Shockwave Therapy - BC

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Extracorporeal Shock Wave Therapy (ESWT) Research



On this page we'll review some of the research
that has been conducted on
Extracorporeal Shock Wave Therapy
in the past few years.




Shock wave therapy for recalcitrant plantar fasciitis with heel spur:
a prospective randomized placebo-controlled double-blind study

Z Orthop Ihre Grenzgeb 2002 Sep-Oct;140(5):548-54 [Article in German]
Abt T, Hopfenmuller W, Mellerowicz H.
Fachbereich Humanmedizin, Freie Universitat Berlin.


In this German study, 32 patients with plantar fasciitis were examined.  Some were treated with ESWT; some with placebo ESWT. 

Results:  In the ESWT group, 88% were pain free or had good results.  In the placebo group, 0% of the placebo group were pain-free and 33% had good results.   

Conclusion:  "The results of this study corroborate the value of ESWT for recalcitrant plantar fasciitis. As a non invasive technique with low side effects, it can complement the row of conservative treatments."


Extracorporeal shock wave therapy for the treatment of chronic plantar fasciitis:
indications, protocol, intermediate results, and a comparison of results to fasciotomy.

J Foot Ankle Surg 2002 May-Jun;41(3):166-72
Weil LS Jr, Roukis TS, Weil LS, Borrelli AH.
Weil Foot & Ankle Institute, Des Plaines, IL 60016, USA

40 feet treated with ESWT were reviewed after 8.4 months. 

Results:  82% of the patients were treated with ESWT were successful compared to 83% of those treated with surgery (percutaneous plantar fasciotomy). 

Conclusion:  "Extracorporeal shock wave therapy is an effective treatment, which significantly reduces the symptoms associated with chronic plantar fasciitis and compares favorably to the results achieved with surgical intervention in the form of a percutaneous plantar fasciotomy."


Shockwave therapy for patients with plantar fasciitis: a one-year follow-up study.

Foot Ankle Int 2002 Mar;23(3):204-7
Wang CJ, Chen HS, Huang TW.
Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Kaohsiung, Taiwan.

79% of patients with plantar fasciitis were studied for the effects of ESWT. 

Results:  "The overall results were 75.3% complaint-free, 18.8% significantly better, 5.9% slightly better and none unchanged or worse. The effect of shockwave therapy seemed cumulative and was time-dependent. The recurrence rate was 5%. There were no device-related problems, systemic or local complications." 

Conclusion:   "Shockwave therapy is a safe and effective modality in the treatment of patients with plantar fasciitis."


Preliminary results on the safety and efficacy of the OssaTron
for treatment of plantar fasciitis.

Foot Ankle Int 2002 Mar;23(3):197-203
Alvarez R.
Southern Orthopaedic Foot and Ankle Center, Chattanooga, TN 37404, USA.


20 patients were treated with ESWT. 

Results:  Of the 20 treated, 18 (90%) were improved or pain-free.  18 stated that they would undergo the procedure again instead of surgery. 

Conclusion:  (ESWT) "is a safe and effective method of treating heel pain syndrome that has been unresponsive to nonoperative management."


High energy shock wave treatment of the painful heel spur
(Hochenergetische Stosswellenbehandlung des schmerzhaften Fersensporns.)
Unfallchirurg 1998 Dec;101(12):914-8 22
AUTHORS: Perlick L; Boxberg W; Giebel G
AUTHOR AFFILIATION: Abteilung fur Unfall- und Wiederherstellungschirurgie, Kreiskrankenhaus, Ludenscheid.

83 patients with heel pain non-responsive to other treatments underwent ESWT. 

Results after 1 year:  51 of 83 (61%) were pain-free; 20 (24%) were improved.  (The total improved or resolved was 85%.)  15% did not improve with ESWT. 


Shockwave treatment of therapy refractory soft tissue pain

AUTHORS: Boxberg W; Perlick L; Giebel G
AUTHOR AFFILIATION: Abteilung fur Unfall- und Wiederherstellungschirurgie, Kreiskrankenhaus Ludenscheid.
SOURCE: Chirurg 1996 Nov;67(11):1174-8

Conclusion:  "The results show the benefit of (shockwave therapy) in the treatment of chronic soft-tissue disorders without severe side effects. Forty-seven of 84 (56%) of the patients obtained complete relief; 24 patients (29%) showed a marked reduction in their complaints. (So 85% had complete or "marked" improvement.)  In only 13 of 84 (15%) cases was the treatment unsuccessful."


