Low-Energy Radial Extracorporeal Shock Wave Therapy for chronic Plantar Fasciitis: A Randomized Control Study

Background and purpose: Despite numerous publications and clinical trials, the results of treatment of chronic plantar fasciitis with extracorporeal shock wave therapy (ESWT) still remain equivocal as to whether or not this treatment reduce pain and improve functional disabilities associated with chronic plantar fasciitis compared to placebo group. The purpose of this study was to clarify the value of low-energy radial extracorporeal shock-wave therapy (rESWT) for plantar fasciitis. Subjects: This study was randomized placebo-controlled double-blind clinical study. Forty six adult subjects with unilateral plantar fasciitis were classified randomly into two equal groups. Methods: The active treatment group received a total 3 treatments (3x2000 impulses) with 0.16 mJ/mm2 , 2.5 bars and frequency of 8Hz given at weekly interval and the placebo group received the identical treatment procedures but shame exposed to shock-wave therapy. All patients were allowed to use previously described night splint. Pain and limitation of foot function were measured at baseline, after 3 weeks of treatment and after 6 weeks of follow up by visual analog scale (V AS) and ankle-hind foot scale (AHFS) respectively. Results: The results revealed significant reduction of pain in both treated and placebo groups after 3 weeks of treatment P<.O.0001 and p=O.0050 respectively, while after 3 weeks of treatment and 6 weeks of follow up the percentage of improvement with respect to baseline was (-32.11 % versus -63.63%) in contrast to (-10.17% versus -8.48%) for placebo group. On other hand there was significant improvement in foot function only in treated group both after3weeks of treatment and 6weeks of follow up (23.71 % versus 36.84%;P