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Comparison of High-Dose Extracorporeal Shockwave Therapy and Intralesional Corticosteroid Injection in the Treatment of Plantar Fasciitis

Istemi Yucel Orthopaedics and Traumatology, Duzce University, Duzce Medical Faculty, Duzce, Turkey.

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Kutay Engin Ozturan Orthopaedics and Traumatology, Abant Izzet Baysal University, Izzet Baysal Medical Faculty, Bolu, Turkey.

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Yavuz Demiraran Anesthesiology, Duzce University, Duzce Medical Faculty, Duzce, Turkey.

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Erdem Degirmenci Orthopaedics and Traumatology, Duzce University, Duzce Medical Faculty, Duzce, Turkey.

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Gursel Kaynak Anesthesiology, Duzce University, Duzce Medical Faculty, Duzce, Turkey.

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Background: The aim of this study was to evaluate the results of high-dose extracorporeal shockwave therapy applied with an ankle block and corticosteroid injection in patients with plantar fasciitis whose symptoms persisted for more than 6 months.

Methods: Sixty patients were assessed clinically at presentation and at 3-month follow-up with a patient-assessed 100-mm visual analog scale of pain and a physician-assessed heel tenderness index. A therapeutic response rate was evaluated. A decrease of at least 50% from baseline to 3 months in visual analog scale or heel tenderness index scores was accepted as a successful result.

Results: Extracorporeal shockwave therapy and corticosteroid injection provided significant improvements in visual analog scale and heel tenderness index scores, but between the two groups there was no significant difference in the visual analog scale score change 3 months after treatment (P > .05). Twenty-seven of 33 patients (82%) in the extracorporeal shockwave therapy group and 23 of 27 (85%) in the corticosteroid injection group had a successful therapeutic response after 3 months.

Conclusions: Corticosteroid injection and extracorporeal shockwave therapy are successful treatment modalities for plantar fasciitis. Corticosteroid injection treatment is cost effective compared with extracorporeal shockwave therapy, and corticosteroid injection may be the first treatment choice according to these results. (J Am Podiatr Med Assoc 100(2): 105–110, 2010)

Corresponding author: Istemi Yucel, MD, Orthopaedics and Traumatology, Duzce University, Duzce Medical Faculty, Konuralp, Duzce, 81620 Turkey. (E-mail: istemiyucel@yahoo.com)