Success and Recurrence Rate after Radial Extracorporeal Shock Wave Therapy for Plantar Fasciopathy: A Retrospective Study

Abstract

Background and Aims. The exploration of an individualised protocol of radial extracorporeal shock wave therapy (rESWT) for plantar fasciopathy, assessing success rates and the recurrence rate over a 1-year period after treatment, is not yet identified in literature. Methods and Results. Between 2006 and 2013, 68 patients (78 heels) were assessed for plantar fasciopathy. An individualised rESWT treatment protocol was applied and retrospectively analysed. Heels were analysed for mean number of shock wave impulses, mean pressure, and mean frequency applied. Significant mean pain reductions were assessed through Visual Analogue Scale (VAS) after 1-month, 3-month, and 1-year follow-up. Success rates were estimated as the percentage of patients having more than 60% VAS pain decrease at each follow-up. 1-year recurrence rate was estimated. The mean VAS score before treatment at 6.9 reduced to 3.6, 1 month after the last session, and to 2.2 and 0.9, after 3 months and 1 year, respectively. Success rates were estimated at 19% (1 month), 70% (3 months), and 98% (1 year). The 1-year recurrence rate was 8%. Moderate positive Spearman's rho correlation (r = 0.462, p < 0.001) was found between pretreatment pain duration and the total number of rESWT sessions applied. Conclusions. Individualised rESWT protocol constitutes a suitable treatment for patients undergoing rESWT for plantar fasciitis.

Comparison of efficacy of shock-wave therapy versus corticosteroids in plantar fasciitis: a meta-analysis of randomized controlled trials

“…Many researchers [ 35 – 37 ] had pointed out that SW was effective in short- and mid-term follow-up in terms of relieving pain and improving functionality, but its efficacy in long-term should be established, especially for the recurrence of plantar fasciitis. Malliaropoulos [ 36 ] et al conducted a retrospective study concerning recurrence rate of plantar fasciitis in 2016, which showed that three key factors for recurrence: female sex, pretreatment pain duration, and the number of SW sessions received. Wang Ching-Jen et al [ 37 ] observed long-term (12 months) results of 79 patients (85 heels) received 1500 impulses of shockwaves at 16 kV to the affected heel in a single session, and the recurrence rate was relative low (11%, 9/81 heels), they also regarded that recalcitrant plantar fasciitis could be caused by plantar fascia thickening and loss of normal tissue elasticity.…”

What are patients' knowledge, expectation and experience of radial extracorporeal shockwave therapy for the treatment of their tendinopathies? A qualitative study

“…A review has recommended that ESWT protocols should be individualised in order to adapt to different stages of a given tendon pathology that will respond to ESWT differently [ 32 ]. A retrospective study [ 33 ] used an individually adapted rESWT protocol for plantar fasciopathy and found promising results.…”

A global approach for plantar fasciitis with extracorporeal shockwaves treatment

“…6,27,28 Therefore, some authors found a recurrence rate of plantar fasciitis from 5% to 11% in the middle-long term follow-up. 20,29,30 In all of these studies ESWT have been directed to the area of maximum pain, localized through profound palpation of the plantar fascia in many areas. Since the fasciae of the lower limb are a continuum, 31 proximal tensions could generate stiffness and pain to distal regions as plantar fascia.…”