This study aimed at estimating the effectiveness of two commonly used modalities—extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT)—each combined with usual care (exercises and orthotic supports) in comparison to only usual care to relieve pain in patients with plantar fasciitis (PF).
Methods:
Participants with PF were randomly allocated into 3 groups: ESWT (n = 25), LLLT (n = 24), and control (n = 17). All participants received a home exercise program with orthotic support. The ESWT group received 2000 shock waves with 0.02 mJ/mm2 for 3 sessions, once a week; LLLT group received gallium-aluminum-arsenide laser with 850 nm wavelength for 10 sessions, 3 times a week. Pain was measured by Foot Function Index-pain subscale (FFI-p) and Numerical Rating Scale for pain (NRS-p). The scores were recorded at baseline, third week, and third month after the treatment. Analysis was performed using repeated measures ANOVA.
Results:
There was a significant improvement in pain over the 3 months in all groups on both FFI-p (P < .001) and NRS-p (P < .001). In NRS-p, LLLT group had significantly lower pain than ESWT (P = .002) at the third week and control (P = .043) and ESWT (P = .003) at third month. In FFI-p total score, ESWT group had higher pain than LLLT (P = .003) and control (P = .035) groups at third week and LLLT (P = .010) group at third month.
Conclusion:
When LLLT and ESWT were combined with usual care, LLLT was found to be more effective than ESWT in reducing pain in PF at short-term follow-up.
World Medical Association. WMA Declaration of Helsinki-Ethical Principles for Medical Research Involving Human Subjects. Ferney-Voltaire, France: WMA; 2016.
2.
BasfordJRMalangaGAKrauseDAHarmsenWS.A randomized controlled evaluation of low-intensity laser therapy: plantar fasciitis. Arch Phys Med Rehab. 1998;79(3):249-254.
3.
BlewRMSardinhaLBMillikenLAet al. Assessing the validity of body mass index standards in early postmenopausal women. Obes Res. 2002;10(8):799-808.
4.
BöddekerIRSchäferHHaakeM.Extracorporeal shockwave therapy (ESWT) in the treatment of plantar fasciitis—a biometrical review. Clin Rheumatol. 2001;20(5):324-330.
5.
Budiman-MakEConradKJMazzaJStuckRM.A review of the foot function index and the foot function index—revised. J Foot Ankle Res. 2013;6:5.
6.
CADTH Rapid Response Reports. Shockwave Therapy for Pain Associated With Lower Extremity Orthopedic Disorders: A Review of the Clinical and Cost-Effectiveness. Ottawa: Canadian Agency for Drugs and Technologies in Health Copyright; 2016.
7.
CelikDKusGSirmaSO.Joint mobilization and stretching exercise vs steroid injection in the treatment of plantar fasciitis: a randomized controlled study. Foot Ankle Int. 2016;37(2):150-156.
8.
ChewKTLeongDLinCYLimKKTanB.Comparison of autologous conditioned plasma injection, extracorporeal shockwave therapy, and conventional treatment for plantar fasciitis: a randomized trial. PM R. 2013;5(12):1035-1043.
9.
ChuckpaiwongBBerksonEMTheodoreGH.Extracorporeal shock wave for chronic proximal plantar fasciitis: 225 patients with results and outcome predictors. J Foot Ankle Surg. 2009;48(2):148-155.
10.
CinarEUygurF.FRI0582-HPR extracorporeal shock wave therapy versus low intensity laser therapy in the treatment of heel pain. Ann Rheum Dis. 2013;72(suppl 3):A572.
11.
CinarEUygurFCelenayST.AB1447-HPR the efficacy of low level laser therapy in the treatment of calcaneal spur. Ann Rheum Dis. 2013;71(suppl 3):757.
12.
DiGiovanniBFNawoczenskiDALintalMEet al. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. J Bone Joint Surg Am. 2003;85-a(7):1270-1277.
13.
DiGiovanniBFNawoczenskiDAMalayDPet al. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up. J Bone Joint Surg Am. 2006;88(8):1775-1781.
14.
El ShazlyOEl HilalyRAAbouElSoudMMEl SayedMN.Endoscopic plantar fascia release by hooked soft-tissue electrode after failed shock wave therapy. Arthroscopy. 2010;26(9):1241-1245.
15.
EslamianFShakouriSKJahanjooFHajialilooMNotghiF.Extra corporeal shock wave therapy versus local corticosteroid injection in the treatment of chronic plantar fasciitis, a single blinded randomized clinical trial. Pain Med. 2016;17(9):1722-1731.
16.
FillipinLIMaurizJLVedovelliKet al. Low-level laser therapy (LLLT) prevents oxidative stress and reduces fibrosis in rat traumatized Achilles tendon. Lasers Surg Med. 2005;37(4):293-300.
17.
GerdesmeyerLMaierMHaakeMSchmitzC.[Physical-technical principles of extracorporeal shockwave therapy (ESWT)]. Der Orthopade. 2002;31(7):610-617.
18.
GoffJDCrawfordR.Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011;84(6):676-682.
19.
HashmiJTHuangY-YOsmaniBZSharmaSKNaeserMAHamblinMR.Role of low-level laser therapy in neurorehabilitation. PM R. 2010;2(12suppl 2):S292-S305.
