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Jan 16, 2023

Journal Watch: Radial Shockwave Therapy Has Similar Results to Focused Shockwave Therapy for Plantar Fasciitis

Plantar fasciitis is characterized by pain and tenderness along the inside of the heel. Treatment typically involves activity modification, ice, nonsteroidal anti-inflammatory drugs (NSAIDs), strengthening exercises, and heel padding.

Despite treatment, up to 20% of individuals with plantar fasciitis have symptoms that persist longer than a year (Rompe & Buchbinder, 2004). Patients not responding to conservative treatment are candidates for more aggressive treatment, and while corticosteroid injections are effective short term, shockwave therapy demonstrated superiority to steroid injections at 6 months (Li et al, 2018).

There are 2 types of shock wave therapy: radial shock wave and focused shock wave. Collective studies have supported the benefits of using radial and focused extracorporeal shockwave therapy for plantar fasciitis (Reilly et al, 2018). Few studies have directly compared the effectiveness of radial shock wave and focused shock wave.

In a recent publication by DeLuca et al (2021), a chart review as part of a quality improvement initiative included patients with a clinical diagnosis of plantar fasciitis and treated with shock wave therapy. The study included 60 patients, and some of the patient had only radial shock wave treatments and some had a combination of radial and focused shock wave treatments.

The authors found that there was no difference in functional improvement between the groups that had radial shock wave treatmetns alone compared to those that had a combination of radial and focused shock wave treatments using the Foot and Ankle Ability Measure (FAAM). This is significant because shock wave treatments are not covered by insurance, and radial treatments are more economical for patients.

References:

DeLuca S, Robinson DM, Yun PH, Rosenberg C, Tan CO, Tenforde AS. Similar Functional Gains Using Radial Versus Combined Shockwave Therapy in Management of Plantar Fasciitis. J Foot Ankle Surg. 2021 Nov-Dec;60(6):1098-1102.

Li H, Lv H, Lin T. Comparison of efficacy of eight treatments for plantar fasciitis: a network meta-analysis. J Cell Physiol 2018;234:860–870.

Reilly JM, Bluman E, Tenforde AS. Effect of shockwave treatment for management of upper and lower extremity musculoskeletal conditions: a narrative review. PM&R 2018;10:1385–1403.

Rompe JD, Buchbinder R. Clinical practice. Plantar fasciitis. N Engl J Med 2004;350:2159–2166.


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