Hamidi Panah S, Tabatabaee SM, Azarakhsh A. Neurofascial dextrose prolotherapy for managing chronic ankle ligament injury. Anesth Pain Med. 2022;12(1):e118317.
- Uğurlar M, Sönmez MM, Uğurlar ÖY, Adıyeke L, Yıldırım H, Eren OT. Effectiveness of four different treatment modalities in the treatment of chronic plantar fasciitis during a 36-month follow-up period: a randomized controlled trial. J Foot Ankle Surg. 2018;57(5):913-8.
- Mullins JF, Nitz AJ, Hoch MC. Dry needling equilibration theory: A mechanistic explanation for enhancing sensorimotor function in individuals with chronic ankle instability. Physiother Theory Pract. 2021;37(6):672-81.
- Abbasi L, Panahi F, Zarei-Kurdshooli Z, Yazdi Yahya-Abadi F. The effect of perturbation training with and without applying the dry needling on leg muscles in patients with chronic ankle sprain. J Bodyw Mov Ther. 2023;35:233-7.
Details
| Primary Language | English |
|---|---|
| Subjects | Orthopaedics |
| Journal Section | Research Article |
| Authors | |
| Early Pub Date | August 11, 2024 |
| Publication Date | August 30, 2024 |
| Submission Date | February 26, 2024 |
| Acceptance Date | July 3, 2024 |
| Published in Issue | Year 2024 Volume: 26 Issue: 2 |
Cite
Duzce Medical Journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.