As a clinician, using shockwave therapy for plantar fasciitis patients is a safe, effective, non-invasive alternative to traditional treatments. In fact, research has shown shockwave therapy to be even more effective than commonly used treatments, such as corticosteroid injections.
Plantar fasciitis is a common musculoskeletal disorder that affects an estimated 7% of the population. It is characterized by inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes, known as the plantar fascia. The plantar fascia is integral to mobility, as it helps to absorb the shock associated with walking, running, or otherwise putting pressure on your feet.
Patients with plantar fasciitis will often feel the most pain first thing in the morning, after standing for long periods, or when standing after a period of sitting. Other signs of plantar fasciitis include shooting or stabbing pain in the bottom of the foot. Often, the pain will subside with a short bout of walking but will recur after long walks.
Despite its prevalence, this issue has proven to be remarkably stubborn to treat. Sadly, the pain from this condition can have severe, damaging effects on your patients’ mobility and, consequently, their quality of life.
Conservative treatments for this disorder are often NSAIDs (Ibuprofen, Aleve, Motrin, etc.), physical therapy, night splints, orthotics, walking boots, cane, crutches, or some combination thereof.
When conservative treatments fail to address this issue, surgery, ultrasonic tissue repair, and corticosteroid injections have been used. These interventions range in invasiveness and associated risk.
In the case of corticosteroid injections, relief is only temporary. And, unfortunately, multiple injections are not recommended as they can weaken the plantar fascia, possibly causing it to rupture.
Shockwave Therapy for Plantar Fasciitis
Shockwave therapy for plantar fasciitis is an effective treatment, especially for patients who have not found more conservative therapies helpful.
For chronic plantar fasciitis that has not responded well to conservative treatments, shockwave therapy can be especially beneficial. For this treatment, sound waves are directed at the area of heel pain to stimulate healing.
Clinical Evidence
According to a randomized study published in the Journal of the American Podiatric Medical Association, the use of radial extracorporeal shockwave therapy for plantar fasciitis proved superior to that of corticosteroid injections.
This is due, in part, to the increased number of possible sessions of shockwave therapy. This makes it more effective than corticosteroid injections which can only be applied a few times every year.
The authors of the randomized study focused on 72 patients with unilateral plantar fasciitis, who received either radial ESWT once a week for three weeks or corticosteroid ultrasound-guided injection consisting of a 1 mL dose of betamethasone sodium plus 0.5 mL of prilocaine.
Researchers found the patients who received shockwave therapy treatments experienced “significant improvements” in measures such as Visual Analog Scale scores, Foot Function Index scores, heel tenderness, and plantar fascia thickness. Importantly, these patients maintained those improvements at follow-up exams. In comparison, the study notes the patients in the corticosteroid group saw improvements in the same measures, but they did not maintain the improvements during follow-up at one, three, and six months.
According to Nicholas Romansky, DPM, FACFAS, a Diplomate of the American Board of Foot and Ankle Surgery, the difference in efficacy is because shockwave therapy addresses the root cause of plantar fasciitis, as opposed to corticosteroid injections, which address the symptoms.
To learn more about the use of shockwave therapy for plantar fasciitis please visit: www.shockwavecanada.ca.