Preliminary Experience of a Single Session of Low-energy Extracorporeal Shock Wave Treatment for Chronic Plantar Fasciitis

Abstract

Background: The purpose of the present study was to evaluate the effect of a single session of ultrasound- and biofeedback-assisted extracorporeal shock wave treatment (ESWT) in patients with chronic plantar fasciitis. Materials and Methods: 20 patients (22 heels) with symptomatic plantar fasciitis that did not respond to conservative treatment for at least 6 months were studied. Patients received a single session of low-energy, ultrasound- and patient feedback-guided ESWT. Visual analog scale (VAS) was used to compare pain intensity before treatment and at followup (72 ± 15 days after treatment). Results: There was a significant decrease in overall pain (VAS 5.5 ± 1.8 vs. 3.3 ± 2.7, p = 0.001), maximum pain (7.7 ± 2.1 vs. 4.0 ± 3.9, p = 0.008) and pain at activities of daily living (5.3 ± 2.1 vs. 2.5 ± 2.6, p = 0.018). Night pain decreased to a lesser extent (2.4 ± 2.5 vs. 1.3 ± 2.1, p = 0.317). ESWT improved symptoms in 16 heels, of which six were completely symptom-free at followup 2.4 months after treatment. Six patients experienced no change. Fourteen patients with pain localized to the heel and all male patients benefited from ESWT. No difference was noted for age, body mass index, duration, and severity of symptoms or previous treatment. Conclusion: Low-energy ESWT proved to be an effective treatment option for the majority of patients with chronic plantar fasciitis that failed to respond to conservative treatment. Predictive parameters for successful outcome are male gender and an easily detectable pain center at the heel.