Successful application of focused extracorporeal shockwave therapy for plantar fasciitis in patients suffering from metastatic breast cancer

Abstract

Purpose Focused extracorporeal shock wave therapy (fESWT) has been shown to be effective in a large number of musculoskeletal disorders. Until 2016, cancer was considered a contraindication for fESWT. The goal of this Commentary is to address the subject of fESWT in cancer patients and present a case of a successful application of fESWT in a breast cancer patient with metastatic bone disease, suffering from debilitating heel pain caused by plantar fasciitis. Methods The subject of fESWT application in cancer patients is discussed using the example of a 75-year-old female with breast cancer and metastatic bone disease suffering from bilateral inferior heel pain, who was referred to our clinic with a tentative diagnosis of polyneuropathy. Patient history, clinical examination, electrodiagnostic testing, and radiological findings all indicated plantar fasciitis, rather than polyneuropathy. The possibility of metastatic bone lesions in the treatment area was excluded and the patient was thereupon treated with 5 weekly applications of low-energy fESWT. Results The treatment lead to a reduction in pain of approximately 80% with no adverse events. Conclusion fESWT may be a viable treatment option for plantar fasciitis even in cancer patients, provided certain conditions are met.

Commentary: Onco-Esthetics Dilemma: Is There a Role for Electrocosmetic-Medical Devices?

“…Although some research has been done on the effects of ESWT on cancer cells, the current consensus does not support its use for this indication (9). Furthermore, in cancer patients with musculoskeletal pain, metastatic disease should be excluded prior to the initiation of ESWT (15)(16)(17). A similar recommendation could presumably be made for patients suffering from skin ulcers or delayed wound healing, however, to our knowledge, research on this topic is lacking.…”