Evaluation of low-energy extracorporeal shock-wave
application for treatment of chronic plantar fasciitis.

J Bone Joint Surg Am 2002 Mar;84-A(3):335-41
Rompe JD, Schoellner C, Nafe B.
Department of Orthopaedics, Johannes Gutenberg University School of Medicine, Mainz, Germany.

The authors conducted a randomized, controlled, observer-blinded study to assess the effectiveness of ESWT on 112 patients with chronic heel pain. 

Results:   At 6 months, the rate of good and excellent outcomes with ESWT was significantly (47%) better in the treated group.  By 5 years, just 13% of the group treated with ESWT had felt a need to proceed with surgery, whereas 58% of those not treated with ESWT felt enough pain to proceed with surgical intervention.


Buch M, Knorr U, Fleming L, Theodore G, Amendola A, Bachmann C, Zingas C, Siebert WE.
Orthopade 2002 Jul;31(7):637-44
Orthopadische Klinik, Kassel.

A randomized, placebo-controlled, double-blind multicenter trial was conducted on patients with plantar fasciitis. 

Conclusion:  "A single shockwave application can improve the condition significantly compared to the placebo treatment.  The treated group has a 61.6% good or excellent result rate. "


Shockwave therapy for chronic proximal plantar fasciitis: a meta-analysis.

Foot Ankle Int 2002 Apr;23(4):301-8
Ogden JA, Alvarez RG, Marlow M.
Skeletal Educational Association Atlanta, GA 30305, USA.


840 patients in eight scientific studies were examined to assess the effectiveness of ESWT.  

Conclusion:  ESWT directed at painful fasciitis is "safe and effective nonsurgical method for treating chronic, recalcitrant heel pain syndrome that has been refractory to other commonly used nonoperative therapies. The results suggest that this therapeutic procedure should be considered before any surgical intervention, and may be preferable prior to cortisone injection, which has a recognized risk of rupture of the plantar fascia and a frequent recurrence of symptoms."


5-years lithotripsy of plantar of plantar heel spur:
experiences and results--a follow-up study after 36.9 months

TITLE: 5 Jahre Lithotripsie des plantaren Fersenspornes: Erfahrungen und Ergebnisse--eine Nachuntersuchung nach 36,9 Monaten.
Z Orthop Ihre Grenzgeb 1998 Sep-Oct;136(5):402-6 31
AUTHORS: Sistermann R; Katthagen BD
AUTHOR AFFILIATION: Orthopadische Klinik, Stadtische Kliniken Dortmund, Klinikzentrum Mitte.

54 patients were treated with two different ESWT machines for plantar fasciitis. 

Results:  After 6 weeks, the two different machines resolved patient pain completely in 70% and 79%.  After 37 months, 40% and 68% were still pain free.  

Conclusion:  Shockwave therapy is "an effective and non-invasive method of treatment."


Analgesic effect of low energy extracorporeal shock waves
in tendinosis calcarea, epicondylitis humeri radialis and plantar fasciitis

Maier M, Durr HR, Kohler S, Staupendahl D, Pfahler M, Refior HJ, Meier M.
Orthopadische Klinik am Klinikum Grosshadern Ludwig-Maximilians Universitat, Munchen.


85 patients were observed with Achilles Tendinitis, epicondylitis of the elbow, and plantar fasciitis.  Low-energy ESWT was provided. 

Conclusion:  After 5 months, all three (groups had) a "significant improvement," with the plantar fasciitis patients demonstrating the greatest improvement, followed by those with Achilles Tendinitis. 


Shock wave therapy for chronic proximal plantar fasciitis.

Clin Orthop 2001 Jun;(387):47-59
Ogden JA, Alvarez R, Levitt R, Cross GL, Marlow M.
Atlanta Medical Center, GA, USA.


A randomized, double-blind study to assess the effects of electrohydraulic ESWT was conducted on 302 patients with chronic heel pain caused by proximal plantar fasciitis present for 6-18 months. 

Results:  After 3 months, the treated group had 56% more of the treated patients had a successful result. 

