Thinner plantar fascia predicts decreased pain after extracorporeal shock wave therapy

▸ Liang H-W, Wang T-G, Chen W-S, Hou S-M. Clin Orthop Rel Res 2007;460:219–25.

Background:

Chronic plantar fasciitis is associated with a thicker plantar fascia thickness — treatment of this condition may be associated with a reduced thickness and reduced pain.

Research question/s:

Does extracorporeal shock wave therapy decrease plantar fascia thickness, and is this associated with reduced pain?

Methodology:

Subjects: 53 patients with plantar fasciitis (78 symptomatic feet).

Experimental procedure: Subjects were assessed and then randomly assigned treatment with either lower-dose (LowD = 25, 0.12 mJ/mm²) or higher-dose (HighD = 28, 0.56 mJ/mm²) extracorporeal shock wave therapy (2000 shock waves, three consecutive sessions, applied at weekly intervals using no local anaesthetic). Pain, foot function, and the Short Form-36 Health Survey were assessed before and after 3 and 6 months. Ultrasonographic measurement of plantar fascia thickness was also measured before and after 3 and 6 months.

Measures of outcome: Pain (VAS), foot function (Foot Function Index), SF-36 score, plantar fascial thickness.

Main finding/s:

Similar improvements in pain and function were observed in the HighD and the LowD groups.

Plantar fascia thickness: there was less pain after treatment in the patients with thinner plantar fascia.

Conclusion/s:

Extracorporeal shock wave therapy (low and high-dose) is associated with reduction in pain and improved …