Comparison of efficacy of shock-wave therapy versus corticosteroids in plantar fasciitis: a meta-analysis of randomized controlled trials

Yuan Xiong,Yi Liu,Guohui Liu,Jing Liu,Adriana C Panayi,Wu Zhou,Qipeng Wu,Hang Xue,Bobin Mi,Liangcong Hu

doi:10.1007/s00402-018-3071-1

Abstract

BackgroundCorticosteroid (CS) injections have been proven to be effective in ameliorating symptoms of plantar fasciitis. Shock-wave (SW) therapy is another common treatment of plantar fasciitis, and several meta-analyses have documented its advantages when compared to placebo treatment. Despite this, few studies have focused on comparing the use of CS and SW in the treatment of plantar fasciitis. The purpose of this meta-analysis is to assess whether SW is superior to CS in managing plantar fasciitis, both in terms of ameliorating pain as well as improving functionality.MethodsA systematic search of the literature was conducted to identify relevant articles that were published in Pubmed, Medline, Embase, the Cochrane Library, SpringerLink, Clinical Trials.gov and OVID from the databases’ inception to July 2018. All studies comparing the efficacy of SW and CS in terms of pain levels and functionality improvement were included. Data on the two primary outcomes were collected and analyzed using the Review Manager 5.3.ResultsSix studies were included in the current meta-analysis. A significant difference in VAS score (MD = − 0.96, Cl − 1.28 to − 0.63, P < 0.00001, I2 = 96%) was noted between the SW group and the CS group. No significant difference was seen in the Mayo CSS or FFI or HFI or 100 Scoring System score at the 3 months follow-up (Chi2 = 0.62, I2 = 0%, P > 0.05).ConclusionsThe clinical relevance of the present study is that both SW and CS were effective and successful in relieving pain and improving self-reported function in the treatment of plantar fasciitis at 3 months. Although inter-group differences were not significant, the VAS score was better improved in the SW group, highlighting that shock-wave therapy may be a better alternative for the management of chronic plantar fasciitis.

Highlights

Data selectionInclusion eligibility was independently performed by two investigators who screened the title and abstracts of all articles
Shock-wave (SW) therapy is another common treatment of plantar fasciitis, and several meta-analyses have documented its advantages over placebo treatment [16, 17]
Both methods are useful for plantar fasciitis, few studies have focused on comparing the use of CS and SW in the treatment of the condition and which treatment is superior, if either, is still uncertain

Summary

Introduction

Data selectionInclusion eligibility was independently performed by two investigators who screened the title and abstracts of all articles. The therapeutic response to SW therapy depends on the intensity, pulse cycle and SW modality [16] Both methods are useful for plantar fasciitis, few studies have focused on comparing the use of CS and SW in the treatment of the condition and which treatment is superior, if either, is still uncertain. Few studies have focused on comparing the use of CS and SW in the treatment of plantar fasciitis The purpose of this meta-analysis is to assess whether SW is superior to CS in managing plantar fasciitis, both in terms of ameliorating pain as well as improving functionality. Inter-group differences were not significant, the VAS score was better improved in the SW group, highlighting that shock-wave therapy may be a better alternative for the management of chronic plantar fasciitis

Methods

Results

Discussion

Conclusion