Shock-Wave Treatment for Plantar Fasciitis
Doctors at eight centers studied the use of a high-energy electrohydraulic shock-wave (EHSW) device to treat plantar fasciitis. The study was done in two phases. The first phase involved 20 patients and tested the treatment for safety. The second phase had 344 patients and looked at both safety and effectiveness of this treatment method.

All patients had heel pain lasting at least six months. Everyone had been treated with physical therapy, orthotic devices, and drugs, but they didn't get better. In the second phase there were two groups of patients. One group received shock-wave treatment to the bottom of the foot. The second group had a placebo treatment (shock waves that weren't absorbed).

Results were measured before treatment, three months after treatment ended, and one year after treatment ended. Pain levels and X-rays of heel spurs were used to measure results. Success was defined as 50 percent improvement in pain on first walking in the morning. Success also meant the patient didn't use any pain relievers for any reason.

The authors reported that age isn't linked with success of treatment. Patients who had symptoms for less time had better results. Patients in the treatment group had a better response than the placebo group. No one was made worse by the treatment.

The authors say there is plenty of proof that shock-wave treatment helps reduce heel pain caused by plantar fasciitis. EHSW should be used after conservative treatment, but before surgery.
John A. Ogden, MD, et al. Electrohydraulic High-Energy Shock-Wave Treatment for Chronic Plantar Fasciitis. In The Journal of Bone and Joint Surgery. October 2004. Vol. 86-A. No. 10. Pp. 2216-2227.