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ESWT biometric review

Posted by dr ben pearl on 10/08/03 at 04:17 (132757)

I am presenting a talk on conservative management of heel pain at a medical symposium for the Marine Corps Marathon and would like to hear some thoughts on why there was not enough evidence in some of the reviews i.e. Boddeker et al in Clin Rheum 2001 to support any eficacy
DRBP

Re: ESWT biometric review

Ed Davis, DPM on 10/10/03 at 17:47 (133532)

Ben:
I am not familiar with the specific study you are referring but would be interested in the complete reference.

One of the largest collection of studies is on the ismst.com web site.
The preponderance of studies support ESWT and almost a decade of clinical experience in Europe favor its use. Some studies, if you read them carefully, have flaws. The most important thing to remember is that ESWT treats tissue quality. Poor tissue quality is associated with long term chronic inflammation. The reason that PF becomes recalcitrant is due to poor tissue quality of the fascia. ESWT applied to acute PF or PF in which tissue quality is not an issue is unlikely to work. A study, in order to be valid, must only include patients with recalcitrant PF, those with a long term history of the problem. Failure to do so was part of the problem with the Buchbinder study discussed above and previously.
Ed

Re: ESWT biometric review

Dr. Z on 10/10/03 at 20:05 (133561)

Ed,

There are studies ( very small group) of patients treated with low energy that had excellent reduce in pain and inflamation with low energy eswt Take a look on the international shockwave therapy web site.