Extracorporeal Pulse-Activated Therapy versus Injection: Treatment of Recalcitrant Plantar Fasciitis

Abstract

Background: Plantar fasciitis is one of the most common clinical presentations seen by podiatric clinicians today. With corticosteroid injection being a classic treatment modality and extracorporeal pulse-activated therapy (EPAT) technology improving, the purpose of this study was to retrospectively compare pain and functional outcomes of patients with plantar fasciitis treated with either injection or EPAT. Methods: Between November 1, 2014, and April 30, 2016, 60 patients who met the inclusion criteria were treated with either corticosteroid injection or EPAT. Patients were evaluated with both the visual analog scale (VAS) and the American Orthopaedic Foot & Ankle Society Hindfoot Score at each visit. Results: The EPAT was found to reduce pain on the VAS by a mean of 1.98 points, whereas corticosteroid injection reduced pain by a mean of 0.94 points. This was a significant reduction in the VAS score for EPAT compared with corticosteroid injection (P = .035). Conclusions: Extracorporeal pulse-activated therapy is as effective as corticosteroid injection, if not more so, for the treatment of recalcitrant plantar fasciitis and should be considered earlier in the treatment course of plantar fasciitis.

Extracorporeal Pulse Activation Therapy and Amniotic Extracellular Matrix Injection for post-traumatic subtalar joint osteoarthritis: A case study

“…Despite this the patient relates to having a significant improvement in his quality of life. As previously stated, EPAT promotes healing by stimulating the production of endogenous proteins [8][9][10][11][12][13][14][15] while AEM injections promote healing by the introduction of exogenous scaffolding proteins [16][17][18][19][20][21][22][23][24]. Because of this, it is our opinion that it is logical they could work synergistically.…”

“…Extracorporeal pulse activation therapy (EPAT), also known as shockwave therapy, has historically been used to treat plantar fasciitis [7,8] and tendinopathies of the Achilles [9], knee [10], and shoulder [11]. EPAT works by transferring mechanical force through radially expanding acoustic waves to an area of pathology.…”

“…EPAT works by transferring mechanical force through radially expanding acoustic waves to an area of pathology. This produces controlled tissue damage stimulating a cascade of biochemical events which can be favorable for healing [8][9][10][11][12][13]. It has been shown to increase vascular endothelial growth factor and decrease inflammatory cytokines in vivo [14].…”