Abstract
The aim of this prospective single-blind pilot study was to explore the pain-alleviating effect of low-energy extracorporeal shock wave therapy (ESWT) in painful heel associated with inferior calcaneal spurs. Thirty patients who suffered from persistent symptoms for more than 12 months qualified for low-energy ESWT and were assigned at random to two groups, real or simulated ESWT. Before beginning the treatment, any other therapy was stopped for a period of 6 weeks. The shock waves were applied by an experimental device allowing exact localization through an integrated fluoroscopy unit. Patients were treated three times at weekly intervals. Each time 1000 impulses of 0.06 mJ/mm2 were given around the heel spur. Follow-ups were done after 3, 6, 12 and 24 weeks. Patients of the placebo group who did not improve at the 6-week follow-up were then offered ESWT therapy and were checked at 3, 6, 12 and 24 weeks after the last treatment. Whereas we noticed no significant differences between the groups before ESWT, there was a significant alleviation of pain and improvement of function at all follow-ups in the treatment group.
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References
Barrett SL, Day SV (1991) Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: surgical technique — early clinical results. J Foot Surg 30:568–570
Baxter DE, Thigpen CM (1984) Heel pain: operative results. Foot Ankle 5:16–22
Bergmann JN (1990) History and mechanical control of heel spur pain. Clin Podiatr Med Surg 7:243–259
Bordelon RL (1983) Subcalcaneal pain, a method of evaluation and plan for treatment. Clin Orthop 177:49–59
Campbell JW, Inman VT (1974) Treatment of plantar fasciitis and calcaneal spurs with the UC-BL shoe insert. Clin Orthop 103:57–62
Chandler TJ, Kiblerm WB (1993) A biomechanical approach to the prevention, treatment and rehabilitation of plantar fasciitis. Sports Med 15:344–352
Chard MD, Hazleman BL (1989) Tennis elbow — a reappraisal. Br J Rheumatol 28:186–192
Conti RJ, Shinder M (1991) Soft tissue calcifications induced by local corticosteroid injection. J Foot Surg 30:34–37
Dahmen GP, Meiss L, Nam VC, Skruodies B (1991) Extrakorporale Stoßwellentherapie (ESWT) im knochennahen Weichteilbereich an der Schulter. Extracta Orthop 15:25–28
Daly PJ, Kitaoka HB, Chao EY (1992) Plantar fasciotomy for intractable plantar fasciitis: clinical results and biomechanical evaluation. Foot Ankle 13:188–195
Du Vries JL (1957) Heel spur (calcaneal spur). Arch Surg 74:536–543
Furey JG (1975) Plantar fasciitis: the painful heel syndrome. J Bone Joint Surg [Am] 57:672–680
Graham CE (1983) Painful heel syndrome: rationale and treatment. Foot Ankle 3:261–268
Greer Richardson E (1992) Painful heel. In: Crenshaw AH (ed) Campbell's operative orthopaedics, vol 4. Mosby, St. Louis, pp 2787–2792
Griffith JD (1910) Osteophytes of the os calcis. Am J Orthop Surg 8:501–510
Haist J, Steeger D, Witzsch U, Bürger RA, Haist U (1992) The extracorporal shockwave therapy in the treatment of disturbed bone union. 7th Int. Conference on Biomedical Engineering, Singapore, 222–224
Hassab HK, El-Sherif AS (1974) Drilling of the os calcis for painful heel with calcaneal spur. Acta Orthop Scand 45:152–157
Kinley S, Frascone S, Calderone D, Wertheimer SJ, Squire MA, Wiseman FA (1993) Endoscopic plantar fasciotomy versus traditional heel spur surgery: a prospective study. J Foot Ankle Surg 32:595–603
Kuhns JC (1949) Changes in elastic adipose tissue. J Bone Joint Surg [Am] 31:541–548
Lapidus PW, Guidotti FP (1965) Painful heel: report of 323 patients with 364 painful heels. Clin Orthop 39:178–185
Lester DK, Buchanan JR (1984) Surgical treatment of plantar fasciitis. Clin Orthop 186:202–204
Loew M, Jurgowski W (1993) Extracorporale StoßwellenLithotripsie bei Tendinosis calcarea. Z Orthop 131:470–473
Manoli A, Harper MC, Fitzgibbons TC, McKeman DJ (1992) Calcaneal fracture after cortical bone removal. Foot Ankle 13:523–525
Michele AA, Kruger FJ (1951) Plantar heel pain treated by countersinking osteotomy. Milit Surg 109:26–34
Mitchell IR, Meyer C, Krueger WA (1991) Deep fascia of the foot. Anatomical and clinical considerations. J Am Pediatr Med Assoc 81:373–378
Schepsis AA, Leach RE, Gorzyca J (1991) Plantar fasciitis. Etiology, treatment, surgical results, and review of the literature. Clin Orthop 266:185–196
Self TC, Kunz RE, Young G (1993) Transverse plantar incision for heel spur surgery. Four-year follow-up survey of 35 patients. J Am Podiatr Med Assoc 83:259–262
Snider MP, Clancy WG, McBeath AA (1983) Plantar fascia release for chronic plantar fasciitis in runners. Am J Sports Med 11:215–219
Snook GA, Chrisman OD (1972) The management of subcalcaneal pain. Clin Orthop 82:163–171
Steindler A, Smith AR (1938) Spurs of the os calcis. Surg Gynecol Obstet 66:663–671
Sukul K, Johannes EJ, Pierik E, van Eijck G, Kristelijn M (1992) The effect of high energy shock waves focused on cortical bone: an in vitro study. J Surg Res 53:110–116
Tanz SS (1963) Heel pain. Clin Orthop 28:169–174
Valchanou VD, Michailov P (1991) High energy shock waves in the treatment of delayed and nonunion of fractures. Int Orthop 15:181–184
Wagner KL, Sharkey PF (1991) The use of night splints for treatment of recalcitrant plantar fasciitis. Foot Ankle 12:135–137
Ward WG, Clippinger FW (1987) Proximal medial longitudinal arch incision for plantar fascia release. Foot Ankle 8:152–155
Woolnough J (1954) Tennis heel. Med J Aust 2:857–862
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Rompe, J.D., Hopf, C., Nafe, B. et al. Low-energy extracorporeal shock wave therapy for painful heel: a prospective controlled single-blind study. Arch Orthop Trauma Surg 115, 75–79 (1996). https://doi.org/10.1007/BF00573445
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DOI: https://doi.org/10.1007/BF00573445