Effectiveness of low-energy extracorporal shock waves for chronic plantar fasciitis

Rompe, Jan D.; Küllmer, K.; Riehle, Hans M.; Herbsthofer, B.; Eckardt, Anke; Burger, Roger A.; Nafe, B.; Eysel, Peer

doi:10.1016/s1268-7731(96)80004-x

Cited by 53 publications

(57 citation statements)

References 21 publications

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“…Basic-science studies increasingly are providing an understanding of the physiologic mechanisms of pain relief (often immediate) and the modification and repair of the target tissue, which usually requires weeks to months to occur [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] . Extracorporeal shock-wave treatments have been applied to patients with chronic plantar fasciitis who have failed to respond to multiple conservative pharmacologic and therapeutic interventions [29][30][31][32][33][34][35][36][37][38] . Recent randomized, controlled stud- ies have been published but with varying results because of differences in study design, direction of the shock-wave delivery, energy levels, size (volume) of the focused energy ellipsoid (f 2 ) that is transcutaneously transmitted to the fascia, and method of forming the shock wave (electrohydraulic, electromagnetic, and piezoelectric) 32,[39][40][41][42][43][44][45][46][47][48][49][50]…”

Section: Discussionmentioning

confidence: 99%

“…Extracorporeal shock-wave treatments have been applied to patients with chronic plantar fasciitis who have failed to respond to multiple conservative pharmacologic and therapeutic interventions [29][30][31][32][33][34][35][36][37][38] . Recent randomized, controlled stud- ies have been published but with varying results because of differences in study design, direction of the shock-wave delivery, energy levels, size (volume) of the focused energy ellipsoid (f 2 ) that is transcutaneously transmitted to the fascia, and method of forming the shock wave (electrohydraulic, electromagnetic, and piezoelectric) 32,[39][40][41][42][43][44][45][46][47][48][49][50][51][52] . One study found that satisfactory results were maintained five years following electromagnetic shock-wave treatment 43 .…”

Section: Discussionmentioning

confidence: 99%

“…32 Treatment with highenergy shock waves, particularly those generated electrohydraulically, requires some type of anesthetic agent. In our study, patients receiving the actual high-energy shock waves were administered an ankle block.…”

Section: Discussionmentioning

confidence: 99%

“…This anesthetic technique also allows the treatment of both heels when appropriate levels of chronic fascial pain are present bilaterally 67 . Rompe et al performed several studies on the treatment of plantar fasciitis with shock waves 4,32,39,43 . Those studies all used electromagnetically generated shock waves, involved multiple treatments, and varied considerably with respect to the treatment protocols.…”

Section: Discussionmentioning

confidence: 99%

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Electrohydraulic High-Energy Shock-Wave Treatment for Chronic Plantar Fasciitis

Ogden¹,

Alvarez

Levitt

et al. 2004

The Journal of Bone & Joint Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Electrohydraulic High-Energy Shock-Wave Treatment for Chronic Plantar Fasciitis

Ogden¹,

Alvarez

Levitt

et al. 2004

The Journal of Bone & Joint Surgery

View full text Add to dashboard Cite

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“…The placebo effect may explain the significant improvements noted by others in uncontrolled studies of soft-tissue lesions. 5,[22][23][24] Pain is the feature which is most responsive to a placebo effect. 25 Other factors can lead to a false impression of the placebo effect, most importantly regression to the mean and two special forms of this, spontaneous improvement and fluctuation of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal shock-wave therapy for tendonitis of the rotator cuff

Speed

Richards

Nichols

et al. 2002

The Journal of Bone and Joint Surgery. British volume

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W e have performed a double-blind placebo-controlled trial of moderate doses of extracorporeal shock-wave therapy (ESWT) for non-calcific tendonitis of the rotator cuff. Adults (74) with chronic tendonitis of the rotator cuff were randomised to receive either active (1500 pulses ESWT at 0.12 mJ/mm 2 ) or sham treatment, monthly for three months. All were assessed before each treatment, and at one and three months after the completion of treatment. The outcome was measured with regard to pain in the shoulder, including a visual analogue score for night pain, and a disability index. There were no significant differences between the two groups before treatment. The mean duration of symptoms in both groups was 23.3 months. Both showed significant and sustained improvements from two months onwards. There was no significant difference between them with respect to change in the Shoulder Pain and Disability Index (SPADI) scores or night pain over the six-month period. A mean (±SD; range) change in SPADI of 16.1 ± 27.2 (0 to 82) in the treatment group and 24.3 ± 24.8 (-11 to 83) in the sham group was noted at three months. At six months the mean changes were 28.4 ± 25.9 (-24 to 69) and 30.4 ± 31.2 (-12 to 88), respectively. Similar results were noted for night pain.We conclude that there is a significant and sustained placebo effect after moderate doses of ESWT in patients with non-calcific tendonitis of the rotator cuff, but there is no evidence of added benefit when compared with sham treatment. Extracorporeal shock-wave therapy (ESWT) by singlepressure pulses of microsecond duration can be guided by ultrasound to focus on a specific site. Having revolutionised the treatment of urolithiasis, ESWT has more recently been used in the treatment of a number of musculoskeletal conditions, including tendinopathies and enthesopathies, at doses of 10% to 20% of those used in lithotripsy for renal calculi.1-5 The theoretical benefits are the stimulation of tissue healing and the breakdown of calcification. [4][5][6][7] In spite of the increasing popularity of this method of treatment, there has been no randomised, controlled trial of its use in specific musculoskeletal conditions. Benefit from ESWT has been demonstrated in calcific tendonitis of the rotator cuff. 4 We present our findings of a double-blind, randomised, controlled trial in non-calcific tendonitis of the rotator cuff. Patients and MethodsWe recruited adult patients with a clinical diagnosis of tendonitis of the rotator cuff. Informed consent was obtained. The patients were more than 18 years of age and had had pain in the shoulder for at least three months with clinical signs of a unilateral tendonitis of the rotator cuff. These included a painful arc and/or an impingement sign and pain, without weakness on resisted testing of one or more musculotendinous units of the rotator cuff. Exclusion criteria were demonstrable shoulder pathology including glenohumeral or acromioclavicular arthritis, instability, polyarthritis, neck pain, a local dermatological condition, n...

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