Paper #90 Extracorporeal Shock Wave Therapy (ESWT) in patients with painful, proximal plantar fasciitis

Abstract

The aim of this study was to compare the effect of extracorporeal shock wave therapy (ESWT) in patients with chronically painful, proximal plantar fasciitis with a conventional conservative treatment. Forty-seven patients (49 heels) with a previously unsuccessful conservative treatment of at least 6 months were prospectively randomized to two groups with a random list. Treatment of group 1 (25 heels) started immediately after enrollment with three sessions of ESWT (3000 shock waves/session of 0.2 mJ/mm2) at weekly intervals. No local anaesthesia was applied. In the patients of group 2 (24 heels) conservative treatment was continued for 12 weeks. After this period they were treated using the protocol of group 1. Patients were followed up at 6, 12 and 24 weeks and 2 years after ESWT. A clinical investigation was performed regarding pain on a visual analogue scale ranging from 0 (no pain) to 100 (maximal pain) and the comfortable walking time. Statistical analysis was done with the non-parametrical Wilcoxon test for paired samples and the non-parametrical Mann-Whitney test for unpaired samples. No significant difference of pain (70.2 ± 22.4 to 70.2 ± 22.2) and comfortable walking time (0.3h ± 0.5 to 0.3h ± 0.5) after further conservative treatment (3 months) was seen (group 2). Six months after ESWT pain during activities of daily living decreased by 83% on the visual analogue scale (VAS) and the comfortable walking time had increased significantly in both groups (p < 0.01). Two years after ESWT pain during activities of daily living had decreased even more by 90% on the visual analogue scale compared to prior to ESWT and the comfortable walking time had increased significantly in both groups (p < 0.01). In our study we could not find any significant differences of pain and walking time after further conservative treatment of 3 months in patients with chronic proximal plantar fasciitis. After ESWT pain and walking time improved significantly.