The Effects of Extracorporeal Shockwave Therapy on Pain, Function, Range of Motion and Strength in Patients with Plantar Fasciitis
Ten percent of the population will develop plantar
fasciitis (PF) during their lifetime. Two million people are treated
yearly accounting for 11-15% of visits to medical professionals.
Treatment ranges from conservative to surgical intervention. The
purpose of this study was to assess the effects of extracorporeal
shockwave therapy (ECSWT) on heel pain, function, range of motion
(ROM), and strength in patients with PF. One hundred subjects were
treated with ECSWT and measures were taken before and three
months after treatment. There was significant differences in visual
analog scale scores for pain at rest (p=0.0001); after activity (p=
0.0001) and; overall improvement (p=0.0001). There was also
significant improvement in Lower Extremity Functional Scale scores
(p=0.0001); ankle plantarflexion (p=0.0001), dorsiflexion (p=0.001),
and eversion (p=0.017),and first metatarsophalangeal joint flexion
(p=0.002) and extension (p=0.003) ROM. ECSWT is an effective
treatment improving heel pain, function and ROM in patients with
PF.
[1] C. Cole, C. Seto, J. Gazewood, "Plantar fasciitis: evidence based review
of diagnosis and therapy," American Family Physician, vol. 72, no. 11,
pp. 2237-2242, 2005.
[2] L. Gerdesmeyer, C. Frey, J. Vester, "Extracorporeal shockwave therapy
for plantar fasciitis," American Journal of Sports Medicine, vol. 10, no.
10, pp. 1-10, 2008.
[3] D. B. Irving, J.L. Cook, H. B. Menz, "Factors associated with chronic
plantar heel pain: a systematic review," J Sci Med Sport, vol. 9, pp. 11-
22, 2006.
[4] K. B. Landorf, H. B. Menz, "Plantar heel pain and fasciitis," BMJ Clin
Evid, vol. 2, pp. 1-16, 2008.
[5] J. D. Rompe, "Plantar fasciopathy," Sports Med Arthrosc Rev, vol. 17,
no. 2, pp. 100-104, 2009.
[6] S. C. Wearing, E. M. Hennig, N. M. Byrne, J. R. Steele, A.P. Hills,
"Musculoskeletal disorders associated with obesity: a biomechanical
perspective," Obesity Reviews, vol. 7, pp. 239-250, 2006.
[7] C. Clemow, B. Pope, H. E. Woodall, "Tools to speed your pain
diagnosis," The Journal of Family Practice," vol. 57, no. 11, pp.714-
723, 2008.
[8] M. Roxas, "Plantar fasciitis: diagnosis and therapeutic considerations,"
Alternative Medicine Review, vol. 10, no. 2, pp. 83-93, 2005.
[9] B. Chuckpaiwong, E. M. Berkson, G.H. Theodore, "Extracorporeal
shock wave for chronic proximal plantar fasciitis: 225 patients with
results and outcome predictors," The Journal of Foot and Ankle
Surgery, vol. 48, no. 2, pp. 148-155, 2009.
[10] G. H. Theodore, M. Buch, A. Amendola, "Extracorporeal shock wave
therapy for the treatment of plantar fasciitis," Foot and Ankle Int, vol.
25, pp. 298-302, 2004.
[11] D. S. Malay, M. M. Pressman, A. Assili, J. T. Kline, S. York, B. Buren
et al., "Extra corporeal shockwave therapy versus placebo for the
treatment of chronic proximal plantar fasciitis: results of a randomized,
placebo controlled, double blinded, multicenter intervention trial," The
Journal of Foot and Ankle Surgery, vol. 45, no. 4, pp. 196-210, 2006.
[12] S. K. Shrivastava, C. Kailash, "Shockwave treatment in medicine," J
Biosci, vol. 30, no. 2, pp. 269-275, 2005.
[13] International Society for Medical Shockwave Treatment, "Basic
Physical Principles," Retrieved from http://www.ismst.com/
history_basic_ physical_principles.htm, 2012.
[14] International Society for Medical Shockwave Treatment , "Basic
Physics," Retrieved from http://www.ismst.com/principles_
basic_physics.htm, 2012.
[15] G. L. Cheing, H. Chang, S. K. Lo, "A comparison of the effectiveness of
extracorporeal shockwave and ultrasound therapy in the management of
heel pain," Shock Waves, vol. 17, pp. 195-201, 2007.
[16] H. Renz, S. Rupp, "Effects of shockwaves on chondrocytes and their
relevance in clinical practice," Arch Orthop Trauma Surg, vol. 129, pp.
