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Extracorporeal Pulse-Activated Therapy versus Injection: Treatment of Recalcitrant Plantar Fasciitis

John Grady Advocate Christ Medical Center and Advocate Children's Hospital, Oak Lawn, IL

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Yelena Boumendjel Jesse Brown VA Medical Center, Chicago, IL

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Kathryn LaViolette Podiatric Residency Program, Advocate Christ Medical Center, Oak Lawn, IL

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Trevor Smolinski Podiatric Residency Program, Advocate Christ Medical Center, Oak Lawn, IL

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Background:

Plantar fasciitis is one of the most common clinical presentations seen by podiatric clinicians today. With corticosteroid injection being a classic treatment modality and extracorporeal pulse-activated therapy (EPAT) technology improving, the purpose of this study was to retrospectively compare pain and functional outcomes of patients with plantar fasciitis treated with either injection or EPAT.

Methods:

Between November 1, 2014, and April 30, 2016, 60 patients who met the inclusion criteria were treated with either corticosteroid injection or EPAT. Patients were evaluated with both the visual analog scale (VAS) and the American Orthopaedic Foot & Ankle Society Hindfoot Score at each visit.

Results:

The EPAT was found to reduce pain on the VAS by a mean of 1.98 points, whereas corticosteroid injection reduced pain by a mean of 0.94 points. This was a significant reduction in the VAS score for EPAT compared with corticosteroid injection (P = .035).

Conclusions:

Extracorporeal pulse-activated therapy is as effective as corticosteroid injection, if not more so, for the treatment of recalcitrant plantar fasciitis and should be considered earlier in the treatment course of plantar fasciitis.

Corresponding author: John Grady, DPM, Advocate Christ Medical Center and Advocate Chîldren's Hospital, 4650 Southwest Hwy, Oak Lawn, IL 60453. (jgrady@footandankleinstitute.com)