Long-term results of radial extracorporeal shock wave treatment for chronic plantar fasciopathy: A prospective, randomized, placebo-controlled trial with two years follow-up

Abstract

Numerous randomized controlled trials (RCTs) demonstrated efficacy and safety of extracorporeal shock wave therapy (ESWT) for chronic plantar fasciopathy (cPF). However, only two such RCTs investigated a follow-up period of more than 1 year, both applying focused ESWT. Corresponding data for radial ESWT (rESWT) have not yet been reported. We therefore tested the hypothesis that rESWT is effective and safe for the management of cPF with long-term follow-up of 2 years. To this end n = 50 patients with cPF were randomly allocated to either two sessions of rESWT (one session per week; 2,000 shock waves with energy flux density of 0.16 mJ/mm per session) (n = 25) or to placebo treatment (n = 25). Evaluation was by change in Visual Analog Scale (VAS) score and Roles and Maudsley (RM) score. Mean pretreatment VAS scores for the rESWT and placebo groups were 8.5 and 8.9, respectively. 1, 3, 6, 12, and 24 months after treatment, the mean VAS scores for the rESWT and placebo groups were 0.6, 1.1, 0.5, 2.3, and 1.4 and 7.6, 7.7, 7.4, 6.9, and 5.6 (p < 0.001), respectively. Differences in mean RM scores were statistically significant between groups at 1, 3, 6, 12, and 24 months post treatment, but not at baseline. There were no significant complications. These data indicate that rESWT is effective and safe for the management of cPF with long-term follow-up of 2 years. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1532-1538, 2017.

Injection Techniques for Common Chronic Pain Conditions of the Foot: A Comprehensive Review

“…However, another metaanalysis suggested that pain improvement and success rate correlated with energy intensity level, with outcomes improved most by highintensity SWT, followed by ICS, and lastly lowintensity SWT [47,48]. A different study indicated that SWT provided better outcomes than placebo at 24-month follow-up [49].…”

“…Comparison of these conflicting results indicates that there is still significant ambiguity regarding the extent and duration of effects of each therapy. ICS, PRP, and SWT have all been reported as safe with side effects limited to brief erythema or throbbing pain at the therapy site [38,39,46,47,49]. Studies have shown that PRP is associated with decreased requirement for reinjection or surgery in the long term and positive effects on soft tissue regeneration and inflammation reduction, but its higher cost must also be considered when choosing a treatment [38,45].…”

Extracorporeal Shock Wave Therapy as Therapeutic Intervention: a Narrative Review

“…Also, the feeling of the pulse is soft, as it has a gentle curve, enabling the patients to receive high energy treatment comfortably. Moreover, RSWT has a shock wave intensity that does not cause cavitation of cells, minimizing damage to tissues and cells in the human body [18].…”

Radial Extracorporeal Shock Wave Therapy for Relief of Arthralgia in Rheumatoid Arthritis

“…Multiple research studies have proved that ESWT improves the microcirculation, inhibits the inflammatory response, promotes neural functional recovery, and stimulates osteoblast and the chondrocyte activity. rESWT has been used to treat chronic pain associated with diseases such as plantar fasciitis, carpal tunnel syndrome, chronic distal biceps tendinopathy, and lateral epicondylitis . Although rESWT is now an accepted therapeutic method to relive pain associated with nonimmune damage, its use in the treatment of RA has not been reported.…”

“…rESWT has been used to treat chronic pain associated with diseases such as plantar fasciitis, carpal tunnel syndrome, chronic distal biceps tendinopathy, and lateral epicondylitis. [4][5][6][7] Although rESWT is now an accepted therapeutic method to relive pain associated with nonimmune damage, its use in the treatment of RA has not been reported. In this study, we used rESWT in RA patients with arthralgia that was not adequately controlled with medication therapy, and examined its effects on pain relief and functional recovery.…”