Clinical Epidemiology - Cabrini

Ultrasound-guided extracorporeal shock wave therapy (ESWT) for plantar fasciitis (painful heel): a randomized controlled trial

A/Prof Rachelle Buchbinder, Dr Ronnie Ptasznik, Jeanine Gordon, Joylene Buchanan, Vasuki Prabaharan, A/Prof Andrew Forbes

Patients with plantar fasciitis, defined as heel pain maximal over the plantar aspect of the foot for at least 6 weeks duration and an ultrasound-confirmed lesion defined as thickening of the origin of the plantar fascia 4 mm, hypoechogenicity and alterations in the normal fibrillary pattern, were randomly assigned to receive either ultrasound-guided ESWT given weekly for 3 weeks to a total dose of 1000 mJ/mm2 or identical placebo to a total dose of 6.0 mJ/mm2.

Results showed that based upon pain, function and quality of life, we found no evidence to support a beneficial effect of ultrasound-guided extracorporeal shock wave therapy over placebo in patients with plantar fasciitis, 6 and 12 weeks following treatment.

Publications arising from this study:
Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A. Ultrasound-guided extracorporeal shock wave therapy (ESWT) for plantar fasciitis (painful heel): a randomised controlled trial. JAMA 2002;288:1364-72

Buchbinder R, Forbes A, Ptasznik R. Shock wave therapy for treatment of plantar fasciitis (Letter). JAMA 2003;289:172-3

Buchbinder R. Plantar Fasciitis. New Engl J Med 2004; 350:2159-66.