Ultrasonographic evaluation at 6-month follow-up of plantar fasciitis after extracorporeal shock wave therapy.
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).
Hammer
Dietrich S
DS
Orthopaedic University Hospital , 66421, Homburg/Saar, Germany.
Adam
Frank
F
Kreutz
Andreas
A
Rupp
Stefan
S
Kohn
Dieter
D
Seil
Romain
R
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