Up to 65 percent of patients with chronic plantar fasciitis may benefit from shock wave therapy

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American Academy of Orthopaedic Surgeons

May 06, 2015, 03:58 ET

ROSEMONT, Ill., May 6, 2015 /PRNewswire-USNewswire/ -- Shock wave therapy may relieve symptoms in up to 65 percent of patients suffering from chronic plantar fasciitis, a common condition causing prolonged pain and discomfort along the bottom of the foot and heel, according to a new study appearing in the May 6 issue of The Journal of Bone & Joint Surgery (JBJS).

The plantar fascia is a long, thin band of connective tissue that supports the arch like a bow string. Too much pressure on the ligament, especially with inappropriate footwear and during sports and exercise, can damage or tear the tissue causing inflammation, heel pain and stiffness. An estimated 2 million Americans suffer from this condition each year. For most patients, the condition subsides within 10 months with rest, ice, stretching exercises, over-the-counter pain medication, supportive shoes, physical therapy, and/or cortisone injections. More recently, extracorporeal shock wave therapy (ESWT), a noninvasive procedure that uses pressure waves to trigger healing, has been used to treat more severe cases, often as a last resort before surgery. To date, ESWT has had inconsistent results.

In this study, 246 plantar fasciitis patients, at multiple health care facilities in the U.S., randomly received either a placebo, or ESWT sessions consisting of 2,000 impulses at three, weekly intervals. The ESWT patients did not receive anesthesia or pain mediation during the procedure. Pain levels were measured immediately following the treatment, and again at 12 weeks and one year post treatment.

There was a "significant" reduction in pain levels—when patients took their first steps in the morning, and during daily activities—in the ESWT group compared to the placebo group (a 69.2 percent reduction versus a 34.5 percent reduction). Diminished pain scores also were recorded in the ESWT group following the procedure. While there were no safety issues, many patients reported temporary pain and swelling during and after ESWT treatment.

"Our study demonstrated that extracorporeal shock wave therapy is effective in the treatment of chronic, recalcitrant cases of plantar fasciitis," said lead study author Hans Gollwitzer, MD. "The advantage of this relatively new treatment is that it is non-invasive and that patients can continue with activity throughout the treatment."

Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the 36 months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is engaged in any other activities that could be perceived to influence or have the potential to influence what is written in this work.

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