Extracorporeal Shock Wave Therapy Is Effective In Treating Chronic Plantar Fasciitis: A Meta-analysis of RCTs

Abstract

Background Plantar fasciitis is the most common cause of heel pain. It may remain symptomatic despite conservative treatment with orthoses and analgesia. There is conflicting evidence concerning the role of extracorporeal shock wave therapy (ESWT) in the management of this condition. Questions/purposes We investigated whether there was a significant difference in the change of (1) VAS scores and (2) Roles and Maudsley scores from baseline when treated with ESWT and placebo. Specifically we compared overall improvement from baseline composite VAS, reduction in overall VAS pain, success rate of improving overall VAS pain by 60%, success rate of improving VAS pain by 60% when taking first steps, doing daily activities, and during application of a pain pressure meter.Methods MEDLINE, Embase, and CINAHL databases were searched from January 1980 to January 2013 and a double extraction technique was used to obtain relevant studies. Studies had to be prospective randomized controlled trials on adults and must not have used local anesthesia as part of their treatment protocol. Studies must have specifically recruited patients who continued to be symptomatic despite a minimum of 3 months of conservative treatments. All papers were assessed regarding their methodologic quality and a meta-analysis performed. Seven prospective randomized controlled trials were included in this study. There were 369 patients included in the placebo group and 294 in the ESWT group. Results After ESWT, patients had better composite VAS scores (random effects model, standardized mean difference [SMD] = 0.38; 95% CI, 0.05, 0.72; z = 2.27). They also had a greater reduction in their absolute VAS scores compared with placebo (random effects model, SMD = 0.60; 95% CI, 0.34, 0.85; z = 4.64). Greater success of improving heel pain by 60% was observed after ESWT when taking first steps (random effects model, risk ratio [RR] = 1.30; 95% CI, 1.04, 1.62; z = 2.29) and during daily activities (random effects model, RR = 1.44; 95% CI, 1.13, 1.84; z = 2.96). Subjective measurement of pain using a pressure meter similarly favored ESWT (random effects model, RR = 1.37, 95% CI, 1.06, 1.78; z = 2.41). There was a significant difference in the change to

Effeciency of extracorporeal shock wave therapy in patients with plantar fasciitis and the relationship with subcalcaneal spur length

“…Literatürde ESWT' nin plantar fasiitis tedavisinde etkinliği konusunda da farklı sonuçlar olmakla birlikte, konservatif tedavilere dirençli kronik plantar fasiitin tedavisinde etkili ve güvenli bir yön-tem olarak kabul edilmekte ve 3 aydan fazla süre-dir topuk ağrısı olan ve konservatif tedaviye cevap vermeyen hastalarda önerilmektedir [15]. Ogden JA ve ark [9] yaptıkları çalışmada ESWT uygulamasını plantar fasiitiste etkili bulmuşlar ve herhangibir cerrahi tedaviden önce uygulanmasını, hatta kotrizon enjeksiyonuna tercih edilebilecek bir yöntem olduğumu önermişlerdir.…”

Low-Dose Radiotherapy of Painful Heel Spur/Plantar Fasciitis as an Example of Treatment Effects in Benign Diseases

“…Three metaanalyses comprising at least five randomized trials found significant short-term pain relief and improved functional outcomes for this therapeutic option [72][73][74]. Another study compared the analgesic efficacy of ultrasound and shock wave therapy in 47 patients [75].…”

Biological Strategies for Improved Osseointegration and Osteoinduction of Porous Metal Orthopedic Implants

“…Lithotripsy is primarily used by nephrologists to ablate kidney stones, but this technology also has applications in orthopedics. Specifically, ESWT is used to treat plantar fasciitis (120), and nonunions This article has been peer-reviewed and accepted for publication, but has yet to undergo copyediting and proof correction. The final published version may differ from this proof.…”