Extracorporeal Shock Wave Therapy for Chronic Planter Fasciitis Associated with Enthesophytosis


ABSTRACT:BACKGROUND: Painful heel is a common syndrome characterized by severe pain in the inferior or posterior aspect of the heel, which is aggravated by weight bearing, becoming progressively worse and often incapacitating, with evidence of a spur in about 50% of cases.OBJECTIVE: To evaluate the efficacy of extracorporeal shock wave treatment (ESWT) in calcaneal enthesophytosis (heel spur).PATIENT AND METHODS: Ninety four patients (66 women, 28 men) were examined who had heel pain associated with heel spur. A double blind randomised study was performed in which 52 patients underwent a standardized treatment (group 1) and 42 patients had sham treatment (group 2). Variations in symptoms were evaluated by visual analogue scale (VAS). Variations in the dimension of calcaneal spur were evaluated by x ray examination.RESULTS: A significant decrease of VAS was seen in group 1. Examination by x ray showed morphological modifications (reduction of the larger diameter >1 mm) of the enthesophytosis in 25 (48.1%) patients.In the control group no significant decrease of VAS was seen. No modification was observed by x ray examination.CONCLUSION: Extracorporeal shockwave therapy is an effective, safe method that improves the signs and symptoms of most patients with a painful heel.KEY WORDS: extracorporeal shock wave, plantar fasciitis, enthesopathy, heel pain, enthesophytosis.