Radial Extracorporeal Shock Wave Therapy is Safe and Effective in the Treatment of Chronic Recalcitrant Plantar Fasciitis

Gerdesmeyer, Ludger; Frey, Carol; Vester, Johannes; Maier, Markus; Lowell, Weil; Weil, Lowell; Russlies, Martin; Stienstra, John J.; Scurran, B L; Fedder, Keith; Diehl, Paula; Lohrer, Heinz; Henne, Mark; Gollwitzer, Hans

doi:10.1177/0363546508324176

Cited by 198 publications

(233 citation statements)

References 35 publications

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“…5). Two studies contributed to the analysis of success rate of heel pain improvement while doing daily activities [6,7]. There was no significant heterogeneity between these two trials (df = 1; I 2 = 0; Q = 0.19; p = 0.66).…”

Section: Resultsmentioning

confidence: 99%

“…6). Two studies contributed to the analysis of the success rate of heel pain improvement after application of a pressure meter [6,7].…”

Section: Resultsmentioning

confidence: 99%

“…Plantar fasciopathy is usually self-limiting, but approximately 10% of patients still have symptoms despite treatment with nonsurgical measures [6]. Patients refractory to conservative measures often require surgery; however, this has been associated with long recovery times and potentially may result in longer periods off work and a Fig.…”

Section: Discussionmentioning

confidence: 99%

“…M-H = Mantel-Haenszel; ESWT = extracorporeal shock wave therapy. delay to sporting activity [6]. Rompe et al [18] questioned the role of ESWT in acute disease.…”

Section: Discussionmentioning

confidence: 99%

“…7). Three studies contributed to the assessment [6][7][8]. As the data were not continuous, it was deemed more appropriate to discuss the results of the trials individually.…”

Section: Placebo 23mentioning

confidence: 99%

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Extracorporeal Shock Wave Therapy Is Effective In Treating Chronic Plantar Fasciitis: A Meta-analysis of RCTs

Aqil

Siddiqui

Solan

et al. 2013

Clinical Orthopaedics &Amp; Related Research

111

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Background Plantar fasciitis is the most common cause of heel pain. It may remain symptomatic despite conservative treatment with orthoses and analgesia. There is conflicting evidence concerning the role of extracorporeal shock wave therapy (ESWT) in the management of this condition. Questions/purposes We investigated whether there was a significant difference in the change of (1) VAS scores and (2) Roles and Maudsley scores from baseline when treated with ESWT and placebo. Specifically we compared overall improvement from baseline composite VAS, reduction in overall VAS pain, success rate of improving overall VAS pain by 60%, success rate of improving VAS pain by 60% when taking first steps, doing daily activities, and during application of a pain pressure meter.Methods MEDLINE, Embase, and CINAHL databases were searched from January 1980 to January 2013 and a double extraction technique was used to obtain relevant studies. Studies had to be prospective randomized controlled trials on adults and must not have used local anesthesia as part of their treatment protocol. Studies must have specifically recruited patients who continued to be symptomatic despite a minimum of 3 months of conservative treatments. All papers were assessed regarding their methodologic quality and a meta-analysis performed. Seven prospective randomized controlled trials were included in this study. There were 369 patients included in the placebo group and 294 in the ESWT group. Results After ESWT, patients had better composite VAS scores (random effects model, standardized mean difference [SMD] = 0.38; 95% CI, 0.05, 0.72; z = 2.27). They also had a greater reduction in their absolute VAS scores compared with placebo (random effects model, SMD = 0.60; 95% CI, 0.34, 0.85; z = 4.64). Greater success of improving heel pain by 60% was observed after ESWT when taking first steps (random effects model, risk ratio [RR] = 1.30; 95% CI, 1.04, 1.62; z = 2.29) and during daily activities (random effects model, RR = 1.44; 95% CI, 1.13, 1.84; z = 2.96). Subjective measurement of pain using a pressure meter similarly favored ESWT (random effects model, RR = 1.37, 95% CI, 1.06, 1.78; z = 2.41). There was a significant difference in the change to

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Section: Resultsmentioning

confidence: 99%

“…6). Two studies contributed to the analysis of the success rate of heel pain improvement after application of a pressure meter [6,7].…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…M-H = Mantel-Haenszel; ESWT = extracorporeal shock wave therapy. delay to sporting activity [6]. Rompe et al [18] questioned the role of ESWT in acute disease.…”

Section: Discussionmentioning

confidence: 99%

“…7). Three studies contributed to the assessment [6][7][8]. As the data were not continuous, it was deemed more appropriate to discuss the results of the trials individually.…”

Section: Placebo 23mentioning

confidence: 99%

See 3 more Smart Citations

Extracorporeal Shock Wave Therapy Is Effective In Treating Chronic Plantar Fasciitis: A Meta-analysis of RCTs

