Abstract
Chronic plantar fasciitis is a common cause of foot pain, with conservative treatment
providing relief for most patients. However, because of the common occurrence of this
pathology, this leaves many patients dissatisfied. The purpose of the present study
was to determine the effectiveness of extracorporeal shock wave therapy (ESWT) to
treat chronic plantar fasciitis (PF) in a largely active duty population. A review
of 82 patients (115 heels) who had undergone ESWT for chronic PF was performed. Outcome
data were obtained by patient telephone interviews. All ESWT was conducted at 24 kV
for 2000 shocks. Of the 82 patients (115 heels), 76 (93%; 111 heels) agreed to participate.
Their mean age was 42 ± 10 years, with 41 males (54%) and 35 females (46%). The mean
follow-up period was 42 ± 22 months. Of the patients, 73.6% were active duty military
personnel. The mean preoperative pain score of 7.8 ± 2 had improved to 2.5 ± 2 at
the last follow-up visit (p < .0001). Active duty patients reported a mean improvement in pain of 4.8 ± 3 compared
with 6.8 ± 3 in non-active duty patients (p = .005). Of the 76 patients, 75 (98%) underwent 1 ESWT session, and 1 (2%) requiring
2 sessions. Overall, 74% of patients rated the outcome of their procedure as either
good or excellent, with 87% stating that ESWT was successful. Ten patients (18%) left
the military because of continued foot pain, with 76% able to return to running. For
patients with chronic PF, these results support the use of ESWT to relieve pain in
>85% of patients, with a preponderance for better pain relief in patients who are
not active duty military personnel.
Level of Clinical Evidence
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Foot and Ankle SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors.Foot Ankle Int. 2004; 25: 303-310
- Risk factors for Plantar fasciitis: a matched case-control study.J Bone Joint Surg Am. 2003; 85A: 872-877
- Correlation of heel pain with body mass index and other characteristics of heel pain.J Foot Ankle Surg. 2001; 40: 351-356
- The relationship of pes planus and calcaneal spur to plantar heel pain.Clin Orthop Relat Res. 1994; 306: 192-196
- Predicting plantar fasciitis in runners.Med Sci Sports Exerc. 1987; 19: 71-73
- McGlamry's Comprehensive Textbook of Foot and Ankle Surgery.Lippincott Williams & Wilkins, Philadelphia2001
- Plantar fasciitis and the windlass mechanism: a biomechanical link to clinical practice.J Athl Train. 2004; 39: 77-82
- Plantar fasciitis: evidence-based review of diagnosis and therapy.Am Fam Physician. 2005; 72: 2237-2242
- Plantar fasciitis: a degenerative process (fasciosis) without inflammation.J Am Podiatr Med Assoc. 2003; 93: 234-237
- Preferred management of recalcitrant plantar fasciitis among orthopaedic foot and ankle surgeons.Foot Ankle Int. 2012; 33: 507-512
- Extracorporeal shock wave therapy for treatment of plantar fasciitis.J Pak Med Assoc. 2014; 64: 675-678
- Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study.J Bone Joint Surg Am. 2015; 97: 701-708
- Extracorporeal shockwave therapy versus placebo for the treatment of chronic proximal plantar fasciitis: results of a randomized, placebo-controlled, double-blinded, multicenter intervention trial.J Foot Ankle Surg. 2006; 45: 196-210
- The effectiveness of extra corporeal shock wave therapy for plantar heel pain: a systematic review and meta-analysis.BMC Musculoskelet Disord. 2005; 6: 19
- Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: a randomized controlled trial.JAMA. 2002; 288: 1364-1372
- Radial tunnel syndrome: resistant tennis elbow as a nerve entrapment.J Bone Joint Surg Br. 1972; 54: 499-508
- Is extracorporeal shock wave therapy clinical efficacy for relief of chronic, recalcitrant plantar fasciitis? A systematic review and meta-analysis of randomized placebo or active-treatment controlled trials.Arch Phys Med Rehabil. 2014; 95: 1585-1593
- Evaluation of therapeutic effects of extracorporeal shock wave therapy in resistant plantar fasciitis patients in a tertiary care setting.Med J Armed Forces India. 2012; 68: 236-239
- Long-term outcome of low-energy extracorporeal shock wave therapy for plantar fasciitis: comparative analysis according to ultrasonographic findings.Ann Rehabil Med. 2014; 38: 534-540
- Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs.Clin Orthop Relat Res. 2013; 471: 3645-3652
- Randomized, placebo-controlled, double-blind clinical trial evaluating the treatment of plantar fasciitis with an extracorporeal shockwave therapy (ESWT) device: a North American confirmatory study.J Orthop Res. 2006; 24: 115-123
- Extracorporeal shock wave therapy for plantar fasciitis: randomised controlled multicentre trial.BMJ. 2003; 327: 75
- Effectiveness of extracorporeal shock wave therapy in chronic plantar fasciitis: a meta-analysis.Am J Phys Med Rehabil. 2013; 92: 606-620
- Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low-energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis.J Orthop Res. 2005; 23: 931-941
- Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale.Pain. 2001; 94: 149-158
- Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department.Acad Emerg Med. 2003; 10: 390-392
- Shock wave application for chronic plantar fasciitis in running athletes: a prospective, randomized, placebo-controlled trial.Am J Sports Med. 2003; 31: 268-275
- Comparison between extracorporeal shockwave therapy, placebo ESWT and endoscopic plantar fasciotomy for the treatment of chronic plantar heel pain in the athlete.Muscles Ligaments Tendons J. 2012; 2: 312-316
- Plantar fasciitis: how successful is surgical intervention?.Foot Ankle Int. 1999; 20: 803-807
- Surgery for patients with recalcitrant plantar fasciitis: good results at short-, medium-, and long-term follow-up.Orthop J Sports Med. 2014; 2 (2325967114527901)
Article info
Publication history
Published online: April 02, 2018
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American College of Foot and Ankle Surgeons.
