Gollwitzer H, Saxena A, DiDomenico L, et al: Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am 97: 701, 2015.
Tomczak R, Haverstock B: A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome. J Foot Ankle Surg 34: 305, 1995.
Porter M, Shadbolt B: Intralesional corticosteroid injection versus extracorporeal shock wave therapy for plantar fasciopathy. Clin J Sport Med 15: 119, 2005.
Thomas JL, Christensen JC, Kravitz SR, et al: The diagnosis and treatment of heel pain: a clinical practice guideline–revision 2010. J Foot Ankle Surg 49: S1, 2010.
Gerdesmeyer L, Frey C, Vester J, et al: Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med 36: 2100, 2008.
Yucel, I, Ozturan K, Demiraran Y, et al: Comparison of high-dose extracorporeal shockwave therapy and intralesional corticosteroid injection in the treatment of plantar fasciitis. JAPMA 100: 105, 2010.
Saxena A, Fournier M, Gerdesmeyer L, et al: Comparison between extracorporeal shockwave therapy, placebo ESWT and endoscopic plantar fasciotomy for the treatment of chronic plantar heel pain in the athlete. Muscles Ligaments Tendons J 2: 312, 2012.
Malay D, Pressman M, Assili A, et al: Extracorporeal shockwave therapy versus placebo for the treatment of chronic proximal plantar fasciitis: results of a randomized, placebo-controlled, double-blinded, multicenter intervention trial. J Foot Ankle Surg 45: 196, 2006.
Pribut SM: Current approaches to the management of plantar heel pain syndrome, including the role of injectable corticosteroids. JAPMA 97: 68, 2007.
Sellman J: Plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int 15: 376, 1994.
Waugh C, Morrissey D, Jones E, et al: In vivo biological response to extracorporeal shockwave therapy in human tendinopathy. Eur Cell Mat 29: 268, 2015.
Saxena A, Ramdath S Jr, O'Halloran P, et al: Extra-corporeal pulsed-activated therapy (“EPAT” sound wave) for Achilles tendinopathy: a prospective study. J Foot Ankle Surg 50: 315, 2011.
Martin RL, Irrgang, JJ, Conti SF: Outcome study of subjects with insertional plantar fasciitis. Foot Ankle Int 19: 803, 1998.
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.
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.
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).
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.