Aqil

Siddiqui

Solan

et al. 2013

Clinical Orthopaedics &Amp; Related Research

111

View full text Add to dashboard Cite

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An investigation of shock wave therapy and low‐intensity pulsed ultrasound on fracture healing under reduced loading conditions in an ovine model

Gadomski

McGilvray

Easley

et al. 2017

Journal Orthopaedic Research

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The use of shock wave therapy (SWT) and low‐intensity pulsed ultrasound (LIPUS) as countermeasures to the inhibited fracture healing experienced during mechanical unloading was investigated by administering treatment to the fracture sites of mature, female, Rambouillet Columbian ewes exposed to partial mechanical unloading or full gravitational loading. The amount of fracture healing experienced by the treatment groups was compared to controls in which identical surgical and testing protocols were administered except for SWT or LIPUS treatment. All groups were euthanized after a 28‐day healing period. In vivo mechanical measurements demonstrated no significant alteration in fixation plate strains between treatments within either partial unloading group. Similarly, DXA BMD and 4‐point bending stiffness were not significantly altered following either treatment. μCT analyses demonstrated lower callus bone volume for treated animals (SWT and LIPUS, p < 0.01) in the full gravity group but not between reduced loading groups. Callus osteoblast numbers as well as mineralized surface and bone formation rate were significantly elevated to the level of the full gravity groups in the reduced loading groups following both SWT and LIPUS. Although no increase in 4‐week mechanical strength was observed, it is possible that an increase in the overall rate of fracture healing (i.e., callus strength) may be experienced at longer time points under partial loading conditions given the increase in osteoblast numbers and bone formation parameters following SWT and LIPUS. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:921–929, 2018.

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Autoregulated heavy slow resistance training combined with radial shockwave therapy for plantar heel pain: Protocol for a mixed‐methods pilot randomised controlled trial

Burton

2021

Musculoskeletal Care

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Background: Plantar heel pain (PHP) is considered a tendinopathy and it affects up to 10% of the population. Both heavy slow resistance training (HSRT) and extracorporeal shockwave therapy (ESWT) have shown effectiveness for treating PHP in isolation. However, more comprehensive exercise protocols and progression methods are needed due to poor long-term outcomes, and better standardisation of ESWT protocols are required. Autoregulation of resistance training involves selfselecting exercise dosage based on individual factors. Although autoregulation has proven effective for strength gains in athletes, it has not been investigated in tendinopathy. Recent studies recommend that PHP should not be treated by one treatment intervention in isolation. However, there is a dearth of research investigating the feasibility and effectiveness of combined treatment interventions for PHP. Currently, no studies have investigated autoregulated HSRT combined withESWT, despite their individual efficacy. The optimal treatment protocol for PHP is unknown, and there is a need to ascertain whether the addition of ESWT to autoregulated HSRT leads to better outcomes compared to either alone.Methods: A three-arm randomised controlled trial (RCT) comparing these groups would be the ideal way to investigate this question, with a pilot RCT testing trial procedures and process evaluation required prior to a definitive RCT. Patients expectations, feasibility and acceptability of combined ESWT and exercise for PHP also remain unknown. Therefore, the addition of qualitative interviews in a mixedmethods pilot RCT would help ascertain acceptability and help explain the intervention outcomes. K E Y W O R D S extracorporeal shockwave therapy, fasciitis, plantar, resistance training, tendinopathy 1 | BACKGROUND Musculoskeletal disorders have recently been identified as a leading global cause of disability and pain, comprising 6.7% of the total global disability-adjusted life years and the second highest (21.3%) global volume of years lived with disability (Sebbag et al., 2019).Musculoskeletal disorders can have a high morbidity for individuals and represent a vast burden to society and healthcare systems, with effective clinical treatments and recommendations lacking (March et al., 2014). In the United Kingdom, musculoskeletal disorders are responsible for 30% of all years lived with disability, and account for 25% of all General Practitioner (GP) consultations

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Radial Extracorporeal Shock Wave Therapy is Safe and Effective in the Treatment of Chronic Recalcitrant Plantar Fasciitis

Abstract: Radial extracorporeal shock wave therapy significantly improves pain, function, and quality of life compared with placebo in patients with recalcitrant plantar fasciitis.

Cited by 198 publications

References 35 publications

Extracorporeal Shock Wave Therapy Is Effective In Treating Chronic Plantar Fasciitis: A Meta-analysis of RCTs

Extracorporeal Shock Wave Therapy Is Effective In Treating Chronic Plantar Fasciitis: A Meta-analysis of RCTs

An investigation of shock wave therapy and low‐intensity pulsed ultrasound on fracture healing under reduced loading conditions in an ovine model

Autoregulated heavy slow resistance training combined with radial shockwave therapy for plantar heel pain: Protocol for a mixed‐methods pilot randomised controlled trial

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