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Original Research| Volume 57, ISSUE 2, P339-345, March 2018

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Extracorporeal Shockwave Therapy Plus Rehabilitation for Patients With Chronic Plantar Fasciitis Might Reduce Pain and Improve Function but Still Not Lead to Increased Activity: A Case-Series Study With Multiple Outcome Measures

  • Patrick C. Wheeler
    Correspondence
    Address correspondence to: Patrick C. Wheeler, MBChB, FFSEM, Department of Sport and Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
    Affiliations
    Consultant, Sport and Exercise Medicine, Department of Sport and Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom

    Senior Lecturer and Visiting Fellow, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom

    Consultant, Sport and Exercise Medicine, National Centre of Sport and Exercise Medicine–East Midlands, Loughborough United Kingdom
    Search for articles by this author
  • Chloe Tattersall
    Affiliations
    Nurse Practitioner, Department of Sport and Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
    Search for articles by this author
Published:October 09, 2017DOI:https://doi.org/10.1053/j.jfas.2017.07.001

      Abstract

      Plantar fasciitis is a common cause of plantar-aspect heel pain. Although many patients will improve, a proportion will have ongoing and sometimes debilitating symptoms. Evidence from randomized controlled trials has shown that extracorporeal shockwave therapy (ESWT) results in benefits in treating pain. However, uncertainties remain whether these benefits translate to improvements in overall function. The present prospective case series examined the results from 35 patients with chronic plantar fasciitis who had undergone a course of ESWT in addition to a graded rehabilitation program. Of the 35 subjects, 34% were male, and the median age was 50.9 years. The duration of symptoms before ESWT was 24 months. The results of the present case series demonstrated statistically significant improvements in measures of self-reported “average pain” from a median of 7.0 of 10 at baseline to 5.0 of 10 at 3 months (p < .001) and of “worst pain” from 9.0 of 10 at baseline to 7.0 of 10 at 3 months (p < .001). In addition, significant improvements were found in several validated patient-rated outcome measures of local foot/ankle function but not in overall markers of health, anxiety/depression scores, or activity levels, despite the improvements in pain. No statistically significant correlations were found between gender, age, or chronicity of symptoms and the improvements seen. No significant side effects occurred in the present study. The results of our series support the use of ESWT for patients with chronic plantar fasciitis for local pain symptoms; however, uncertainties remain regarding global benefits to health.

      Level of Clinical Evidence

      Keywords

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