A prospective randomized controlled trial comparing extracorporeal shockwave therapy and physiotherapy in the treatment of acute plantar fasciitis.

AIMS

We aimed to evaluate whether the addition of early extracorporeal shockwave therapy (ESWT) to physiotherapy improved outcomes in patients with acute plantar fasciitis.

METHODS

We conducted a randomized controlled trial in a tertiary hospital in Singapore. Eligibility criteria were patients ≥21 years old presenting from April 2017 to November 2019 with untreated plantar fasciitis for <1 month with no prior physiotherapy. Exclusion criteria included history of plantar fasciitis, calcaneal fractures, chronic steroid use, pregnancy, chronic limb injuries and risks for venous thromboembolism. Patients were randomized using a random number generator into either Group A (ESWT + physiotherapy) or Group B (physiotherapy only). Visual Analogue Scale (VAS), 36-Item Short Form Survey (SF-36) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were measured at baseline and 3 months. T-tests were performed for statistical significance.

RESULTS

46 patients were eligible for the trial. 10 were lost to follow up. 15 in Group A and 21 in Group B were treated and assessed. Mean age was 51.6. Baseline VAS scores were Group A (5.5 ± 2.3) and Group B (6.1 ± 2.1) (p = 0.451). There was no significant difference in 3-month VAS scores between Group A (4.7 ± 2.2) and Group B (5.2 ± 2.6) (p = 0.543). Baseline AOFAS scores were Group A (72.7 ± 12.8) and Group B (73.9 ± 14.2) (p = 0.801). There was also no significant difference in 3-month AOFAS scores between Group A (76.7 ± 5.1) and Group B (77.2 ± 13.4) (p = 0.876). No significant difference in SF-36 scores was seen at 3 months between the two groups.

CONCLUSION

The addition of early ESWT to physiotherapy did not result in better outcomes compared to physiotherapy alone for acute plantar fasciitis.