Shocking Results for Plantar Fasciitis
For some people, it's hard enough to get up in the morning. You may have an especially painful start to your day, if you have plantar fasciitis in your feet when they hit the ground. Plantar fasciitis is pain on the underside of the heel when standing or walking. This can be caused by many things--a tight calf muscle, high arch, or repeated stress on the thick tissues underneath the foot. Repeated stress where the plantar fasci attaches to the heel bone sets up a cycle of inflammation. Usually, this causes a bone spur to form.

Foot problems of this kind occur in about 10 percent of the general adult population. This increases with age. More than half of all older adults (over 65 years) have foot pain of this type. Women are affected twice as often as men, especially during midlife. The pain is the worst when first placing the feet on the floor after resting or sleeping for hours.

A new treatment for plantar fasciitis is being tried. It is called extracorporeal shock waves. Extracorporeal shock waves were first used for kidney stones 20 years ago. Now, shock waves are being used for orthopedic problems. The idea is that the shock waves stimulate healing in the tendons and nearby bones. Most likely, the shock waves help release growth factors and increase blood supply to the area.

Researchers in Germany tried using two different levels of low-energy shock waves on people with plantar fasciitis. There were 112 people in the study. They had all undergone treatment without success. Previous treatment included ice, medication, stretching exercises, splints, shoe inserts, and physical therapy.

Of the two groups, the patients who had the higher dose of shock waves had more relief from symptoms. They could press the spot without causing pain or tenderness, and they could walk without pain. The improvements lasted six months for most people. By five years, the results were about the same for the two groups. This was because the group with the lower shock-wave treatment eventually had surgery.

Therapy options for painful plantar fasciitis now include shock-wave treatment. There are very few side effects with this treatment, and patients may avoid surgery. The effects last up to six months for most people, but only 11 percent still have relief after five years. The U. S. Food and Drug Administration (FDA) has approved shock waves as therapy for heel pain. However, more studies are needed before using this treatment as the first therapy applied.
Jan D. Rompe, MD, et al. Evaluation of Low-Energy Extracorporeal Shock-Wave Application For Treatment of Chronic Plantar Fasciitis. In The Journal of Bone and Joint Surgery. March 2002. Vol. 84-A. No. 3. Pp. 335-341.