Feeling the Pulse of New Treatments for Heel Pain
Plantar fasciitis (PF) is a painful condition affecting the heel. The causes of PF are not well understood, though it is especially common in runners. It usually gets better with time, anti-inflammatory medicine, and physical therapy. But when PF doesn't improve, pain and symptoms can last for months. Surgery can bring relief--but not always. And surgery can sometimes create new complications.

Doctors and therapists have been searching for alternative treatments for PF. Shock wave treatment has shown some success in treating PF. Shock waves are administered with a machine that emits low-energy electromagnetic pulses to the treatment area.

These doctors in Germany tested a specific schedule and dosage of shock waves to treat PF. The patients were all runners who had heel pain from PF for longer than one year, despite trying many conservative treatments. Their pain levels and function were recorded. Then half of the patients got three shock wave treatments, with one week between treatments. The other half of the patients got sham treatments. Neither group got any other treatment during this time.

The patients were seen six months and again one year after treatment. Both groups had gotten better. However, the group that had gotten shock wave treatments reported significantly less pain and significantly better function. At one year, 72 percent of the treatment group said their pain had been cut at least in half, compared to 35 percent of the sham group. Similar numbers in both groups needed further treatment, and one patient in each group had needed surgery. There were no major side effects from shock wave treatment, although patients found it unpleasant.

Based on this and other research, the authors feel that shock wave therapy has been proven successful in treating PF. They recommend shock wave treatments to patients with PF who have not gotten relief from other conservative treatments over a period of at least six months.
Jan D. Rompe, MD, et al. Shock Wave Application for Chronic Plantar Fasciitis in Running Athletes: A Prospective, Randomized, Placebo-Controlled Trial. In The American Journal of Sports Medicine. March/April 2003. Vol. 31. No. 2. Pp. 268-275.