Comparison of two extracorporeal shock wave therapy techniques for the treatment of painful subcalcaneal spur. A randomized controlled study.

OBJECTIVE

To describe and compare two extracorporeal shock wave therapy techniques for the treatment of painful subcalcaneal spur.

DESIGN

Random assignment to two groups of treatment with two and eight months follow-up.

SETTING

The data were collected in outpatients.

SUBJECTS

Forty-five subjects with a history of at least six months of heel pain were studied.

INTERVENTIONS

Each subject received a three-session ultrasound-guided extracorporeal shock wave therapy (performed weekly). Perpendicular technique was used in group A (n=22, mean age 59.3 +/- 12 years) and tangential technique was used in group B (n= 23, mean age 58.8 +/- 12.3 years).

MAIN OUTCOME MEASURES

Mayo Clinical Scoring System was used to evaluate each subject before the treatment and at two and eight months follow-up.

RESULTS

Mayo Clinical Scoring System pretreatment scores were homogeneous between the groups (group A 55.2 +/-18.7; group B 53.5 +/- 20; P>0.05). In both groups there was a significant (P<0.05) increase in the Mayo Clinical Scoring System score at two months (group A 83.9 +/- 13.7; group B 80 +/- 15,8) and eight months (group A 90 +/- 10.5; group B 90.2 +/-8.7) follow-up. No significant differences were obtained comparing the Mayo Clinical Scoring System scores of the two groups at two and eight months follow-up.

CONCLUSIONS

There was no difference between the two techniques of using extracorporeal shock wave therapy. The tangential technique was found to be better tolerated as regards treatment-induced pain, allowing higher energy dosages to be used.