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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." __________________________________________________
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." __________________________________________________
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." __________________________________________________
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." __________________________________________________
(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.
___________________________________________________ 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."__________________________________________________
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.
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Buch M, Knorr U, Fleming L, Theodore
G, Amendola A, Bachmann C, Zingas C, Siebert WE. 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. " __________________________________________________
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.____________________________________________________
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. _____________________________________________________
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." ____________________________________________________
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.
___________________________________________________ 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.____________________________________________________
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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