Extracoporeal Shock Wave Therapy for Plantar Fasciitis

EFFECTIVENESS: 3/5

Results of scientific studies on ESWT effectiveness have been conflicting. A 2003 study found no evidence of effectiveness, while a more recent study found the rate of effectiveness was between 50 and 65% compared to placebo treatment.

Another recent review of all available scientific literature concluded ESWT is effective at relieving PF when other conservative methods fail.

Sources:

Haake M, Buch M, Schoellner C, et al. Extracorporeal shock wave therapy for plantar fasciitis: randomized controlled multicentre trial. BMJ : British Medical Journal. 2003;327(7406):75.

Gollwitzer H. et al.: Clinically Relevant Effectiveness of Focused Extracorporeal Shock Wave Therapy in the Treatment of Chronic Plantar Fasciitis. A Randomized, Controlled Multicenter Study. [J Bone Joint Surg Am. 2015 May 6;97(9):701-8

Lou J, Wang S, Liu S, Xing G. Effectiveness of Extracorporeal Shock Wave Therapy Without Local Anesthesia in Patients With Recalcitrant Plantar Fasciitis: A Meta-Analysis of Randomized Controlled Trials. Am J Phys Med Rehabil. 2017 Aug;96(8):529-534.

SELF CARE: 0/5

ESWT can only be performed by licensed health care providers.

COST: 2/5

ESWT costs range from about $900-1500 for three lower energy treatments or $1000 to $3000 for single higher energy treatment. It may or may not be covered by insurance.

Sources:

Weil L. ESWT For Plantar Fasciitis: What Do The Long-Term Results Reveal? Podiatry Today 2011; 24 (11).

USEFULNESS (overall rating): 3/5

While there is still some dispute about its overall effectiveness, ESWT appears to be helpful for chronic plantar fasciitis that has not responded to other treatments. It is relatively safe but somewhat expensive. We recommend you try other treatments first, such as stretches, orthotics, night splints and ice.

ESWT uses pulses of sound energy (shock waves), similar to those used in lithotripsy, where shock waves are used to pulverize kidney stones. There are essentially two types: lower energy waves, which require 3 or more sessions and are often painless or mildly painful, and high energy, which are often quite painful and require numbing medicine or anesthesia.

ESWT is thought to work for plantar fasciitis by causing microtrauma which triggers a healing response, thereby reducing pain and promoting healing.