Conclusion: The directed application of electrohydraulic-generated shock waves to the insertion of the plantar fascia onto the calcaneus is a safe and effective nonsurgical method for treating chronic, recalcitrant heel pain syndrome that has been present for at least 6 months and has been refractory to other commonly used nonoperative therapies.   The results suggest that this therapeutic modality should be considered before any surgical options, and even may be preferable to cortisone injection, which has a recognized risk of rupture of the plantar fascia and recurrence of symptoms.


Using extracorporeal shockwave therapy in orthopedics--a meta-analysis
TITLE: Der Einsatz der extrakorporalen Stosswellentherapie in der Orthopadie-- eine Metaanalyse.
Z Orthop Ihre Grenzgeb 1998 Sep-Oct;136(5):390-401 32
AUTHORS: Heller KD; Niethard FU
AUTHOR AFFILIATION: Orthopadische Universitatsklinik, Rheinisch-Westfalischen Technischen Hochschule Aachen.

Authors looked at 4825 cases from 55 publications and abstracts that underwent ESWT were evaluated. The authors took the best studies (24 papers with 1585 cases) and examined the results.  

Conclusion: "Because of the high complication rate in operative treatment of heel spur, ESWT seems to be justifiable."


Low-energy extracorporeal shock wave therapy for painful heel: a prospective controlled single-blind study.

Arch Orthop Trauma Surg 1996;115(2):75-9 117
AUTHORS: Rompe JD; Hopf C; Nafe B; Burger R
AUTHOR AFFILIATION: Department of Orthopaedics, University Hospital, Mainz, Germany.

This study looked at 30 patients with heel pain present for 12 months or more.  Some received true, low-energy ESWT.  Others received simulated ESWT. 

:  "There was
significant alleviation of pain and improvement of function at all follow-up (visits) in the treatment group." 


Symptomatic low-energy shockwave therapy
in heel pain and radiologically detected plantar heel spur

TITLE: Symptomatische niedrig-energetische Stosswellentherapie bei Fersenschmerzen und radiologisch nachweisbarem plantaren Fersensporn.
Z Orthop Ihre Grenzgeb 1998 Mar-Apr;136(2):169-74 47
AUTHORS: Krischek O; Rompe JD; Herbsthofer B; Nafe B
AUTHOR AFFILIATION: Orthopadische Universitatsklinik Mainz.


50 patients with long-term heel pain and a heel spur on X-ray were treated with two different levels of ESWT energy. 

Conclusion:  Results showed that "there was clear improvement and relief of pain in both groups on manual pressure and while walking and an increase of the pain-free walking ability from 10 minutes before the treatment to 2 and 3 hours respectively after 12 months....The extracorporal shock-wave therapy is an effective treatment in refractory heel pain."


Complications, side-effects and contraindications in the use of
medium and high-energy extracorporeal shock waves in orthopedics

TITLE: Komplikationen, Nebenwirkungen und Kontraindikationen der Anwendung mittel-und hochenergetischer extrakorporaler Stosswellen im orthopadischen Bereich.
Z Orthop Ihre Grenzgeb 1998 Mar-Apr;136(2):175-81 46
AUTHORS: Sistermann R; Katthagen BD
AUTHOR AFFILIATION: Orthopadische Klinik, Stadtische Kliniken Dortmund, Klinikzentrum Mitte, Dortmund.

The authors looked at 542 shockwave procedures in 276 patients for evidence of complications. 

Conclusion: In general lithotripsy (shockwave therapy) has only minor complications when it is used accurately.


xtracorporeal shock-wave therapy. Experimental basis, clinical application
TITLE: Extrakorporale Stosswellentherapie. Experimentelle Grundlagen, klinischer Einsatz.
Orthopade 1997 Mar;26(3):215-28 88
AUTHORS: Rompe JD; Kullmer K; Vogel J; Eckardt A; Wahlmann U Eysel P; Hopf C; Kirkpatrick CJ; Burger R; Nafe B
AUTHOR AFFILIATION: Orthopadische Universitatsklinik Mainz.

Conclusion:  "In the treatment of persistent tennis elbow, plantar fasciitis, calcifying tendinitis, and pseudarthrosis, our data show that extracorporeal shock waves may provide analgesic, resorptive and osteo-inductive reactions with nearly no side effects.



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For information on foot-related problems, visit the website of our shared facility,
the Achilles Foot Health Centre (