title: A comparative analysis of analgesic efficacy of ultrasound and shock wave therapy in the treatment of patients with inflammation of the attachment of the plantar fascia in the course of calcaneal spurs.
abstract: BACKGROUND
  Troublesome heel spur is a nuisance condition that affects people of all ages. Treatment of patients with heel spur is a difficult and lengthy process requiring patience from both the patient and the therapist. Sometimes, the only and ultimate method of treatment is surgery, although spurs tend to recur. The aim of the study is a comparative analysis of the analgesic efficacy of ultrasound and shock wave therapy in patients with heel spur. The cause of pain in the course of calcaneal spur is inflammation of the attachment of the plantar fascia, which plays an important role in the process of walking and is seriously strained during different types of movement. Treatment of patients is a difficult and lengthy process.
  
  
  METHODS
  The study was conducted on a group of 47 patients of both sexes, aged 38-60 years (mean 51.3) with a plantar calcaneal spur confirmed by X-ray images. Patients were randomly assigned into two groups using a simple randomization: Group 1-ultrasound therapy group (a series of ten treatments) and Group 2-the radial shock wave group (series of four treatments). In all patients, pain intensity was assessed three times: before therapy, after the first and second weeks of treatment. A version of Laitinen's pain assessment questionnaire and the Huskisson visual analogue scale (VAS) were used. Of the group of studied respondents, 47 patients of both sexes and aged 38-60 years (mean age 51.3) with a heel spur (confirmed on X-rays), who had pain for at least a month, were randomly included in the study. The patients were classified into: Group 1-US therapeutic group (a series of ten treatments) and Group 2-with RSWT (a series of five treatments). Pain intensity was assessed three times: before the treatment, after the first and second week of the treatment with the application of the VAS and the Leitinen Pain Questionnaire.
  
  
  RESULTS
  However, a decrease in pain sensation was reported in all test intervals, and its largest decrease occurred in both groups within 1 week of beginning treatment. More dynamic change in this period was recorded in Group 1.
  
  
  CONCLUSIONS
  The conclusion is that while ultrasound and shock wave therapy show significant analgesic efficacy in patients with heel spur, fewer shock wave therapy sessions are needed than ultrasound sessions for effective relief, suggesting that the shock wave therapy has greater analgesic efficacy. A similar analgesic effect was achieved with the administration of a smaller number of shock wave treatments and a full series of ultrasound treatments.
authors.affiliation: Physiotherapy Laboratory, Department of Physical Medicine, Medical University of Lodz, Lodz, Poland.|Faculty of Pedagogy and Health Promotion, Some College of Informatics and Skills of Lodz, Lodz, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Krukowska
authors.affiliation: Outpatient for the Rehabilitation of Communal Health Outpatient Clinic in Andrespol, Andrespol, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Wrona
authors.affiliation: Department of Allergology and Respiratory Rehabilitation, Medical University of Lodz Poland, Hallera 1, 90-549, Lodz, Poland. monika.sienkiewicz@umed.lodz.pl.
authors.forename: Monika
authors.initials: M
authors.lastname: Sienkiewicz
authors.affiliation: Faculty of Pedagogy and Health Promotion, Some College of Informatics and Skills of Lodz, Lodz, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Czernicki
mesh_terms: D000328:Adult; D036981:Fasciitis, Plantar / Q000209:etiology / Q000628:therapy*; D005260:Female; D036982:Heel Spur / Q000150:complications*; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D014464:Ultrasonic Therapy
keywords: Heel spur; Pain; Shock wave therapy; Shock wave therapy inflammation of the attachment of the plantar fascia; Ultrasound