20.
HawkerGAMianSKendzerskaTFrenchM.Measures of adult pain: visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short-form mcgill pain questionnaire (sf-mpq), chronic pain grade scale (cpgs), short form-36 bodily pain scale (sf-36 bps), and measure of intermittent and constant osteoarthritis pain (icoap). Arthritis Care Res. 2011;63(S11):S240-S252.
21.
IlievaEM.Radial shock wave therapy for plantar fasciitis: a one year follow-up study. Folia Med. 2013;55(1):42-48.
22.
InTSJungJHKimKJungKSChoHY.The reliability and validity of the Korean version of the foot function index for patients with foot complaints. J Phys Ther Sci. 2017;29(1):53-56.
23.
JastiferJRCatenaFDotyJFStevensFCoughlinMJ.Low-Level laser therapy for the treatment of chronic plantar fasciitis: a prospective study. Foot Ankle Int. 2014;35(6):566-571.
24.
KatzmarzykPT.Cost-effectiveness of exercise is medicine. Curr Sports Med Rep. 2011;10(4):217-223.
25.
KiritsiOTsitasKMalliaropoulosNMikroulisG.Ultrasonographic evaluation of plantar fasciitis after low-level laser therapy: results of a double-blind, randomized, placebo-controlled trial. Lasers Med Sci. 2010;25(2):275-281.
26.
LandorfKBRadfordJA.Minimal important difference: values for the Foot Health Status Questionnaire, Foot Function Index and Visual Analogue Scale. Foot. 2008;18(1):15-19.
27.
LandorfKBRadfordJAHudsonS.Minimal important difference (MID) of two commonly used outcome measures for foot problems. J Foot Ankle Res. 2010;3:7.
28.
LangeBChipchaseLEvansA.The effect of low-Dye taping on plantar pressures, during gait, in subjects with navicular drop exceeding 10 mm. J Orthop Sports Phys Ther. 2004;34(4):201-209.
MendesA.An overview of plantar fasciitis. Br J Community Nurs. 2016;21(3):160.
34.
PetragliaFRamazzinaICostantinoC.Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review. Muscles Ligaments Tendons J. 2017;7(1):107-118.
35.
RiddleDLPulisicMPidcoePJohnsonRE.Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg Am. 2003;85-a(5):872-877.
36.
RompeJD.Plantar fasciopathy. Sports Medicine Arthrosc. 2009;17(2):100-104.
37.
SheferGPartridgeTAHeslopLGrossJGOronUHalevyO.Low-energy laser irradiation promotes the survival and cell cycle entry of skeletal muscle satellite cells. J Cell Sci. 2002;115(7):1461-1469.
38.
SpeedC.A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence. Br J Sports Med. 2014;48(21):1538-1542.
39.
Spörndly-NeesSDåsbergBNielsenROBoesenMILangbergH.The navicular position test–a reliable measure of the navicular bone position during rest and loading. Int J Sports Phys Ther. 2011;6(3):199-205.
40.
StuberKKristmansonK.Conservative therapy for plantar fasciitis: a narrative review of randomized controlled trials. J Can Chiropr Assoc. 2006;50(2):118-133.
41.
SunJGaoFWangYSunWJiangBLiZ.Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs. Medicine. 2017;96(15):e6621.
42.
SuttonDANordinMCotePet al. The effectiveness of multimodal care for soft tissue injuries of the lower extremity: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration. Manipulative Physiol Ther. 2016;39(2):95-109.e101-e102.
43.
SweetingDParishBHooperLChesterR.The effectiveness of manual stretching in the treatment of plantar heel pain: a systematic review. J Foot Ankle Res. 2011;4(1):19.
44.
TheodoreGHBuchMAmendolaABachmannCFlemingLLZingasC.Extracorporeal shock wave therapy for the treatment of plantar fasciitis. Foot Ankle Int. 2004;25(5):290-297.
45.
ThingJMaruthappuMRogersJ.Diagnosis and management of plantar fasciitis in primary care. Br J Gen Pract. 2012;62(601):443-444.
46.
UlusoyACerrahogluLOrgucS.Magnetic resonance imaging and clinical outcomes of laser therapy, ultrasound therapy, and extracorporeal shock wave therapy for treatment of plantar fasciitis: a randomized controlled trial. J Foot Ankle Surg. 2017;56(4):762-767.
47.
YalimanASenEIEskiyurtNBudiman-MakE.Turkish translation and adaptation of foot function index in patients with plantar fasciitis/Ayak fonksiyon indeksi’nin plantar fasiitli hastalarda turkce’ye ceviri ve adaptasyonu. Turkish Journal of Physical Medicine and Rehabilitation. 2014;60(3):212-223.
48.
YoungC.In the clinic. Plantar fasciitis. Ann Intern Med. 2012;156(1Pt 1):ITC1-1, ITC1-2, ITC1-3, ITC1-4, ITC1-5, ITC1-6, IT.
49.
YucelUKucuksenSCingozHTet al. Full-length silicone insoles versus ultrasound-guided corticosteroid injection in the management of plantar fasciitis: a randomized clinical trial. Prosthet Orthot Int. 2013;37(6):471-476.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
