Chronic plantar fasciitis: which is more effective? Prolotherapy/extracorporeal shock wave therapy? A randomized controlled trial.

INTRODUCTION / AIM: Chronic plantar fasciitis is a prevalent musculoskeletal disorder. The objective of this study was to compare the effects of ESWT and prolotherapy on pain, foot function, plantar fascia thickness and plantar pressure distribution in patients with chronic plantar fasciitis.

MATERIALS AND METHODS

A total of 70 patients were included in this prospective, randomised controlled study. The patients were randomly assigned to one of two groups. The study population was divided into two groups: the ESWT group (n = 36) and the prolotherapy group (n = 34). In the ESWT group, a total of 1800 to 2000 focused shock waves (0.15-0.25 mJ/mm² sessions with a frequency of 3-4 Hz) were applied. The prolotherapy group was administered a 3-ml injection of a 15% dextrose solution. The ESWT and prolotherapy treatments were administered in a total of three sessions, with two-week intervals between each session. The efficacy of the treatment was evaluated using a number of different measures, including the Visual Analogue Scale (VAS), the Foot and Ankle Ability Measurement (FAAM), the thickness of the plantar fascia and the distribution of plantar pressure. The evaluations were conducted at the outset of the study, at the six-week mark, and at the 12-week mark following the final intervention.

RESULTS

In both groups, there was a statistically significant reduction in morning VAS value and plantar fascia thickness at week 12 compared to baseline (p < 0.001). The difference between the groups was only in plantar fascia thickness at week 6 and overall VAS value at week 12.

CONCLUSION

Prolotherapy was found relatively more effective than ESWT in reducing VAS value in the medium term (3 months), although there is no difference in functional parameters. The results demonstrated that both prolotherapy and ESWT exhibited comparable outcomes during the follow-up period.