SEATTLE, June 2 /PRNewswire/ -- Shockwave therapy provides a new treatment option for patients with a common foot problem, plantar fasciitis (a type of heel pain). Two studies published in the May issue of the Foot & Ankle International (journal of the American Orthopaedic Foot and Ankle Society) discuss the viability of both high energy and low energy shockwave therapy.
Plantar fasciitis is an overuse injury affecting the sole or flexor surface (plantar) of the foot resulting in inflammation of the tough, fibrous band of tissue (fascia) connecting the heel bone to the base of the toes. Those more likely to get the condition include women, overweight individuals, or those with a job that requires much walking or standing on hard surfaces (over 50 per cent of people who suffer from plantar fasciitis are on their feet nearly all day). Walking or running for exercise also puts people at risk. About 90 percent of people with plantar fasciitis improve significantly after two months of initial conservative treatment such as doing special exercises or wearing heel cups. Those who don’t respond within a few months often need more aggressive treatment up to and including surgery. Shockwave therapy offers an alternative to such aggressive treatment.
In “Extracorporeal Shock Wave Therapy for the Treatment of Plantar Fasciitis,” researchers found low energy shock wave therapy to be an effective treatment for heel pain. “I think that shock wave therapy offers another alternative for non-invasive treatment of plantar fasciitis,” said Christopher Zingas, MD, Detroit Michigan, an AOFAS member and co-author of the study.
This blind study used low energy shock wave therapy done in the doctor’s office to treat patients with heel pain who might otherwise have been surgical candidates. Some of the patients received a placebo treatment rather than receiving shock wave therapy. After three months, 62% of the group receiving shock wave treatment improved and 39% receiving the placebo treatment also improved. “In office procedures of low energy shock wave therapy showed similar results to previous reports of high energy shock wave therapy,” said Dr. Zingas. After a year of treatment, over 90% of patients had shown improvements.
“The most important difference between high and low energy shock wave therapy is the amount of sedation/anesthesia needed,” said Dr. Zingas. “With high energy the patient needs to be under heavy sedation or general anesthesia. This need for anesthesia and conscious sedation restricts usage of the device to surgical centers and requires an anesthesia team.”
Using low energy shock wave therapy as a treatment for heel pain is a relatively new procedure that may potentially become a common office treatment option. “I believe that in the future, shock wave therapy will offer another conservative treatment modality for patients with plantar fasciitis,” said Dr. Zingas. “However, much more work needs to be done in order to determine the best protocols and patient selection for the use of shock wave therapy.”
In “Bilateral Chronic Proximal Plantar Fasiopathy: Treatment with Electrohydraulic Orthotripsy,” researchers found high intensity shockwave therapy to be an effective treatment option for patients with long standing heel pain. “Three quarters of patients show great results after just one treatment of high intensity shockwave therapy,” said John A. Ogden, MD, of Atlanta, Georgia, co-author of the study.
The study examined patients who had long standing heel pain which did not respond to other more conservative methods of treatment. The shockwave therapy also was administered to both heels in many cases, which was different from previous studies done through the FDA. “In this study both heels were treated with great success,” said Dr. Ogden. “Patients can very rapidly return to both work and athletic related activities.”
Shock wave therapy usually allows for patients to return to their daily activities within a day of the treatment. “Normally it is not possible to treat both heels at a time because a patient would probably have to be put in a wheelchair,” said Dr. Ogden. “When I use shock wave therapy they can go back to work the next day.”
Given the success of this study, shock wave therapy is now being used in many other procedures. “We are trying to increase the utilization of the technology of shock wave therapy beyond the foot and ankle, to all parts of the body,” said Dr. Ogden.
Foot & Ankle International is the official publication of the American Orthopaedic Foot & Ankle Society (AOFAS). It is a monthly medical journal that emphasizes surgical and medical management as well as basic clinical research related to foot and ankle problems.
American Orthopaedic Foot & Ankle Society
CONTACT: Richard Cantrall, +1-206-223-1120, ext. 109, +1-800-235-4855ext. 109, or rich@cantrall.com, for American Orthopaedic Foot & Ankle Society
Web site: http://www.aofas.org/
