Evaluation of therapeutic effects of extracorporeal shock wave therapy in resistant plantar fasciitis patients in a tertiary care setting

Abstract

Plantar Fasciitis is a widely prevalent condition and is extremely disabling if it remains unresolved. Despite many available treatment modalities, the management of recalcitrant cases is still a dilemma. We conducted this study to evaluate and compare the role of two novel modalities: Intralesional PRP (Platelet Rich Plasma) injection and Extra Corporeal Shockwave Therapy (ESWT) for the management of this condition.60 patients with a clinical diagnosis of recalcitrant plantar fasciitis were randomized into 2 groups; PRP Group (n = 30) and ESWT Group (n = 30). In PRP group patients received 3 intralesional injections of PRP and in ESWT group 3 sessions of Extra Corporeal Shockwave Therapy were administered. The Primary outcome measures were Visual Analogue Scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, Roles and Maudsley Index and Heel Tenderness Index (HTI). The secondary outcome measures were complications. The patients were followed up for a period of 6 months and evaluated for various scores.At 6 months follow-up, significant results were found only on VAS score for both groups (p-value <0.05). However, both modalities resulted in significant clinical improvement with no complications reported. No statistically significant differences were reported between the two test groups.Both autologous PRP and ESWT can become extremely useful modalities for management of recalcitrant cases of plantar fasciitis with no known adverse effects.