Abstract
Purpose of Study: Assessing short and long term eficacy of Extracorporal Shock Wave Therapy (ESWT) as a treatment for recalcitrant plantar fasciitis (PF).
Methods: Prospective follow up of 63 heels among 50 patients with persistent PF patients, (mean age 57.2±10.5); symptoms’ duration 15.8±14.3 months, resistant to non-operative treatment modalities including steroid injections.
All patients underwent thorough physical examination and AOFAS Hindfoot score was obtained before treatment and a follow-up examination one week and one year after applicaton of ESWT course. Pain was assessed by Visual Analog Scale (VAS) relating to six parameters: pain on first step in the morning, maximum pain intensity, pain during prolonged walking, standing, at the end of the day and night pain. ESWT was applied in five consecutive courses of 1500 impulses of 0.32mj/mm² once a week in a routine previously described manner.
Results:. All the six VAS parameters decreased significantly post treatment. The Vas parameter of the first steps in the mornining was the most severe before 8.6±1.8 and after treatment 4.2±2.0 and 1.4±1.9 one year after tretment (p< 0.0001). Night pain was the less intenes before treatment 3.9±3.7 and was nearly eliminated to 0.9±1.6 and 0.2±0.8 after one week and a one year post treatment (p< 0.0001). AOFAS hind-foot Score increased from 49.7±15.8 before ESWT to 87.7±10.9 and 86.3±10.7 one week and year after the courses (p< 0.0001). Three patients couldn’t complete the ESWT course one, one of them with bilateral PF. From those patients two had tarsal tunnel syndrome and one with the tibial nerve first branch which was fassing through the plantar fascia. There were no side effects other than minimal local discomfort during the session time.
Conclusion: ESWT is a safe, efficient treatment modality for resistant PF.
The abstracts were prepared by Ms Orah Naor. Correspondence should be addressed to Israel Orthopaedic Association at PO Box 7845, Haifa 31074, Israel.
