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Shock wave application for chronic plantar fasciitis in running athletes

Posted by Jan Rompe on 3/19/03 at 06:32 (113434)

Dear colleagues:

Our latest study has just been published in:

Am J Sports Med 2003 Mar-Apr;31(2):268-75

Shock wave application for chronic plantar fasciitis in running athletes: a prospective, randomized, placebo-controlled trial.

Rompe JD, Decking J, Schoellner C, Nafe B.

Department of Orthopaedics, Johannes Gutenberg University School of Medicine, Mainz, Germany.

BACKGROUND: Recent articles have reported success with repeated low-energy shock wave application for treatment of chronic plantar fasciitis in runners. HYPOTHESIS: Shock wave treatment for chronic plantar fasciitis is safe and effective. STUDY DESIGN: Prospective, randomized, placebo-controlled trial. METHODS: Forty-five running athletes with intractable plantar heel pain for more than 12 months were enrolled; half were assigned to a treatment group that received three applications of 2100 impulses of low-energy shock waves, and half received sham treatment. Follow-up examinations were performed at 6 months and at 1 year by a blinded observer. RESULTS: After 6 months, self-assessment of pain on first walking in the morning was significantly reduced from an average of 6.9 to 2.1 points on a visual analog scale in the treatment group and from an average of 7.0 to 4.7 points in the sham group. The mean difference between groups was 2.6 points. After 12 months, there was a further reduction of pain in both groups, to an average 1.5 points in the treatment group, and to 4.4 points in the sham group. CONCLUSION: Three treatments with 2100 impulses of low-energy shock waves were a safe and effective method for treatment of chronic plantar fasciitis in long-distance runners.

Any PROFESSIONAL comments are welcome to:

Jan D. Rompe
Dept. of Orthopaedic Surgery
Johannes gutenberg University
School of Medicine
Langenbeckstr. 1
D-55131 Mainz

e-mail: (email removed)

Re: Shock wave application for chronic plantar fasciitis in running athletes

DrMan on 3/19/03 at 21:41 (113586)

DR. Rompe, congratulations on the publication of your most recent article in Am J Sports Med. I am Dr John E Mancuso in New York City. I'm sorry you weren't able to attend the most recent International Society of Musculoskeletal Shock Wave Therapy meeting. I was looking forward to meeting you. It would have been a pleasure to speak with you. I am a colleaque of Lowell S Weil, Sr and Jr. In fact we are working together on an FDA study on a new high-energy ESWT unit. In reading your Background information that you posted many questions come to mind which, I'm sure, should be answered in the actual manuscript. I'm curious to find out the Pre-ESWT treatments in both populations and what safeguards were taken to control Post-ESWT treatments such as activity, medications and exersize over such a long period of time. I know, from our clinical trials, which has an end point at 12 weeks, that if the patient continues to experience pain it is difficult to control their intake of analgesic or anti-inflammatory medications. It must have been difficult to control this over a full year. The population was small so improvement over 6 months to a year by natural causes is always possible. Again, I expect these questions to be answered in your manuscript, and I do look forward to reading it.

I do have one question for you, if you don't mind. Within our small community of musculoskeletal shock wave therapy experts one question is that of high-energy verses low-energy. What is your experience as to effectiveness in the treatment of chronic proximal plantar fasciitis?

Re: Shock wave application for chronic plantar fasciitis in running athletes

Ed Davis, DPM on 3/21/03 at 00:58 (113704)

Dr. Rompe:
Thank you for the informative post. The evidence favoring effectiveness continues to accumulate.
Which machine was used in this study?

Re: Shock wave application for chronic plantar fasciitis in running athletes

Jan Rompe on 3/24/03 at 02:03 (114136)

Dear Ed:

A Siemens Sonocur device was used in this study.

Jan D. Rompe