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Shockwave therapy vs physiotherapy for plantar fasciitis

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Apr 23, 2009.

  1. NewsBot

    NewsBot The Admin that posts the news.

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    Comparison of radial shockwaves and conventional physiotherapy for treating plantar fasciitis.
    Greve JM, Grecco MV, Santos-Silva PR.
    Clinics. 2009 Apr;64(2):97-103.
  2. Admin2

    Admin2 Administrator Staff Member

  3. Don ESWT

    Don ESWT Active Member

    Here we go again? How can you compare apples with oranges and lemons. The three treatments are poles apart.
    Extracorporeal Shockwave Therapy is as different to Radial Shockwave Therapy as it is to Conventional Physiotherapy.

    Don Scott
  4. pnunan

    pnunan Member

    I would agree with Don, there is confusion about the various types of shockwave therapy. First, those of us who use shockwave, only perform it after all other conservative treatment fails (at least that is what you are supposed to do!). That includes physiotherapy, NSAIDS, injections, night braces, orthotics, change in shoes, weight reduction, etc. Then you have several choices. Non surgically you can perform ESWT which is high energy. Usually involves one at the most two treatments performed under sedation and nerve block. Low energy or radial shock wave often is done in an office setting, no anesthesia and may take3-4 treatments. Another option is injection of platlet derived growth factors. Have had limited experience with this modality but it seems to work well, needs to be done under ultrasound guided imagery. Surgery is usually the final options. Recently, I have been using percutaneous radiofrequency treatments (Topaz) with good success. While some market this as non-invasive, you are poking holes through the skin to the plantar fascia in multiple locations. The final option is surgery either endoscopic or open.

    Plantar fasciitis/heel pain syndrome/plantar fasciosis or whatever you want to call it, responds to traditional conservative treatment, 95% of the time.

    STEVE LEVITZ Active Member

    98% of the time
  6. Paul Bowles

    Paul Bowles Well-Known Member

    It always amazes me that for a condition which we have a 98% (thanks Steve) success rate in treating conservatively we still find the need to argue the treatment options so much?

    Carpel tunnel syndrome has a 33% success rate in surgical treatment and it isn't discussed half as much as plantar heel pain. Maybe the real question should be "...are we just a bunch of whingers?"

  7. drjasmine

    drjasmine Welcome New Poster


    Is these therapy effective for plantar fasciitis really? Which one is more effective?

    In shock-wave therapy how much voltage shock is given and is there any side effects from it?

    Could anyone suggest it?
  8. pnunan

    pnunan Member

    Physiotherapy in my opinion is still the first treatment option along with orthotics for plantar fasciitis pain. Shockwave is used after failure of all conservative treatment including NSAIDS, injections, night braces, etc. The International Society for Medical Shockwave has alot of useful information. Not seen any side effects so far. Saw a patient today who had chronic peroneal tendonitis. NO relief with physiotherapy, orthotics, NSAIDS, immobilization and even surgical decompresson of the tendon and sheath. Performed 3 low energy shock wave treatments in office over 8 week period. Patient was in today, now pain free.
  9. Don ESWT

    Don ESWT Active Member

    Dr Jasmine,
    There is no electrical shock (voltage) involved, it is not a T.E.N.S. machine.
    The Shock is more of a pneumatic sensation or hammering
    The analogy is that there is a little man inside hitting you with a big sledge hammer.:hammer:
    You go and have a look at these machines

    Don Scott:good:
  10. footdrcb

    footdrcb Active Member

    I have had quite a bit of success with a chattanooga ifc and us premodulated machine.. 50-180 Hz Ifc and 3 W psq cm usound for 15 mins ..continuous us ..

  11. NewsBot

    NewsBot The Admin that posts the news.

    This appears to be the 12 month follow up (?):

    One-year treatment follow-up of plantar fasciitis: radial shockwaves vs. conventional physiotherapy
    Marcus Vinicius Grecco, Guilherme Carlos Brech, and Júlia Maria D'Andrea Greve
    Clinics (Sao Paulo). 2013 August; 68(8): 1089–1095.
  12. NewsBot

    NewsBot The Admin that posts the news.

    A comparison of the effectiveness of radial extracorporeal shock wave therapy and ultrasound therapy in the treatment of chronic plantar fasciitis: a randomized controlled trial.
    Konjen N, Napnark T, Janchai S.
    J Med Assoc Thai. 2015 Jan;98 Suppl 1:S49-56.
  13. NewsBot

    NewsBot The Admin that posts the news.

    Radial shock wave treatment alone is less efficient than radial shock wave treatment combined with tissue-specific plantar fascia-stretching in patients with chronic plantar heel pain.
    Rompe JD, Furia J, Cacchio A, Schmitz C, Maffulli N
    Int J Surg. 2015 May 1
  14. NewsBot

    NewsBot The Admin that posts the news.

    Therapeutic effect of extracorporeal shock wave combined with orthopaedic insole on plantar fasciitis
    Yan W, Sun S, Li X.
    Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014 Dec;39(12):1326-30
  15. NewsBot

    NewsBot The Admin that posts the news.

    A comparative analysis of analgesic efficacy of ultrasound and shock wave therapy in the treatment of patients with inflammation of the attachment of the plantar fascia in the course of calcaneal spurs.
    Krukowska J et al
    Arch Orthop Trauma Surg. 2016 Jul 11.

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