Abstract
Randomised controlled trials (RCTs) have reported conflicting results on whether extracorporeal shock wave therapy alleviates the pain of recalcitrant plantar fasciitis patients. We focused on high-energy extracorporeal shock wave therapy (HESWT) and aimed to assess the effectiveness and feasibility of HESWT versus placebo in the treatment of recalcitrant plantar fasciitis. We reviewed all RCTs comparing HESWT and placebo from PubMed, EMBASE, Cochrane Central Register of Controlled Trials and also the reference lists of articles. We used a fixed-effects model or a random model depending on heterogeneity and estimated the odds radio (OR) and 95% confidence interval (95% CI). Study quality was assessed using the Jadad scale. Five placebo-controlled and double-blinded clinical trials including 716 patients were included. Overall, the quality of the trials was good, and a test for heterogeneity confirmed the presence of little heterogeneity (p = 0.31, I2 = 16%). The pooled OR from the five trials was estimated to be 2.25 (95% CI, 1.66-3.06; p <0.00001) at 12 weeks after active treatment. The results of the meta-analysis provide strong evidence that HESWT was effective in the treatment of recalcitrant plantar fasciitis when compared with placebo. We recommend HESWT as a remedial measure after failure of traditional conservative treatment and ahead of surgical intervention.
Highlights
Plantar fasciitis is the most common cause of inferior heel pain, and about 10% of people develop this disease throughout their lifetime
Randomised controlled trials (RCTs) have reported conflicting results on whether extracorporeal shock wave therapy alleviates the pain of recalcitrant plantar fasciitis patients
We focused on high-energy extracorporeal shock wave therapy (HESWT) and aimed to assess the effectiveness and feasibility of HESWT versus placebo in the treatment of recalcitrant plantar fasciitis
Summary
Plantar fasciitis is the most common cause of inferior heel pain, and about 10% of people develop this disease throughout their lifetime. The American College of Foot and Ankle Surgeons (ACFAS) heel pain committee recommend that patients should have chronic symptoms and undergo conservative treatment for at least 6 months prior to considering extracorporeal shock wave therapy (ESWT) or surgical treatment [7]. It is generally understood that enough energy should be delivered to induce a therapeutic response, and that LESWT needs repeated treatments to achieve a therapeutic dose and is more expensive than HESWT. We performed this meta-analysis focusing on HESWT in order to produce a firm evidence base for clinical decisionmaking. Strong evidence is needed to guide clinical decisions and to provide the best therapeutic schedule for the patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
