Extracorporeal shock wave therapy versus corticosteroid injection for chronic plantar fasciitis

Background: Extracorporeal shock wave therapy (ESWT) is a nonsurgical treatment for plantar fasciitis (PF) that has had satisfactory clinical outcomes. However, local corticosteroid injection (LCI) is often regarded as first-line treatment of PF, but there have been few studies comparing the 2 methods. Therefore, we compared the effect of ESWT and LCI on patients with PF. Methods: This was a block randomized controlled study comparing 49 patients treated with ESWT and 47 patients treated with LCI from January 2017 to December 2018 who were followed for 6 months. We evaluated the clinical outcomes in the 2 groups, including average pain, first-step pain, plantar fascia thickness, and Foot Function Index, Chinese version of the PF patients. Results: All patients had pain relief and function improvement after treatment, whereas the LCI group did not maintain significant clinical improvement at the 3-month follow-up. The patients in the ESWT group had a significantly better clinical outcome with better duration of improvement than the LCI group. Conclusion: For PF patients, both ESWT and LCI resulted in clinical improvement but EWST provided longer relief than LCI. Level of Evidence: Level II, prospective comparative study.

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Outcome of Corticosteroid Injections, Extracorporeal Shock Wave Therapy, and Radiofrequency Thermal Lesioning for Chronic Plantar Fasciitis

Foot & Ankle International ◽

10.1177/1071100720949469 ◽

2020 ◽

pp. 107110072094946

Author(s):

Tunay Erden ◽

Berkin Toker ◽

Omer Cengiz ◽

Bugra Ince ◽

Seyda Asci ◽

...

Keyword(s):

Shock Wave ◽

Pain Intensity ◽

Plantar Fasciitis ◽

Corticosteroid Injection ◽

Extracorporeal Shock Wave Therapy ◽

Heel Pain ◽

Symptom Duration ◽

Shock Wave Therapy ◽

Plantar Heel Pain ◽

Extracorporeal Shock Wave

Background: Chronic heel pain with plantar fasciitis is relatively common and can affect adults of all ages regardless of an active or sedentary lifestyle. The purpose of the present study was to evaluate the effectiveness of corticosteroid injection (CSI), extracorporeal shock wave therapy (ESWT), and radiofrequency thermal lesioning (RTL) treatments in chronic plantar heel pain that has been unresponsive to other conservative treatments. Methods: We retrospectively analyzed the results of 217 patients treated with CSI ( n = 73), ESWT ( n = 75), and RTL ( n = 69). The treatment efficacy and pain intensity, as measured using the visual analog scale, were recorded and compared at the 6-month follow-up. Results: Pain intensity decreased significantly in all patients. However, it decreased significantly more in the CSI and RTL groups than in the ESWT group ( P < .001). Age, sex, body mass index, calcaneal spur presence, and symptom duration were similar among 3 groups ( P > .05). No complications were noted after the CSI, ESWT, or RTL sessions. Conclusion: CSI, ESWT, and RTL successfully treated chronic plantar heel pain that did not respond to other conservative treatments; however, CSI and RTL yielded better therapeutic outcomes. Level of Evidence: Level III, retrospective comparative study.

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