Shock wave therapy for recalcitrant plantar fasciitis with heel spur:: prospective randomized placebo-controlled double-blind study

Aim: Efficacy of low-energy shock wave therapy for recalcitrant plantar fasciitis. Method: 32 patients were randomly assigned into real and placebo ESWT groups, treatment Comprised 1000 impulses of 0,08 mJ/mm(2) at 14 kV (OssaTron OSA 120, HMT AG, Switzerland) in 12 cases repeated after six weeks or placebo (energy-absorbing foil). Follow-up evaluation (19, 32 and 48 wks.) included specific questionnaire, clinical-functional examination and measurement of plantar pressure while walking (Erned AT-4. pedograph, Novel GmbH, Munich). Examiner and patients were blinded. Results: 88% of the treatment group were pain free or had good results. None of the placebo group were pain free, 33.3% had good results (Roles and Maudsley Score). The treatment group showed significantly better outcome for morning and resting pain, pressure stamp-tolerance and walking ability. Pedography did not show a clear correlation between pain relief and load pattern. Conclusion: The results of this study corroborate the value of ESWT for recalcitrant plantar faciitis. As a non invasive technique with low side effects, it can complement the row of conservative treatments.