Shockwave Therapy versus Local Corticosteroid Injection in the Treatment of Chronic Plantar Fasciitis: A comparative study.

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Abstract
Objectives: This study aimed to assess the reliability and safety of extracorporeal shockwave therapy (ESWT) versus local corticosteroid injection on pain intensity and functional disability, as treatment modalities of patients suffering from chronic plantar fasciitis (PF). Patients and methods: This study was conducted on 45 patients suffering from chronic PF who failed to respond to conservative treatments. Patients were divided into 3 groups: 15 patients treated with ESWT once per week for 6 successive sessions (Group I), 15 patients treated with a local corticosteroid injection (Group II) and 15 patients taking acetaminophen 500mg/6 hrs for 7 days and exercises, as controls (Group III). All patients were subjected to history taking, clinical examination and assessment of foot pain, disability and activity limitations using the Foot Function Index (FFI) at the beginning of the study and after 6 weeks. Results: At the beginning of the study, no significant differences were reported between the studied groups regarding the FFI (p value = 0.23). However, at the end of the study, a highly statistically significant difference was reported between the three groups regarding the outcome variables (p value =0.001). Improvement occurred in group I and II but it was superior among group I patients. Skin reddening occurred in 11 patients (73.3%) of group I and 2 patients (13%) of group II with a statistically significant difference (p < 0.001) between the 2 groups. Pain was reported in 4 patients (26.7%) and 15 patients (100%) in group I and group II respectively with a highly significant difference (p < 0.001). None of the cases reported allergy or fat bad atrophy. Conclusion: Both ESWT and local corticosteroid injection treatments improved pain and functional ability in patients with chronic PF. Improvement of the FFI total scores was superior with the ESWT therapy that seems to be an unconventional but a safe method for the management of chronic PF.