title: Approaches to optimize focused extracorporeal shockwave therapy (ESWT) based on an observational study of 363 feet with recalcitrant plantar fasciitis.
abstract: BACKGROUND
  Extracorporeal shockwave therapy (ESWT) is an established second-line treatment option for plantar fasciitis. Longer term results of focused ESWT are rare in literature. This study assessed the treatment success-rates of single session ESWT compared to repetitive ESWT treatment sessions, the mid-term results as well as treatment- or patient-related factors influencing the outcome of focused ESWT for plantar fasciitis.
  
  
  METHODS
  284 patients (363 feet) received ESWT for plantar fasciitis and answered a questionnaire on socio-demographic and anamnestic data immediately before as well as 19-77 weeks after the first application of ESWT.
  
  
  RESULTS
  76 percent of patients treated only once and 74 percent of all patients reported satisfying pain relief (with up to three treatment sessions). This was consistent in the mid-term and over different physicians as well as independent of assessed patient- or treatment-related factors.
  
  
  CONCLUSIONS
  Applying repeated ESWT in weekly intervals by default may be helpful in reducing healing time for those patients requiring more than one treatment session. Prospective research is needed to find out whether further treatment sessions are justifiable in patients who indicate no improvement after two or three treatment sessions.
  
  
  CONCLUSIONS
  In many cases, focused ESWT needs to be applied only once. Further research should focus on the number of treatment sessions as well as the minimum energy flux density needed.
authors.affiliation: Orthopaedic Hospital Vienna Speising, 1130 Vienna, Austria; CEOPS - Center of Excellence for Orthopaedic Painmanagement Speising, 1130 Vienna, Austria. Electronic address: raphael.scheuer@oss.at.
authors.forename: R
authors.initials: R
authors.lastname: Scheuer
authors.affiliation: Orthopaedic Hospital Vienna Speising, 1130 Vienna, Austria; CEOPS - Center of Excellence for Orthopaedic Painmanagement Speising, 1130 Vienna, Austria. Electronic address: brunnergasse2@gmx.at.
authors.forename: M
authors.initials: M
authors.lastname: Friedrich
authors.affiliation: CEOPS - Center of Excellence for Orthopaedic Painmanagement Speising, 1130 Vienna, Austria. Electronic address: julia.hahne@oss.at.
authors.forename: J
authors.initials: J
authors.lastname: Hahne
authors.affiliation: Orthopaedic Hospital Vienna Speising, 1130 Vienna, Austria; CEOPS - Center of Excellence for Orthopaedic Painmanagement Speising, 1130 Vienna, Austria. Electronic address: joerg.holzapfel@oss.at.
authors.forename: J
authors.initials: J
authors.lastname: Holzapfel
authors.affiliation: Orthopaedic Hospital Vienna Speising, 1130 Vienna, Austria; CEOPS - Center of Excellence for Orthopaedic Painmanagement Speising, 1130 Vienna, Austria. Electronic address: peter.machacek@oss.at.
authors.forename: P
authors.initials: P
authors.lastname: Machacek
authors.affiliation: Orthopaedic Hospital Vienna Speising, 1130 Vienna, Austria. Electronic address: michael.ogon@oss.at.
authors.forename: M
authors.initials: M
authors.lastname: Ogon
authors.affiliation: Orthopaedic Hospital Vienna Speising, 1130 Vienna, Austria. Electronic address: matthias.pallamar@oss.at.
authors.forename: M
authors.initials: M
authors.lastname: Pallamar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D036981:Fasciitis, Plantar / Q000628:therapy*; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods; D016896:Treatment Outcome
keywords: Extracorporeal shockwave; Heel spur; High energy shock waves; Pain management; Plantar fasciitis; Treatment outcome