The effect of paraffin bath therapy versus extracorporeal shockwave therapy in the management of plantar fasciitis: A randomized clinical trial

Abstract

Plantar fasciitis (PF) is the most common cause of painful heel. The etiology is multifactorial but usually involves inflammation and degeneration of the plantar fascia origin. Physical therapy interventions such as contrast bath, ultrasonography and iontophoresis help in resolution of symptoms. According to our current knowledge the efficacity paraffin bath therapy (PBT) is ambiguous. This prospective, randomized controlled study aims to compare the efficacy of PBT and extracorporeal shockwave therapy (ESWT) in the treatment of plantar fasciitis. Seventy patients were randomized into either the PBT (12 men, 23 women; mean age 39.12 ± 7.15 years) or ESWT (14 men, 21 women; mean age 38.37 ± 8.87 years) groups. Four patients in PBT group and five patients in ESWT group were lost to follow-up. Groups were similar regarding age, sex, and body mass index (all P > 0.05). PBT group had paraffin bath therapy (5 times per week, for 3-week duration) for affected foot while ESWT was applied twice a week for three weeks. As outcome measures patients’ pain and functional status were evaluated with Visual Analog Scale (VAS), Heel Tenderness Index (HTI), Foot and Ankle Outcome Score (FAOS) and ultrasonographic thickness of the plantar fascia recorded. The study parameters were administered at baseline, immediately after treatment and after 12 weeks. Statistically significant improvement was observed in several studied parameters after the treatment and during the follow-up study in the both groups. The PBT significantly improved the VAS, HTI and FAOS but not in thickness of the plantar fascia, even in the long-term. Both PBT and ESWT treatments improved pain levels and function and quality of life in individuals with plantar fasciitis. But ESWT method was superior according to PBT in treating plantar fasciitis.