To Compare the Effect of Different Time Ratio of Heat and Cold in Contrast Bath on Clinical Improvement in Plantar Fascitis

Contrast bath is commonly used therapy in plantar fascitis. However there is no standard regimen followed as to the order and time ratio of hot and cold fomentation. This study was conducted to establish a standard hot: cold fomentation ratio to achieve maximum efficacy of contrast bath in plantar fascitis. 75 patients of plantar fasciitis were equally divided into three groups, A: 3 cycles of alternate 3 minutes hot fomentation and 1 minute of cold fomentation, B: hot fomentation for 3 minutes followed by 1 minute cold fomentation followed by a sustained 12 minutes of hot fomentation and C: cold fomentation for 5 minutes followed by 21/2 minutes of hot and again 5 minutes cold fomentation. Thrice daily regimen was followed. VAS score was used to note the initial pain, pain relief at 1 week and 1 month. The mean pain value in group A was 7.52±1.27 SD on initial evaluation, was 6.32±1.31 SD at 1 week and 2.8±1.42 SD at 1 month. Respective values in group B was 6.8±1.37 SD, 5.8±1.25 SD and 2.6±1.31 SD and in group C was 7.81±1.43 SD, 6.37±1.09 SD and 3.1±1.49 SD. In plantar fascitis, only temperature fluctuations at subcutaneous level are required to bring a local pumping effect. This needs only alternation of hot and cold fomentation, the order of fomentation and time duration of each cycle is not specific. No time ratio is superior to another.