title: Ultrasonographic evaluation at 6-month follow-up of plantar fasciitis after extracorporeal shock wave therapy.
abstract: BACKGROUND
  The aim of this study was to investigate the effect of extracorporeal shock wave therapy (ESWT) on the ultrasonographic appearance of chronically painful, proximal plantar fasciitis.
  
  
  METHODS
  Twenty-two patients with a unilateral proximal plantar fasciitis were prospectively enrolled after unsuccessful conservative treatment lasting 6 months. The contralateral plantar fascia was used as the control. ESWT (3x3000 shock waves/session of 0.2 mJ/mm2) was performed at weekly intervals. The thickness of the plantar fascia was measured ultrasonographically about 2 cm distal of the medial calcaneal tuberosity. Pain estimation on a visual analogue scale (VAS) and the comfortable walking time were recorded. No local anaesthesia was applied. Follow-up was done at 6, 12 and 24 weeks.
  
  
  RESULTS
  Before ESWT, the plantar fasciitis side was ultrasonographically significantly thicker than the control side (p<0.05), whereas 6 months after ESWT, the thickness of the fascia was no longer significantly different. The decrease in thickness of the plantar fasciitis side was significant (p<0.05). Pain during activities of daily living decreased by 79% according to the VAS, and the comfortable walking time increased, both significantly (p<0.01). In patients with little pain (VAS<30), the thickness of the plantar fasciitis side was significantly less (p<0.01) compared with patients who still suffered more pain (VAS>30).
  
  
  CONCLUSIONS
  After ESWT, the thickness of the plantar fascia in patients with plantar fasciitis decreased, pain and walking time improved (all significantly).
authors.affiliation: Orthopaedic University Hospital , 66421, Homburg/Saar, Germany.
authors.forename: Dietrich S
authors.initials: DS
authors.lastname: Hammer
authors.forename: Frank
authors.initials: F
authors.lastname: Adam
authors.forename: Andreas
authors.initials: A
authors.lastname: Kreutz
authors.forename: Stefan
authors.initials: S
authors.lastname: Rupp
authors.forename: Dieter
authors.initials: D
authors.lastname: Kohn
authors.forename: Romain
authors.initials: R
authors.lastname: Seil
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D036981:Fasciitis, Plantar / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography