Comparison of effects of low-level laser therapy and extracorporeal shock wave therapy in calcaneal spur treatment: A prospective, randomized, clinical study

Abstract

Objectives: In this study, we aimed to evaluate and compare the efficacy of low-level laser therapy (LLLT) and extracorporeal shock wave therapy (ESWT) in the treatment of calcaneal spurs. Patients and methods: A total of 62 patients (14 males, 48 females; mean age: 47.6±11.7 years; range, 18 to 70 years) who were diagnosed with calcaneal spurs based on clinical examination and plain radiography between April 2019 and September 2019 were included in this study. A total of 15 sessions of plantar fascia gastroc-soleus stretching exercises and cold pack treatments were given to both groups. The LLLT (904 nm wavelength, 3,000 Hz, 8 J/cm2 dose to the painful heel area and insertion of the plantar fascia on the medial calcaneal area, five points for a total of 5 min for three weeks) was applied to the first group (n=31), whereas ESWT (10 Hz, 2,000 shock waves with a 2.5 bar pressure into the areas of the painful heel, insertion of the plantar fascia on the medial calcaneal area) was applied the second group (n=31). All patients were evaluated using the Visual Analog Scale (VAS) and Foot Function Index (FFI) before and after treatment. Results: In both groups, the median VAS and FFI scores after treatment showed a significant improvement, compared to pre-treatment scores (p=0.001). There was no significant difference between the groups in terms of the median post-treatment VAS scores (p>0.05). In the ESWT group, the median FFI pain and total scores after treatment were significantly lower than in the LLLT group (p=0.033). The change in the median FFI pain and total scores were significantly higher in the ESWT group (p=0.046). Conclusion: Both treatment modalities are effective and not superior to each other in terms of disability and activity limitation reduction, although a greater improvement in the FFI pain and total scores can be achieved with the ESWT. Based on these findings, we recommend both non-invasive treatment methods to be used in the treatment of calcaneal spurs in the clinical practice.