Extracorporeal shockwave therapy versus placebo for the treatment of chronic proximal plantar fasciitis: results of a randomized, placebo-controlled, double-blinded, multicenter intervention trial.
Extracorporeal shockwave therapy (ESWT) has demonstrated efficacy in the treatment of recalcitrant proximal plantar fasciitis. The objective of this investigation was to compare the outcomes of participants treated with a new ESWT device with those treated with placebo. A total of 172 volunteer participants were randomized in a 2:1 active-to-placebo ratio in this prospective, double-blind, multicenter trial conducted between October 2003 and December 2004. ESWT (n=115) or placebo control (n=57) was administered on a single occasion without local or systemic anesthesia or sedation, after which follow-up was undertaken. The primary outcomes were the blind assessor's objective, and the participant's subjective assessments of heel pain during the first 3 months of follow-up. Participants were also followed up to 1 year to identify any adverse outcomes that may have been related to the shockwave device. On the visual analog scale, the blind assessor's objective assessment of heel pain displayed a mean reduction of 2.51 in the shockwave group and 1.57 in the placebo group; this difference was statistically significant (P=.045). On the visual analog scale, the participant's self-assessment of heel pain displayed a mean reduction of 3.39 in the shockwave group and 1.78 in the placebo group; this difference was statistically significant (P<.001). No serious adverse events were observed at any time. It was concluded that ESWT was both efficacious and safe for participants with chronic proximal plantar fasciitis that had been unresponsive to exhaustive conservative treatment.
Malay
D Scot
DS
Ankle and Foot Medical Centers of the Delaware Valley, University of Pennsylvania School of Medicine, Philadelphia 19104, and Yale-New Haven Hospital, CT, USA. malays@uphs.upenn.edu
Pressman
Martin M
MM
Assili
Amir
A
Kline
Jason T
JT
York
Shane
S
Buren
Ben
B
Heyman
Eugene R
ER
Borowsky
Pam
P
LeMay
Carley
C
D002908:Chronic Disease; D004311:Double-Blind Method; D036981:Fasciitis, Plantar / Q000628:therapy*; D005260:Female; D006365:Heel; D019220:High-Energy Shock Waves / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010919:Placebos; D011446:Prospective Studies; D016896:Treatment Outcome
D010919:Placebos