The effect of extracorporeal shock wave therapy for the treatment of plantar fasciitis in regard to middle-aged patients' activity level and pain localization

In this retrospective cohort study, we compared the efficacy of extracorporeal shock wave therapy (ESWT) for plantar fasciitis in patients with different activity levels and different pain locations. In total, 92 patients (99feet) who were over 40years old with chronic plantar fasciitis were treated with ESWT after being categorized as participating in recreational sports(group R) or only activities of daily living (group D). On the other hand, patients were categorized as having pain in the plantar fascia enthesis (group E) or the entire plantar fascia (group W). Pain during activity and general tenderness were evaluated by using the visual analog scale (VAS) before and after ESWT. Although the VAS for pain score during activity significantly improved in both groups R and D after ESWT (P<0.001 in both groups), the degree of improvement in the VAS for pain score in group R was not significantly different from that in group D (P=0.061). The VAS for tenderness score also significantly improved in both groups R and D (P<0.001 in both groups), but there was also no significant difference between the degree of improvement in the VAS for tenderness in group R and that in group D (P=0.41). However, the degree of improvement in the VAS for pain and VAS for tenderness scores was significantly greater in group E than that in group W (P<0.001,=0.042, respectively). We concluded that ESWT was effective for treating plantar fasciitis in middle-aged patients and ESWT was effective in patients not only playing recreational sports but also having activities of daily living. ESWT was more effective in patients with pain in the plantar fascia enthesis than in patients with pain in the entire plantar fascia.