High-Energy Extracorporeal Shock-Wave Therapy (ESWT) for the Treatment of Chronic Plantar Fasciitis

Abstract

Few reports about the success of high-energy extracorporeal shock-wave therapy in cases of plantar fasciitis exist, even fewer about long-term results. This study investigated results of high-energy extracorporeal shock wave therapy applied to patients with recalcitrant plantar fasciitis. Ninety ESWT were applied to 63 patients (73 heels; 25 male and 38 female; average age 54 (29 to 77) years) from November 1999 to July 2003. All patients had plantar fasciitis for more than 6 months and failure of all non-surgical treatment for more than 3 months. A Dornier Lithotripter S, equipped with an electromagnetic shock-wave emitter was used. Routinely, 1000 shock wave impulses (frequency 2 per second, energy flux density (ED) 0.35 mJ/mm² at 10.5 kV, total dose 350 mJ/mm²) were applied per treatment. Followup was carried out 6 weeks after ESWT, then a second clinic evaluation and a final followup at an average of 73 months after ESWT by telephone. The success of ESWT, defined as a 30% VAS reduction, was seen in 81% at 6-week followup, at 88% at last clinic followup and in 96% at final phone followup. High-energy ESWT (0.35 mJ/mm²) was successful in the treatment of plantar fasciitis and the good short-term results seemed to be maintained over time.