The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification

Background Plantar fasciitis is the most common cause of pain in the plantar region of the heel, and extracorporeal shockwave therapy (ESWT) is an option used in cases where conservative treatment fails. Hyaluronic acid (HA), initially used for osteoarthrosis, is a treatment option because it has been applied to extra-articular regions, such as tendons, ligaments, and fascia. The aim of the present study will be to evaluate the outcomes of pain, function, and personal satisfaction after a single injection of HA and to compare the results with those of ESWT in patients with chronic plantar fasciitis. Methods The study will include 80 patients who will be randomized to receive three sessions of ESWT (n = 40) or a single ultrasound-guided HA injection in the plantar fascia (n = 40). The outcomes will include the visual analog pain scale score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Outcome Score (FAOS). All of the assessments will be performed at baseline and 3, 6, and 12 months after treatment. Statistical analysis will be performed using the repeated measures ANOVA (analysis of variance test) for primary and secondary outcomes and also Fisher’s Least Significant Difference, a Post-Hoc test. We will use R software for statistical analysis, randomization, and sample size calculation. Results Recruitment and data collection will begin in November 2020, with completion scheduled for November 2022 and final publication available in March 2023. Conclusion This trial will evaluate the effects of a single ultrasound-guided HA injection for the treatment of chronic plantar fasciitis. Trial registration Brazilian Clinical Trials Registry (Register Number: RBR-97vkx4) http://www.ensaiosclinicos.gov.br/rg/RBR-97vkx4/.

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Comparative Effectiveness of Radial Extracorporeal Shockwave Therapy and Ultrasound-Guided Local Corticosteroid Injection Treatment for Plantar Fasciitis

Journal of the American Podiatric Medical Association ◽

10.7547/14-114 ◽

2017 ◽

Vol 107 (3) ◽

pp. 192-199 ◽

Cited By ~ 8

Author(s):

Sehriban Hocaoglu ◽

Umit Erkan Vurdem ◽

Mehtap Aykac Cebicci ◽

Serap Tomruk Sutbeyaz ◽

Zuhal Guldeste ◽

...

Keyword(s):

Outcome Measures ◽

Plantar Fasciitis ◽

Corticosteroid Injection ◽

Plantar Fascia ◽

Injection Therapy ◽

Ultrasound Guided ◽

Extracorporeal Shockwave Therapy ◽

Extracorporeal Shockwave ◽

Shockwave Therapy ◽

Injection Treatment

Background: We compared the long-term clinical and ultrasonographic effects of radial extracorporeal shockwave therapy (rESWT) versus ultrasound-guided corticosteroid injection treatment in patients with plantar fasciitis unresponsive to conservative therapy. Methods: Seventy-two patients with unilateral plantar fasciitis were randomized to receive either rESWT (three times once per week) (n = 36) or corticosteroid treatment (a single 1-mL dose of betamethasone sodium plus 0.5 mL of prilocaine under ultrasound guidance by injection into the plantar fascia) (n = 36). The primary outcome measures were visual analog scale (VAS) and Foot Function Index (FFI) scores. Secondary outcome measures included the heel tenderness index (HTI) score and plantar fascia thickness (PFT) as obtained by ultrasound examination. All of the assessments were performed at baseline and 1, 3, and 6 months after treatment. Results: Significant improvements were observed in the rESWT group in VAS, HTI, and FFI scores and PFT at the end of treatment and were maintained during follow-up. Posttreatment improvements in VAS, HTI, and FFI scores and PFT were also seen in the corticosteroid group but were not maintained for VAS and FFI scores after the completion of therapy and were lost at 1 and 6 months, respectively. No serious treatment-related complications occurred. Conclusions: Both rESWT and corticosteroid injection therapy are effective modalities for treatment of chronic plantar fasciitis. However, rESWT seems to be superior to corticosteroid injection therapy due to its longer duration of action.

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Ultrasound guided local steroid injection versus extracorporeal shockwave therapy in the treatment of plantar fasciitis

Alexandria Journal of Medicine ◽

10.1016/j.ajme.2011.11.005 ◽

2012 ◽

Vol 48 (1) ◽

pp. 35-42 ◽

Cited By ~ 15

Author(s):

Nayera Saber ◽

Hosam Diab ◽

Wael Nassar ◽

Hanaa A. Razaak

Keyword(s):

Plantar Fasciitis ◽

Steroid Injection ◽

Ultrasound Guided ◽

Extracorporeal Shockwave Therapy ◽

Extracorporeal Shockwave ◽

Shockwave Therapy ◽

Local Steroid Injection

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The Effectiveness of High-Energy Extracorporeal Shockwave Therapy Versus Ultrasound-Guided Needling Versus Arthroscopic Surgery in the Management of Chronic Calcific Rotator Cuff Tendinopathy: A Systematic Review

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2015.06.049 ◽

2016 ◽

Vol 32 (1) ◽

pp. 165-175 ◽

Cited By ~ 29

Author(s):