641-647, 2009.
[17] K. A. Herr, K. Spratt, P. R. Mobily, G. Richardson, "Pain intensity
assessment in older adults: use of experimental pain to compare
psychometric properties and usability of selected pain scales with
younger adults," Clin J Pain, vol. 20, no. 4, pp. 207-219, 2004.
[18] R. A. Swinkels, L. M. Bouter, R. A. Oostendorp, C. H. Van den Ende,
"Impairment measures in rheumatic disorders for rehabilitation medicine
and allied health care: a systematic review," Rheumatol Int, vol. 25, pp.
501-512, 2005.
[19] J. Binkley, P. W. Stratford, S. A. Lott, D. L. Riddle, "The lower
extremity functional scale: scale development, measurement properties
and clinical application," Phys Ther, vol. 79, no.4, pp. 371-383, 1999.
[20] C. L. Chung Wei, A. M. Moseley, K. M. Reshauge, A. C. Bundy, "The
lower extremity functional scale has good clinimetric properties in
people with ankle fracture," Phys Ther, vol. 89, no. 6, pp. 580-588,
2009.
[21] S. S. Yeung, E. W. Yeung, L. D. Gillespie, "Interventions for preventing
lower limb soft tissue running injuries," Cochrane Database of
Systematic Review, vol. 10, 2011.
[22] G. L. Cheing, H. Chang, "Extracorporeal shock wave therapy," J Orthop
Sports Phys Ther, vol. 33, no. 6, pp. 337-343, 2003.
[23] Y. Dogramaci, A. Kalaci, A. Emir, A. N. Yanat, A. Gokce,
"Intracorporeal pneumatic shock application for the treatment of chronic
plantar fasciitis: a randomized, double blind prospective clinical trial,"
Archives of Orthopaedic & Trauma Surgery," vol. 130, no. 4, pp. 541-
546, 2010.
[24] H. Gollwitzer, P. Dieh, A. Von Korff, V. W. Rhalfs, L. Gerdesmeyer,
"Extracorporeal shockwave therapy for chronic painful heel syndrome:
a prospective, double blind, randomized trial assessing the efficacy of a
new electromagnetic shockwave device," The Journal of Foot and Ankle
Surgery, vol. 46, no. 5, pp. 348-357, 2007.
[25] M. I. Ibrahim, R. A. Donatelli, C. Schmitz, M. A. Hellman, F. Buxbaum,
"Chronic plantar fasciitis treated with two sessions radial extracorporeal
shock wave therapy," Foot & Ankle International, vol. 31, no. 5, pp.
391-397, 2010.
[26] H. Lohrer, T. Nauck, N. V. Dorn-Lange, J. Scholl, J. C. Vester,
"Comparison of radial versus focused extracorporeal shock waves in
plantar fasciitis using functional measures," Foot & Ankle International,
vol. 31, no. 1, pp. 1-9, 2010.
[27] G. Metzner, C. Dohnalek, E. Aigner, "High energy extracorporeal shock
wave therapy for the treatment of chronic plantar fasciitis," Foot &
Ankle International, vol. 31, no. 9, pp. 790-796, 2010.
[28] B. Moretti, R. Garofalo, V. Patella , G. L. Sisti, M. Corrado, E.
Mouhsine, "Extracorporeal shock wave therapy in runners with a
symptomatic heel spur," Knee Surg Sports Traumatol Arthrosc, vol. 14,
pp.1029-1032, 2006.
[29] J. D. Rompe, C. Carsten, B. Nafe, "Evaluation of low energy
extracorporeal shock wave application for treatment of chronic plantar
fasciitis," Journal of Bone and Joint Surgery, vol. 84, no. 3, pp. 335-341,
2002.
[30] J. D. Rompe, A. Cacchio, L.Weil, "Plantar fascia stretching versus radial
shockwave therapy as initial treatment of plantar fasciopathy," Journal
of Bone & Joint Surgery - American Volume, vol. 92, no. 15, pp. 2514-
2522, 2010.
[31] J. Vogel, C. Hopf, P. Eysel, J. D. Rompe, "Application of extracorporeal
shockwaves in the treatment of pseudarthrosis of the lower extremity,"
Arch Orthop Trauma Surg, vol. 116, pp. 480-483, 1997.
[32] I. Yucel, K. E. Ozturan, Y. Demiraran, E. Degirmenci, G. Kaynak,
"Comparison of high dose extracorporeal shockwave therapy and
intralesional corticosteroid injection in the treatment of plantar fasciitis,"
Journal of the American Podiatric Medical Association, vol. 100, no. 2,
pp. 105-110, 2010.
[33] B. D. DiGiovanni, D. A. Nawoczenski, M. E. Lintal, E. A. Moore, J. C.
Murray, G. E. Wilding et al., "Tissue specific plantar fascia stretching
exercise enhances outcomes in patients with chronic c heel pain. A
prospective, randomized study," J Bone Joint Surg Am, vol. 85-A, no. 7,
pp. 1270-1277, 2003.
[34] B. D. DiGiovanni, D. A. Nawoczenski, D. P. Malay, P. A. Graci, T. T.
Williams, G. E. Wilding et al., "Plantar fascia specific stretching
exercise improves outcomes in patients with chronic plantar fasciitis. A
prospective clinical trial with two year follow up," J Bone Joint Surg
Am, vol. 88, pp. 1775-1781, 2006.
[35] A. Stang, H. W. Hense, K. H. Jockel, "Is it always unethical to use a
placebo in a clinical trial," PLoS Medicine, vol. 2, no. 3, pp. 177-180.
[36] A. M. Othman, E. M. Ragab, "Endoscopic plantar fasciotomy versus
extracorporeal shock wave therapy for treatment of chronic plantar
fasciitis," Archives of Orthopedic & Trauma Surgery, vol. 130, no.11,
pp.1343-1347, 2010.
[37] J. A. Cleland,J. H. Abbott, M. O. Kidd, "Manual physical therapy and
exercise versus electrophysical agents and exercise in the management
of plantar heel pain: a multicenter randomized clinical trial," JOSPT,
vol. 39, no. 8, pp. 573-585. 2009.
[38] D. S. Teyhen, "Heel pain: hands on physical therapy and stretching
prove effective for treating heel pain," JOSPT, vol. 41, no. 2, pp. 51,
2011.
[39] G. F. Spadoni, P. W. Stratford, P. E. Solomon, L. R. Wishart, "The
development and cross validation of the P4: aself report intensity
measure," JOSPT, vol. 34, no. 4, pp. 187-193. 2004.
[1] C. Cole, C. Seto, J. Gazewood, "Plantar fasciitis: evidence based review
of diagnosis and therapy," American Family Physician, vol. 72, no. 11,
pp. 2237-2242, 2005.
[2] L. Gerdesmeyer, C. Frey, J. Vester, "Extracorporeal shockwave therapy
for plantar fasciitis," American Journal of Sports Medicine, vol. 10, no.
10, pp. 1-10, 2008.
[3] D. B. Irving, J.L. Cook, H. B. Menz, "Factors associated with chronic
plantar heel pain: a systematic review," J Sci Med Sport, vol. 9, pp. 11-
22, 2006.
[4] K. B. Landorf, H. B. Menz, "Plantar heel pain and fasciitis," BMJ Clin
Evid, vol. 2, pp. 1-16, 2008.
[5] J. D. Rompe, "Plantar fasciopathy," Sports Med Arthrosc Rev, vol. 17,
no. 2, pp. 100-104, 2009.
[6] S. C. Wearing, E. M. Hennig, N. M. Byrne, J. R. Steele, A.P. Hills,
"Musculoskeletal disorders associated with obesity: a biomechanical
perspective," Obesity Reviews, vol. 7, pp. 239-250, 2006.
[7] C. Clemow, B. Pope, H. E. Woodall, "Tools to speed your pain
diagnosis," The Journal of Family Practice," vol. 57, no. 11, pp.714-
723, 2008.
[8] M. Roxas, "Plantar fasciitis: diagnosis and therapeutic considerations,"
Alternative Medicine Review, vol. 10, no. 2, pp. 83-93, 2005.
[9] B. Chuckpaiwong, E. M. Berkson, G.H. Theodore, "Extracorporeal
shock wave for chronic proximal plantar fasciitis: 225 patients with
results and outcome predictors," The Journal of Foot and Ankle
Surgery, vol. 48, no. 2, pp. 148-155, 2009.
[10] G. H. Theodore, M. Buch, A. Amendola, "Extracorporeal shock wave
therapy for the treatment of plantar fasciitis," Foot and Ankle Int, vol.
25, pp. 298-302, 2004.
[11] D. S. Malay, M. M. Pressman, A. Assili, J. T. Kline, S. York, B. Buren
et al., "Extra corporeal shockwave therapy versus placebo for the
treatment of chronic proximal plantar fasciitis: results of a randomized,
placebo controlled, double blinded, multicenter intervention trial," The
Journal of Foot and Ankle Surgery, vol. 45, no. 4, pp. 196-210, 2006.
[12] S. K. Shrivastava, C. Kailash, "Shockwave treatment in medicine," J
Biosci, vol. 30, no. 2, pp. 269-275, 2005.
[13] International Society for Medical Shockwave Treatment, "Basic
Physical Principles," Retrieved from http://www.ismst.com/
history_basic_ physical_principles.htm, 2012.
[14] International Society for Medical Shockwave Treatment , "Basic
Physics," Retrieved from http://www.ismst.com/principles_
basic_physics.htm, 2012.
[15] G. L. Cheing, H. Chang, S. K. Lo, "A comparison of the effectiveness of
extracorporeal shockwave and ultrasound therapy in the management of
heel pain," Shock Waves, vol. 17, pp. 195-201, 2007.
[16] H. Renz, S. Rupp, "Effects of shockwaves on chondrocytes and their
relevance in clinical practice," Arch Orthop Trauma Surg, vol. 129, pp.
641-647, 2009.
[17] K. A. Herr, K. Spratt, P. R. Mobily, G. Richardson, "Pain intensity
assessment in older adults: use of experimental pain to compare
psychometric properties and usability of selected pain scales with
younger adults," Clin J Pain, vol. 20, no. 4, pp. 207-219, 2004.
[18] R. A. Swinkels, L. M. Bouter, R. A. Oostendorp, C. H. Van den Ende,
"Impairment measures in rheumatic disorders for rehabilitation medicine
and allied health care: a systematic review," Rheumatol Int, vol. 25, pp.
501-512, 2005.
[19] J. Binkley, P. W. Stratford, S. A. Lott, D. L. Riddle, "The lower
extremity functional scale: scale development, measurement properties
and clinical application," Phys Ther, vol. 79, no.4, pp. 371-383, 1999.
[20] C. L. Chung Wei, A. M. Moseley, K. M. Reshauge, A. C. Bundy, "The
lower extremity functional scale has good clinimetric properties in
people with ankle fracture," Phys Ther, vol. 89, no. 6, pp. 580-588,
2009.
[21] S. S. Yeung, E. W. Yeung, L. D. Gillespie, "Interventions for preventing
lower limb soft tissue running injuries," Cochrane Database of
Systematic Review, vol. 10, 2011.
[22] G. L. Cheing, H. Chang, "Extracorporeal shock wave therapy," J Orthop
Sports Phys Ther, vol. 33, no. 6, pp. 337-343, 2003.
[23] Y. Dogramaci, A. Kalaci, A. Emir, A. N. Yanat, A. Gokce,
"Intracorporeal pneumatic shock application for the treatment of chronic
plantar fasciitis: a randomized, double blind prospective clinical trial,"
Archives of Orthopaedic & Trauma Surgery," vol. 130, no. 4, pp. 541-
546, 2010.
[24] H. Gollwitzer, P. Dieh, A. Von Korff, V. W. Rhalfs, L. Gerdesmeyer,
"Extracorporeal shockwave therapy for chronic painful heel syndrome:
a prospective, double blind, randomized trial assessing the efficacy of a
new electromagnetic shockwave device," The Journal of Foot and Ankle
Surgery, vol. 46, no. 5, pp. 348-357, 2007.
[25] M. I. Ibrahim, R. A. Donatelli, C. Schmitz, M. A. Hellman, F. Buxbaum,
"Chronic plantar fasciitis treated with two sessions radial extracorporeal
shock wave therapy," Foot & Ankle International, vol. 31, no. 5, pp.
391-397, 2010.
[26] H. Lohrer, T. Nauck, N. V. Dorn-Lange, J. Scholl, J. C. Vester,
"Comparison of radial versus focused extracorporeal shock waves in
plantar fasciitis using functional measures," Foot & Ankle International,
vol. 31, no. 1, pp. 1-9, 2010.
[27] G. Metzner, C. Dohnalek, E. Aigner, "High energy extracorporeal shock
wave therapy for the treatment of chronic plantar fasciitis," Foot &
Ankle International, vol. 31, no. 9, pp. 790-796, 2010.
[28] B. Moretti, R. Garofalo, V. Patella , G. L. Sisti, M. Corrado, E.
Mouhsine, "Extracorporeal shock wave therapy in runners with a
symptomatic heel spur," Knee Surg Sports Traumatol Arthrosc, vol. 14,
pp.1029-1032, 2006.
[29] J. D. Rompe, C. Carsten, B. Nafe, "Evaluation of low energy
extracorporeal shock wave application for treatment of chronic plantar
fasciitis," Journal of Bone and Joint Surgery, vol. 84, no. 3, pp. 335-341,
2002.
[30] J. D. Rompe, A. Cacchio, L.Weil, "Plantar fascia stretching versus radial
shockwave therapy as initial treatment of plantar fasciopathy," Journal
of Bone & Joint Surgery - American Volume, vol. 92, no. 15, pp. 2514-
2522, 2010.
[31] J. Vogel, C. Hopf, P. Eysel, J. D. Rompe, "Application of extracorporeal
shockwaves in the treatment of pseudarthrosis of the lower extremity,"
Arch Orthop Trauma Surg, vol. 116, pp. 480-483, 1997.
[32] I. Yucel, K. E. Ozturan, Y. Demiraran, E. Degirmenci, G. Kaynak,
"Comparison of high dose extracorporeal shockwave therapy and
intralesional corticosteroid injection in the treatment of plantar fasciitis,"
Journal of the American Podiatric Medical Association, vol. 100, no. 2,
pp. 105-110, 2010.
[33] B. D. DiGiovanni, D. A. Nawoczenski, M. E. Lintal, E. A. Moore, J. C.
Murray, G. E. Wilding et al., "Tissue specific plantar fascia stretching
exercise enhances outcomes in patients with chronic c heel pain. A
prospective, randomized study," J Bone Joint Surg Am, vol. 85-A, no. 7,
pp. 1270-1277, 2003.
[34] B. D. DiGiovanni, D. A. Nawoczenski, D. P. Malay, P. A. Graci, T. T.
Williams, G. E. Wilding et al., "Plantar fascia specific stretching
exercise improves outcomes in patients with chronic plantar fasciitis. A
prospective clinical trial with two year follow up," J Bone Joint Surg
Am, vol. 88, pp. 1775-1781, 2006.
[35] A. Stang, H. W. Hense, K. H. Jockel, "Is it always unethical to use a
placebo in a clinical trial," PLoS Medicine, vol. 2, no. 3, pp. 177-180.
[36] A. M. Othman, E. M. Ragab, "Endoscopic plantar fasciotomy versus
extracorporeal shock wave therapy for treatment of chronic plantar
fasciitis," Archives of Orthopedic & Trauma Surgery, vol. 130, no.11,
pp.1343-1347, 2010.
[37] J. A. Cleland,J. H. Abbott, M. O. Kidd, "Manual physical therapy and
exercise versus electrophysical agents and exercise in the management
of plantar heel pain: a multicenter randomized clinical trial," JOSPT,
vol. 39, no. 8, pp. 573-585. 2009.
[38] D. S. Teyhen, "Heel pain: hands on physical therapy and stretching
prove effective for treating heel pain," JOSPT, vol. 41, no. 2, pp. 51,
2011.
[39] G. F. Spadoni, P. W. Stratford, P. E. Solomon, L. R. Wishart, "The
development and cross validation of the P4: aself report intensity
measure," JOSPT, vol. 34, no. 4, pp. 187-193. 2004.
@article{"International Journal of Medical, Medicine and Health Sciences:61148", author = "P. Sanzo", title = "The Effects of Extracorporeal Shockwave Therapy on Pain, Function, Range of Motion and Strength in Patients with Plantar Fasciitis", abstract = "Ten percent of the population will develop plantar
fasciitis (PF) during their lifetime. Two million people are treated
yearly accounting for 11-15% of visits to medical professionals.
Treatment ranges from conservative to surgical intervention. The
purpose of this study was to assess the effects of extracorporeal
shockwave therapy (ECSWT) on heel pain, function, range of motion
(ROM), and strength in patients with PF. One hundred subjects were
treated with ECSWT and measures were taken before and three
months after treatment. There was significant differences in visual
analog scale scores for pain at rest (p=0.0001); after activity (p=
0.0001) and; overall improvement (p=0.0001). There was also
significant improvement in Lower Extremity Functional Scale scores
(p=0.0001); ankle plantarflexion (p=0.0001), dorsiflexion (p=0.001),
and eversion (p=0.017),and first metatarsophalangeal joint flexion
(p=0.002) and extension (p=0.003) ROM. ECSWT is an effective
treatment improving heel pain, function and ROM in patients with
PF.", keywords = "Extracorporeal shockwave therapy, shockwave therapy, plantar fasciitis, heel pain, function, range of motion, strength.", volume = "7", number = "6", pages = "297-7", }
