Objective:

Plantar fasciitis is a common cause of heel pain. The pain is originating from the insertion of plantar fascia near the medial tubercle of the calcaneus. Several conservative methods are known in the treatment of plantar fasciitis. Nearly 10% of the patients have a poor response to conservative therapy and are referred for surgical release for plantar fascia. The purpose of this study was to determine the effects of extracorporeal shock wave therapy (ESWT) on patients with plantar fasciitis.

Materials and Methods:

31 patients (25 females, 6 males) with a diagnosis of plantar fasciitis longer than 6 weeks were included in this study. Visual analog scale (VAS) was used to evaluate the pain intensity of the patients. Walking time without pain was assessed by 6-point rating scale at baseline and 1 month after treatment. Three sessions of ESWT were applied once per week, for 3 weeks, with 12-15 Hz frequency setting, in the form of 2-3 bar and 2500 pulses. In addition the role of features like age, body mass index and gender related to plantar fasciitis were examined. Statistics was performed using SPSS PASW Statistics version 18. P value was calculated for all tests and interpreted as significant for p values smaller than 0.05.

Results:

There was significant difference between VAS scores before and after 1 month of the treatment for both morning pain and activity pain (p=0.000, t=5.27; p=0.000, t=6.12, respectively). No significant difference appears between VAS scores at rest before and after 1 month of the treatment (p=0.091, t=1.74). Twenty two (%71) patients had a painless walking duration for less than 5 minutes before treatment. 1 month after the treatment, only 5 patients had walking time without pain less than 5 minutes according to 6-point rating scale. There were no side effects in patients treated with ESWT.

Conclusion:

ESWT is a safe and effective option for the treatment of plantar fasciitis. The complication rates are low and negligible. However, long-term researches including more patients are needed to assess the efficacy of ESWT.

Keywords: Plantar fasciitis, extracorporeal shock wave therapy, heel pain