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RESEARCH PRODUCT

Effectiveness of low-energy extracorporal shock waves for chronic plantar fasciitis

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Summary Over a period of 4 years we performed a prospective randomized trial on 100 patients in order to compare the effects of low-energy extracorporal shock-wave therapy (ESWT) in the treatment of painful heel (chronic plantar fasciitis). Patients in group I were treated three times at weekly intervals with 1000 impulses of 0.08 mJ/mm 2 given around the heel spur. Group II received treatment three times with 10 impulses of the same energy density at weekly intervals. Follow-up examinations were done at 12 and 52 weeks, respectively. The main outcomes assessed were reduction in severity of pressure pain, period of pain-free walking, and patient satisfaction. At 12 weeks, 16 of 50 patients in group I were almost or completely pain free, compared to one in group II. The period of pain-free walking increased by 141% in group I, compared to 33% in group II. The subjective assessment showed 10 excellent and 18 good results in group I compared to no excellent and eight good or fair results in group II. Twenty-six patients in group I were satisfied with the treatment compared to six in group II. Several patients had additional treatment after the 12-week assessment. At one year, 20% of group I patients had received combined conservative therapy, and 4% had had an operation, whereas 58% of group II had had combined therapy and 32% had had surgery. At the one-year follow-up there was still a difference in outcome in favour of group I, with 29 patients satisfied in group I versus 18 in group II. We conclude that three treatments with 1000 impulses of low-energy shock waves at 12 and 52 weeks provides an effective therapy for chronic plantar fasciitis.