title: Thinner plantar fascia predicts decreased pain after extracorporeal shock wave therapy.
abstract: Increased plantar fascia thickness is common with chronic plantar fasciitis, and reduction of the thickness after extracorporeal shock wave therapy or steroid injection has been reported. We hypothesized a decrease of plantar fascia thickness was associated with pain reduction after extracorporeal shock wave therapy. Fifty-three eligible patients with 78 symptomatic feet were randomly treated with piezoelectric-type extracorporeal shock wave therapy of two intensity levels (0.12 and 0.56 mJ/mm2). Two thousand shock waves for three consecutive sessions were applied at weekly intervals. A visual analog scale for pain, the Foot Function Index, the Short Form-36 Health Survey, and ultrasonographic measurement of plantar fascia thickness were evaluated at baseline and 3 and 6 months after treatment. We analyzed the association between pain level and plantar fascia thickness with generalized estimating equation analysis and adjusted for demographic and treatment-related variables. Patients with thinner plantar fascia experienced less pain after treatment; high-intensity treatment and regular exercise were associated with lower pain level. The overall success rates were 63% and 60% at the 3- and 6-month followups. High- and low-intensity treatments were associated with similar improvements in pain and function. Receiving high-intensity treatment, although associated with less pain at followup, did not provide a higher success rate.
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Huey-Wen
authors.initials: HW
authors.lastname: Liang
authors.forename: Tyng-Guey
authors.initials: TG
authors.lastname: Wang
authors.forename: Wen-Shiang
authors.initials: WS
authors.lastname: Chen
authors.forename: Sheng-Mou
authors.initials: SM
authors.lastname: Hou
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005205:Fascia / Q000503:physiopathology; D036981:Fasciitis, Plantar / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome