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Shockwave therapy vs physiotherapy for plantar fasciitis

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  #1  
Old 22nd April 2009, 04:43 PM
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Default Shockwave therapy vs physiotherapy for plantar fasciitis

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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.
Quote:
OBJECTIVE: To compare radial shockwave treatment and conventional physiotherapy for plantar fasciitis.

MATERIALS AND METHODS: Thirty-two patients with plantar fasciitis were included in this study. They were randomly divided into two groups. Group 1 was composed of 16 patients who underwent 10 physiotherapy sessions each, consisting of ultrasound, kinesiotherapy and instruction for stretching exercises at home. Group 2 was composed of 16 patients who underwent three applications of radial shockwaves (once a week) and received instruction for stretching exercises at home. Pain and ability to function were evaluated before treatment, immediately afterwards, and three months later. The mean age of the patients was 47.3 +/- 10.3 years (range 25-68); 81% were female, 87% were overweight, 56% had bilateral impairment, and 75% used analgesics regularly.

RESULTS: Both treatments were effective for pain reduction and for improving the functional abilities of patients with plantar fasciitis. The effect of the shockwaves was apparent sooner than physiotherapy after the onset of treatment.

CONCLUSION: Shockwave treatment was no more effective than conventional physiotherapy treatment when evaluated three months after the end of treatment.
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Old 22nd April 2009, 04:49 PM
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Default Re: Shockwave therapy vs physiotherapy for plantar fasciitis

Related threads:
Shock Wave Therapy Useful For Stress Fractures
Extracorporeal Shock Wave Therapy
Eccentric loading vs shockwave for achilles tendonitis
Extracorporeal shock wave therapy (ESWT) as a cure all
Threads tagged with ESWT
Threads tagged with plantar fasciitis
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  #3  
Old 23rd April 2009, 12:09 AM
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Default Re: Shockwave therapy vs physiotherapy for plantar fasciitis

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
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Old 23rd April 2009, 04:40 AM
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Default Re: Shockwave therapy vs physiotherapy for plantar fasciitis

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.
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Old 23rd April 2009, 03:24 PM
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Default Re: Shockwave therapy vs physiotherapy for plantar fasciitis

98% of the time
S.Levitz
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Old 23rd April 2009, 03:32 PM
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Default Re: Shockwave therapy vs physiotherapy for plantar fasciitis

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Originally Posted by STEVE LEVITZ View Post
98% of the time
S.Levitz
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?"

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Old 15th December 2010, 06:37 AM
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Default Re: Shockwave therapy vs physiotherapy for plantar fasciitis

Hi,

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?
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Old 15th December 2010, 09:21 PM
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Default Re: Shockwave therapy vs physiotherapy for plantar fasciitis

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.
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Old 17th December 2010, 03:37 AM
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Default Re: Shockwave therapy vs physiotherapy for plantar fasciitis

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.
You go and have a look at these machines

Don Scott
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Old 31st January 2011, 08:16 PM
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Default

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 ..



Quote:
Originally Posted by NewsBot View Post
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.
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Old 30th August 2013, 04:42 PM
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Default Re: Shockwave therapy vs physiotherapy for plantar fasciitis

Quote:
Originally Posted by NewsBot View Post
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.
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.
Quote:
OBJECTIVE:
To compare radial shockwave treatment with conventional physiotherapy for plantar fasciitis after 12 months of follow-up.

METHOD:
This was a randomized, prospective, comparative clinical study. Forty patients with a diagnosis of plantar fasciitis were divided randomly into two treatment groups: group 1, with 20 patients who underwent ten physiotherapy sessions comprising ultrasound, kinesiotherapy and guidance for home-based stretching; and group 2, with 20 patients who underwent three applications of radial shockwaves, once a week, and guidance for home-based stretching. All patients were assessed regarding pain and functional abilities before treatment, immediately after and 12 months after treatment. The mean age was 49.6±11.8 years (range: 25-68 years), 85% were female, 88% were overweight, 63% were affected bilaterally, and 83% used analgesics regularly.

RESULTS:
At the 12-month follow-up, both treatments were effective for improving pain and functional ability among the patients with plantar fasciitis. The improvement with shockwaves was faster.

CONCLUSION:
Shockwave treatment was not more effective than conventional physiotherapy treatment 12 months after the end of the treatment.
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