Ultrasonic Shock Wave Therapy for Plantar Fasciitis

Plantar fasciitis is a common foot ailment wherein plantar fascia, a stretch of tissue running along the bottom of the foot that connects the heel bone to the toes, becomes inflamed. Caused by consistent stretching and tearing of the fascia, plantar fasciitis is especially common in runners and typically effects those between 40 and 60 years of age. Treatments options are myriad, and one kind, ultrasonic shock wave therapy has been a much debated method of treatment, with no clear conclusion drawn on its effectiveness.

What is Ultrasonic Shock Wave Therapy?

Ultrasonic shock wave therapy for plantar fasciitis is a method of treatment that employs sound waves directed at the painful area in an attempt to stimulate healing. When treatments such as drugs (non-steroidal anti-inflammatory medication, corticosteroids), physical therapy or splinting fail to adequately work, ultrasonic shock wave therapy is typically used. However, one study has shown it to be a very ineffective method of treatment, while another says otherwise.

Studies on the Ineffectiveness of Ultrasonic Shock Wave Therapy

A study conducted in 2002 and detailed in the December 2002 issue of the Journal of Family Practice showed ultrasonic shock wave therapy to be a relatively ineffective method of treatment for plantar fasciitis. A randomized, placebo-controlled double-blind study was conducted with 166 Australian patients and assess six and twelve weeks after therapy was administered. The study showed that while pain did improve among both groups in the trial, the improvements were not significant and it was therefore concluded that ultrasonic shock wave therapy is not an effective method of treatment for plantar fasciitis.

Studies on the Effectiveness of Ultrasonic Shock Wave Therapy

Despite the conclusion drawn in the 2002 study, an American study conducted in 2002 showed ultrasonic shock wave therapy (called radial extracorporeal shock wave therapy in the study) to be an effective method of treatment for plantar fasciitis. The overall success rate was 61 percent compared to 42.2 percent in the placebo group, and no side effects were noted among those who took part in the trial.

While the study conducted in Australia focused on improvement after six and twelve weeks, the American study focused on a twelve-week improvement and a twelve-month improvement.

Criticism

Given the contrary indications of each study, there is a substantial amount of criticism for both. The study performed in Australia in 2002 is considered to be flawed by the authors of the American study, as the energy levels of the therapy were far less than those used in the United States. Additionally, the study was conducted by a non-clinician who worked for the government of a national health care system, and as such the motives and results have been called into question.

Opponents of the American study often cite the fact that it is a retrospective study and therefore not accurate. Though admitted to be true by Dr. Weil, one of the authors of the study, he rebuts by saying that comparative surgical studies are conducted in the same manner and therefore comparable in terms of the outcome.

It should also be noted, however, that footnotes in the article abstract found in the American Journal of Sports Medicine describe a possible conflict of interest. The study was funded by Electro Medical Systems, an inventor and developer of radial shock wave therapy technology.

Benefits of Ultrasonic Shock Wave Therapy

While the effectiveness of ultrasonic shock wave therapy is up for debate, there are a number of benefits associated with the treatment not found in surgery. Surgery can often lead to post-operative infections, which can be quite costly (higher than the ultrasonic shock wave therapy itself), while ultrasonic shock wave therapy allows the patient to return to work and normal social activities immediately.