LOW-ENERGY EXTRACORPOREAL SHOCK WAVE THERAPY: A CRITICAL ANALYSIS OF THE EVIDENCE FOR EFFECTIVENESS IN THE TREATMENT OF PLANTAR FASCIITIS

Extracorporeal shock wave therapy (ESWT) has been proposed as a therapy for plantar fasciitis, after conservative treatment has failed and before surgical management is indicated. The purpose of this review was to analyse the literature critically, assessing the effectiveness of low-energy ESWT for alleviating pain associated with plantar fasciitis. CINAHL and Medline databases were searched from inception to February 2005, using the keywords: extracorporeal shock wave therapy, ESWT and plantar fasciitis. Eleven clinical trials were retrieved and critically appraised. Five were rejected due to limiting methodological flaws. Three studies reported significant decreases in pain symptoms associated with ESWT; however, one study was not double-blinded and another was possibly confounded. The other three studies using slightly different methodologies found no difference between treatment and placebo groups. There is, therefore, only limited evidence to support the use of low-energy ESWT as a therapeutic modality for treating plantar fasciitis; more research is warranted in this area.