EFFECTIVENESS OF HIGH ENERGY RADIAL EXTRACORPOREAL SHOCK WAVE THERAPY (RSWT) VERSUS LOCAL STEROID INJECTIONS IN THE TREATMENT OF CHRONIC PLANTAR FASCIITIS

Plantar fasciitis is pain caused by inflammation of the plantar fascia at the
junction of the medial calcaneal tuberosity. The aim of this study was to determine the effectiveness of
high energy radial extracorporeal shock wave therapy (RSWT) versus local steroid injections in the
treatment of chronic plantar fasciitis.
Materials & Methods: In a randomized clinical trial that was performed in the Department of
Rehabilitation and Physical Medicine of Tabriz University of Medical Sciences, 40 patients with
chronic plantar fasciitis were randomly divided into two gropus with 20 patients, that RSWT group
underwent five step high energy radial extracorporeal shock wave therapy (RSWT) with 0.2 mj/mm2
and local injection group included injection of depomederol steroid. Pain severity at the base of visual
analogue scale at moring and day length, daily function base on Foot function index questionnaire and
satisfaction with polling of patients were determind.
Results: In this study, 40 patients including 33 female and 7 male patients with the meas age of
42.85±8.62 year with plantar fasciitis underwent high energy radial extracorporeal shock wave therapy
(RSWT), and local steroid injections were evaluated. Significant difference was not found between
morning and daily pain of pateints at the beginning of the study, one and two months later. Significant
decrease was found in mornig and daily pain and FFI of patients in both groups during treatment
(P<0.001). Pain reduction rate at the end of two months in RSWT group was above 60% and in
function improvement was about 67.4% and in stroeid injection group was near 50% in pain relife and
function. Although significant statistical difference was not found in this changes between two groups
(P=0.068,0.081).
Conclusion: Both shock therapy and local steroid injection was effective in treatment of chronic
plantar fasciitis in reduction of pain and improve daily function of patients up to two months after
treatment without significant differences in their therapeutic efficacy. However, shock wave therapy
because of more percent improvement and high patient satisfaction was more recommended as the
preferred treatment.