Dose-Related Effect of Extracorporeal Shock Wave Therapy for Plantar Fasciitis

Abstract

ObjectiveTo examine the dose-related effect of extracorporeal shock wave therapy (ESWT) for plantar fasciitis.MethodsSixty patients with plantar fasciitis despite conservative treatment were enrolled. The patients were divided into a low-energy group (group L: n=30, 1,000 shocks/session, energy flux density [EFD] per shock 0.08 mJ/mm2) and a medium-energy group (group M: n=30, 1,000 shocks/session, EFD 0.16 mJ/mm2). The main outcome measures were visual analogue scale (VAS), Roles and Maudsley (RM) score, and thickness of plantar fascia (PF). To compare the effects between each group, follow-up was carried out 1 week after 3 and 6 sessions, and 1 and 3 months after ESWT.ResultsSignificant VAS and RM score improvement, and PF thickness reduction were observed in both groups (p<0.01). After 3 sessions of ESWT, group M showed significant improvement in the VAS and RM score than group L, whereas after 3 additional sessions applied in group L, the main outcomes were no longer significantly different in both groups (p>0.05).ConclusionTherapeutic effect might disclose a dose-related relationship; therefore, EFD and the times of the session are considerable factors when treating with ESWT.

Extracorporeal Shockwave Therapy Versus Kinesiology Taping in the Management of Plantar Fasciitis: A Randomized Clinical Trial

“…27,28 This discrepancy may be explained by methodological differences. For example, the use of local anesthesia, 23,29,30 applicator position, 23 and the use of different energy densities of ESWT 31 are all factors that may have affected study results. In a study by Lee et al, 31 a medium-energy (0.16 mj/mm 2 ) ESWT group showed statistically significant pain reduction and improved function scores compared to a low-energy (0.08 mj/mm 2 ) group.…”

“…For example, the use of local anesthesia, 23,29,30 applicator position, 23 and the use of different energy densities of ESWT 31 are all factors that may have affected study results. In a study by Lee et al, 31 a medium-energy (0.16 mj/mm 2 ) ESWT group showed statistically significant pain reduction and improved function scores compared to a low-energy (0.08 mj/mm 2 ) group. In another study, Park et al 32 measured the long-term effects of ESWT on PF and found that subjective pain began to decrease one week after the first treatment session, and continued to improve with time, up to a mean of 24 months.…”

Radial extracorporeal shockwave therapy for the treatment of finger tenosynovitis (trigger digit)

“…The higher the pressure, the greater the treatment effects; thus, less sessions are required, but pain during the treatment increases. The lower the pressure, the more sessions are required to have a therapeutic effect 49. Therefore, in the present study, pressure was set between 1.0 and 1.7 bars depending on each patient’s individual pain tolerance.…”

Healing of Achilles Tendon Partial Tear Following Focused Shockwave: A Case Report and Literature Review

“…Most reports show evidence of therapeutic benefits of ESWT in calcific rotator cuff tendinopathy 19 and plantar fasciitis, 20 and it has been found to be more effective than traditional methods on chronic patellar tendinopathy. 21 In recommended energy densities, minor complications of ESWT like pain and local swelling without structural damage have been reported; 22,23 skin erosions, hematoma, or nerve lesions have also been noted.…”