April 19, 2006

Shockwave therapy can ease type of foot pain

By David Douglas

NEW YORK (Reuters Health) - Shockwave treatment has
recently been tried to alleviate a common cause of heel pain,
and in many cases it appears to be helpful with good long-term
results, Taiwanese researchers report.

Plantar fasciitis, as the condition is called, involves
inflammation of the connective tissues linking the muscles of
the sole of the foot, and is often difficult to treat.

Dr. Ching-Jen Wang told Reuters Health that his group found
that shockwave therapy was more effective and resulted in a
lower recurrence rate than traditional treatment for plantar
fasciitis over long-term follow-up.

Focused shockwaves, generated by a special machine, is an
established method of breaking up kidney stones. Dr. Wang and
colleagues at Chang Gung Memorial Hospital at Kaohsiung used
such a device in a study of 149 patients (168 heels) with
chronic plantar fasciitis.

As reported in the American Journal of Sports Medicine,
half the patients were given 1500 shockwave impulses to the
affected heel, under local anesthesia, during a single session.
The other half received a variety of treatments including
standard painkillers, orthotic appliances, physical therapy and

At follow-up ranging from about 3 to 6 years, patients in
the shockwave group had significantly better scores on pain and

Almost 83 percent in the shockwave group achieved excellent
or good results compared with 55 percent of patients in the
comparison group. In addition, the recurrence rate was 11
percent in the shockwave group versus 55 percent in the other
group, a significant difference.

In their paper, the researchers say they don't know why
shockwave therapy works. They say it may be that it
hyperstimulates the nerves, raising the threshold of pain. Or
possibly the shockwaves enhance blood-flow to tendons, which
speeds up the repair process.

Whatever the mechanism, Wang's group concludes that this
approach is "a new therapeutic modality that can safely and
effectively treat patients with plantar fasciitis."

SOURCE: American Journal of Sports Medicine, April 2006.