Radial Extracorporeal Shock Wave Therapy Is Safe and Effective in the Treatment of Chronic Recalcitrant Plantar Fasciitis
The American Journal of Sports Medicine, Vol. X, No. X
AJSM PreView, published on October 1, 2008 as doi:10.1177/0363546508324176
Ludger Gerdesmeyer,*†‡ MD, PhD, Carol Frey,§ MD, Johannes Vester,|| PhD,
Markus Maier,¶ PhD, Lowell Weil Jr,# DPM, Lowell Weil Sr,# DPM, Martin Russlies,** PhD,
John Stienstra,†† DPM, Barry Scurran,†† DPM, Keith Fedder,§ MD, Peter Diehl,‡‡ MD,
Heinz Lohrer,§§ MD, Mark Henne,† MD, and Hans Gollwitzer,† MD
From the †Department of Orthopedic and Traumatology, Technical University Munich, Klinikum Rechts der Isar, Germany, the ‡Department of Joint Arthroplasty and Clinical Science, Mare Clinic, Kiel, Germany, §Orthopaedic Foot and Ankle Center, Manhattan Beach, California, ||IDV Data Analyses and Study Planning, Biometrics in Medicine, Gauting, Germany, the ¶Department of Orthopedics, Ludwig Maximilian University, Munich, Germany, the #Weil Foot and Ankle Institute, Des Plaines, Illinois, **University Schleswig Holstein, Campus Lübeck, Lübeck, Germany, the ††Department of Podiatry, The Permanente Medical Group Inc, Union City, California, the ‡‡Department of Orthopedics, University Rostock, Rostock, Germany, and the§§Institute of Sportsmedicine, Frankfurt am Main, Germany
Methods: Three interventions of radial extracorporeal shock wave therapy (0.16 mJ/mm2; 2000 impulses) compared with placebo were studied in 245 patients with chronic plantar fasciitis. Primary endpoints were changes in visual analog scale composite score from baseline to 12 weeks’ follow-up, overall success rates, and success rates of the single visual analog scale scores (heel pain at first steps in the morning, during daily activities, during standardized pressure force). Secondary endpoints were single changes in visual analog scale scores, success rates, Roles and Maudsley score, SF-36, and patients’ and investigators’ global judgment of effectiveness 12 weeks and 12 months after extracorporeal shock wave therapy.
Results: Radial extracorporeal shock wave therapy proved significantly superior to placebo with a reduction of the visual analog scale composite score of 72.1% compared with 44.7% (P = .0220), and an overall success rate of 61.0% compared with 42.2% in the placebo group (P = .0020) at 12 weeks. Superiority was even more pronounced at 12 months, and all secondary outcome measures supported radial extracorporeal shock wave therapy to be significantly superior to placebo (P < .025, 1- sided). No relevant side effects were observed.
Radial extracorporeal shock wave therapy significantly improves pain, function, and quality of life compared with placebo in patients with recalcitrant plantar fasciitis.