Lowell Well, Jr., DPM, MBA, FACFAS
Weil Foot & Ankle Institute, Des Plaines, Illinois, USA
Extracorporeal Shock Wave (ESWT) has become a common treatment modolity for chronic plontar fascutis worldwide. All studies in the literature evaluate ESWT for unilateral plantar fascUtis with comparisons to placebo control on another subect.
The purpose of this study was to use a patient as their own control to assess the value of ESWT in chronic bilateral plantar fasciitis.
Patients, Material, Methods:
36 patients with bilateral plantar fasciitis of greater than 6 months duration and pain of greater than 6 an a VAS on both feet and that failed to respond to conservative care were eligible to participate. Additional systemic and neurologic causes of heel pain were ruled out in all cases. Patients were anesthetized with intravenous sedation and an infiltrative local block to both heels. Computer randomization then determined which foot was to be treated actively while the other was left as placebo
Utilizing an Ossatron by Healthtronics, the appropriate foot was treated with 2000 pulses at 19 kV from twa different positions
Patients were evaluated at 1 week, 6 weeks and 12 weeks by a blinded investigator.
End point evaluation parameters were reduction in VAS and Roles and Mauldsey quality of Life assessment.
The treated foot improved 70% of the time while the Sham foot improved 52% of the time. 67% of the treated feet improved by >50%, while 47% of the Sham feet improved by >50%. 65% of the treated feet attained a VAS of <3, while only 39% of the Sham group achieved <3 on a VAS. In 39% of the patients, both feet improved and in 4% of the patients, neither foot improved.
This study, utilizing patients as their awn control, shows that ESWT is a valuable and efficacious treatment for chronic plantar fascutis. Placebo success is significant but nat equal to treated subiects following ESWT for plantar fasciitis.
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