May 12 2007
Shockwave Therapy for Plantar Fasciitis
A study in the July/August issue of The Journal of Foot and Ankle Surgery in 2006, has demonstrated that Extracorporeal Shockwave Therapy is an effective and safe treatment for plantar fasciitis. 
Extracorporeal Shockwave Therapy (ESWT) has been used for treating medical conditions for many years, but emerged in the mid-90s as a treatment for plantar fasciitis. Shockwave therapy is the production of sound waves, not electrical shocks. The sound waves cause controlled tissue injury at an area of chronic inflammation or degeneration and stimulate a healing response by the body. The treatment was FDA approved for treatment of plantar fasciitis in 2000, but has remained under scrutiny because of conflicting research studies.
In the new study, the authors examined 172 patients with plantar fasciitis. The patients were divided randomly into two groups, a placebo group and the ESWT group. The ESWT group included 115 patients with plantar fasciitis and underwent ESWT. The placebo group included 57 patients with plantar fasciitis who had a sham procedure. All patients were brought into the procedure room and The Orthospec (ESWT device) was used to apply shockwaves to the heel area. The placebo group had a foam membrane placed against the heel to absorb the sounds waves, while the ESWT group had only a membrane placed on the heel. The procedure lasted 25 minutes for both groups. Although the administrator of the shockwave therapy was not blinded, the investigators evaluating the patients before and after the procedure were blinded.
A total of 152 participant completed the 12 week trial and 168 participants completed the procedure and had at least one follow up visit. The authors considered a successful treatment to be one in which the participants had a 50% improvement from baseline. The improvement in the ESWT group was significantly greater than in the placebo group (receiving the sham treatment).
In this study, there was only a single treatment of shockwave therapy and no local anesthetics or systemic analgesics were used during the procedure. There were no serious adverse events during the trial, but some complained of bruising at the heel and swelling.
Malay SD, et al. Extracorporeal Shockwave Therapy Versus Placebo for the Treatment of Chronic Proximal Plantar Fasciitis: Results of a Randomized, Placebo-Controlled, Double-Blinded, Multicenter Intervention Trial. JFAS 45(4):196-209 July/August 2006.
note: the picture shown above is not The Orthospec device.
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