Jan K.G. Louwerens ◽

Ewout S. Veltman ◽

Arthur van Noort ◽

Michel P.J. van den Bekerom

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Arthroscopic Surgery ◽

High Energy ◽

Ultrasound Guided ◽

Extracorporeal Shockwave Therapy ◽

Extracorporeal Shockwave ◽

Shockwave Therapy ◽

Rotator Cuff Tendinopathy

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Comments on the article comparing radial extracorporeal shockwave therapy with ultrasound therapy in patients with lateral epicondylitis

Journal of Medical Ultrasonics ◽

10.1007/s10396-021-01087-1 ◽

2021 ◽

Author(s):

Dimitrios Stasinopoulos

Keyword(s):

Lateral Epicondylitis ◽

Ultrasound Therapy ◽

Extracorporeal Shockwave Therapy ◽

Extracorporeal Shockwave ◽

Shockwave Therapy

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Focused Extracorporeal Shockwave Therapy in Physical Medicine and Rehabilitation

Current Physical Medicine and Rehabilitation Reports ◽

10.1007/s40141-020-00306-z ◽

2020 ◽

Author(s):

Richard Crevenna ◽

Michael Mickel ◽

Othmar Schuhfried ◽

Christina Gesslbauer ◽

Andrej Zdravkovic ◽

...

Keyword(s):

Pain Syndrome ◽

Surrounding Tissue ◽

Patellar Tendinopathy ◽

Physical Medicine ◽

Physical Treatment ◽

Extracorporeal Shockwave Therapy ◽

Non Union ◽

Extracorporeal Shockwave ◽

Shockwave Therapy ◽

Physical Medicine And Rehabilitation

Abstract Purpose of Review Focused extracorporeal shockwave therapy (fESWT) is a physical treatment modality developed over the last 25 years for musculoskeletal indications. It has many indications in the field of physical medicine and rehabilitation (PM&R) and is effective, time-efficient, and cost-efficient. This review focuses on basics and on clinical indications as well as on significant trends in fESWT. Recent Findings In PM&R, stimulation of healing processes in tendons, surrounding tissue, and bones via mechanotransduction seems to be a relevant biological effect. The International Society for Medical Shockwave Treatment (ISMST) describes different types of indications (such as approved standard indications—in accordance with most scientific evidence—like calcifying tendinopathy of the shoulder, plantar fasciitis lateral epicondylopathy of the elbow, greater trochanter pain syndrome, patellar tendinopathy, Achilles tendinopathy and bone non-union, common empirically tested clinical uses, exceptional or expert indications, and experimental indications). Summary fESWT is a relevant treatment option in PM&R and regenerative medicine. In recent years, historical paradigms (for example, application in cancer patients) have changed and new indications (such as nerve regeneration, myofascial trapezius syndrome, low back pain, dermatosclerosis, and lymphedema) are supported. Future translational research should focus on establishing actual exceptional indications and experimental indications for clinical routine.

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Extracorporeal shockwave therapy versus musculoskeletal mesotherapy for Achilles tendinopathy in athlete

Egyptian Rheumatology and Rehabilitation ◽

10.1186/s43166-020-00033-2 ◽

2020 ◽

Vol 47 (1) ◽

Author(s):

Reem EL-Mallah ◽

Enas A. Elattar

Keyword(s):

Treatment Options ◽

Visual Analogue Score ◽

Achilles Tendinopathy ◽

Extracorporeal Shockwave Therapy ◽

Extracorporeal Shockwave ◽

Shockwave Therapy ◽

Tendon Thickness ◽

Vas Scores ◽

Tendon Pathology

Abstract Background Achilles tendinopathy (AT) is considered the commonest tendon pathology, occurring mainly in athletes. Different conservative treatment options have been introduced but with short-term effects; however, extracorporeal shockwave therapy (ESWT) and mesotherapy (MT) injections were claimed to provide longer effects and could be used in cases failure of response to conservative treatments. The objective of our prospective 12-week study was to compare the effect of ESWT and MT on chronic Achilles tendinopathy in athletes by both clinical and ultrasonographical assessment. Results Forty patients with chronic AT diagnosed clinically and with high-resolution ultrasound (US) randomly allocated in two groups first received weekly ESWT session, and the other group underwent weekly MT sessions for 4 consecutive weeks. Both groups improved during the treatment and follow-up period. The mean visual analogue score (VAS) decreased in both the ESWT group and the MT group. Mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score and VAS scores were not significantly different between ESWT and MT groups at the 4th and the 12th week of follow-up. However, US assessment significantly improved after 12 weeks in the ESWT group (as regards tendon thickness, calcifications, and Doppler signal), and for the mesotherapy group, there was the only improvement of tendon thickness. Conclusion ESWT showed improvement of pain and inflammation and calcifications of AT than MT injections, which was documented by US improved findings at week 12 follow up.

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