Wheatgrass & Plantar Fasciitis
Efficacy of a wheatgrass topical application in the treatment of plantar fasciitis: an internet pilot study
Dr. C. L. Reynolds.
M.B.,B.S.
Melbourne, Australia
2001
Keywords: plantar fasciitis, wheatgrass, inflammation
Abstract
A wheatgrass-based topical application shows promise in the treatment of plantar fasciitis.
IntroductionPlantar fasciitis (PF) is a common, painful heel condition that can subject some
sufferers to physical and associated psychological disability for many
years. It is often refractory to treatment, although many cases remit
spontaneously. Response to therapy varies as widely as
the many interventions available, such as orthotic footwear, steroid
injections, extra-corporeal shock wave therapy, anti-inflammatory
medication, physiotherapy and surgery.
Given the documented, anti-inflammatory effects of wheatgrass
1,2 and
preliminary clinical observations of symptomatic improvement in
patients with plantar fasciitis using a topical wheatgrass cream, this
pilot study was instigated to test the efficacy of the application.
Materials and Methods
The
pilot study was performed over the internet. Thirty-one patients were
recruited on a first come, first served basis with the approval of the
webmaster of
www.heelspurs.com, a popular, semi-commercial English language website in the
United States .
This site offers support and advice via message boards for sufferers of
plantar fasciitis and associated heel pain conditions.
Participants
were not informed of any of the known effects of wheatgrass, and were
promised adequate supplies of the application to cover the three month
trial period in return for completing pain level measurements at the
requested times. Tubes of cream were despatched to each respondent, and
replenished at one and two months after commencement of the trial or on
request. Participants were sent a basic questionnaire and a protocol by
email. They were asked to report their maximum pain levels on either
foot on an ascending scale of 0 to 10 at weeks 1, 2, 3, 4, 6, 8, and 12
following commencement of treatment. Because some pre-trial patients
had responded rapidly, often within the first week of treatment, pain
levels were requested more frequently in the early stage of the trial
period. If updates were not received on the prescribed date,
respondents were contacted by email for their pain levels. Once daily
application was advised in order to examine the effects of minimal
intervention. Participants were instructed to apply a small amount
(“rice-grain size”) of cream to the most tender or painful area on
either or both heels.
Participant
responses were collected regularly and descriptive statistics
calculated. Baseline and followup pain scores were compared using a
paired sample t-test.
Results
Thirteen males and 18 females joined the trial; 29 from the
USA , one from
Canada and one from
Ireland
. Twenty subjects had undertaken previous therapeutic interventions
which included surgery, extra-corporeal shock-wave therapy and steroid
injections. No exclusion criteria were imposed. The average age of
participants was 45 years (range 23-68 years) and the mean overall
symptomatic period for PF was 48 months (range 9-144 months).
Fig.
1. Heel pain. Daily wheatgrass topical application. Mean maximum pain
levels associated with plantar fasciitis over 12 weeks. n = 31
There
was a progressive overall decline in mean maximum pain levels over the
12 week period from 6.1 to 3.25. (Figure 1). By the end of the 12
th
week, 16 participants (51.7%) had a greater than 40% reduction in
maximum pain level while four (12.9%) recovered completely. Six
subjects (19.4%) experienced no improvement and one suffered an
increase in pain and withdrew from the study.
The mean +/- (SD) pain at baseline was 6.1 +/-(2.5) and at 12 weeks was
3.25 (2.5). There was a significant difference between pain at baseline
and 12 weeks, (p <0.05).
DiscussionTo
the author’s knowledge, topical applications have been of little use in
the treatment of plantar fasciitis. Extensive research into the
therapeutic properties of cereal grasses began in the 1930’s in the
U.S.A. ,
however, no study of the effects of topical wheatgrass applications in
the treatment of plantar fasciitis was found in the literature.
This
study resulted from the clinical observation that several patients with
plantar fasciitis responded quite rapidly (sometimes in a day or two)
to treatment using the wheatgrass-based topical application. The
findings of this study suggest that this application may be a useful
and effective adjunct to treatment in some patients. Kubota et. al.
demonstrated potent anti-inflammatory effects from barley juice.
3
In
a privately funded, unpublished study, the author found
indomethacin-equivalent anti-inflammatory responses to
carrageenin-induced inflammation on the skin of laboratory rats. Given
all cereal grasses are essentially nutritionally identical,
4 an effective anti-inflammatory response to wheatgrass extract in some of the trial subjects was not an unexpected finding.
The
results of the study are limited by the small numbers of participants,
the lack of a control group and by the subjective method of pain
measurement by participants. A larger, well-controlled study is
indicated.
References
1. Seibold. R. L. 1991. Cereal Grass. 112-117. Keats Publishing, Inc.
2. Meyerowitz. S. 1999. Wheat Grass. 59-74. Book Publishing Company.
3. Kubota, K., Matsuoka, Y., Seki, H., 1983. Isolation of potent anti-inflammatory protein from barley leaves. Jap. J. Inflam. Vol. 3. No.4
4. Seibold. R. L. 1991. Cereal Grass. p61. Keats Publishing, Inc.
This study was funded by the author.
