Effect of Glyceryl Trinitrate Gel Phonophoresis in Treatment of Plantar Fasciitis: A Randomized Controlled Trial

Plantar fasciitis (PF), considered the most common cause of sub-calcaneal pain, was first described in 1812, related to painful sensation in the calcaneus, resulting from degeneration of the plantar fascia. Some reported cases are the result of biomechanical failure that provides tension along the plantar fascia. It is a common dysfunction in runners, due to the high loads they exert on the plantar fascia, but other risk factors are also worth mentioning, such as increased planter flexion, high body mass and high body mass index phonophoresis emerges as a valuable and versatile modality within physiotherapy, demonstrating clinical efficacy across a spectrum of musculoskeletal and inflammatory conditions. The combination of topically applied gel or cream-based medications with ultrasound therapy, operating within specific frequency and intensity ranges, enhances percutaneous absorption of pharmacological agents.

Glyceryl trinitrate can directly relax vascular smooth muscles, especially the smooth muscle of small blood vessels, thus dilating blood vessels and improving the microcirculation. In addition, nitroglycerin interacts with intracellular sulfhydryl to release nitric oxide (NO). NO, as endothelial relaxing factor, activates guanylate cyclase to transform into cyclic guanosine monophosphate (cGMP), which increases cGMP in smooth muscles and other tissues, thereby causing dephosphorylation of myosin light chain, regulating the contractile state of smooth muscles, relaxing smooth muscles, and dilating blood vessels gap in literature about the effect of glyceryl trinitrate gel in treatment of plantar fasciitis. So the aim of this study is to investigate the effect of glyceryl trinitrate gel in treatment of plantar fasciitis.