Long-term results of extracorporeal shockwave treatment for plantar fasciitis.
BACKGROUND
Extracorporeal shockwave treatment has shown mixed short-term results for plantar fasciitis. However, the long-term results are not available.


OBJECTIVE
Long-term results of shockwave treatment are comparable with short-term results.


METHODS
Randomized controlled clinical trial; Level of evidence, 1.


METHODS
This prospective study consisted of 149 patients (168 heels) with an established diagnosis of chronic plantar fasciitis, including 79 patients (85 heels) in the shockwave treatment group and 70 patients (83 heels) in the control group. In the shockwave group, patients received 1500 impulses of shockwaves at 16 kV to the affected heel in a single session. Patients in the control group received conservative treatment consisting of nonsteroidal anti-inflammatory drugs, orthotics, physical therapy, an exercise program, and/or a local cortisone injection. Patients were evaluated at 60 to 72 months (shockwave group) or 34 to 64 months (control group) with a 100-point scoring system including 70 points for pain and 30 points for function. The clinical outcomes were rated as excellent, good, fair, or poor.


RESULTS
Before treatment, the groups showed no significant differences in the scores for pain and function. After treatment, the shockwave group showed significantly better pain and function scores as compared with the control group. The overall results were 69.1% excellent, 13.6% good, 6.2% fair, and 11.1% poor for the shockwave group; and 0% excellent, 55% good, 36% fair, and 9% poor for the control group (P < .001). The recurrence rate was 11% (9/81 heels) for the shockwave group versus 55% (43/78 heels) for the control group (P < .001). There were no systemic or local complications or device-related problems.


CONCLUSIONS
Extracorporeal shockwave treatment is effective and safe for patients with plantar fasciitis, with good long-term results.
Wang
Ching-Jen
CJ
Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao Sung Hsiang, Kaohsiung, Taiwan 833. w281211@adm.cgmh.org.tw
Wang
Feng-Sheng
FS
Yang
Kuender D
KD
Weng
Lin-Hsiu
LH
Ko
Jih-Yang
JY
D000328:Adult; D000368:Aged; D036981:Fasciitis, Plantar / Q000532:radiotherapy*; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D016896:Treatment Outcome