Studies have shown shockwave therapy to be a highly effective, long-term treatment for plantar fasciitis. Plantar fasciitis plagues close to 10% of the population and is one of the most common foot-related conditions in Canada. This condition is characterized by persistent pain in the heel or arch. In fact, many patients are reminded of this pain as soon as they get out of bed in the morning. Plantar fasciitis is caused by strain to the plantar fascia, the thick, web-like tissue under the skin at the bottom of the foot that extends from the heel to the toes.

When it comes to athletes, those at most risk of suffering from plantar fasciitis are runners. However, many people whose job requires standing on hard surfaces for hours (e.g. teachers, nurses, mail carriers) are also at risk.

According to a study by the American Orthopaedic Foot & Ankle Society, for patients with a greater than 12-month history of heel pain, shockwave therapy can effectively decrease plantar fascia thickness. This was demonstrated objectively by ultrasound evaluation as well as through a reduction in patient reported pain. The intent of this study was to determine the ability for shockwave therapy to provide long-lasting relief for those who suffer from plantar fasciitis.

Plantar fasciitis can lead to recalcitrant painful heel syndrome, often requiring operative intervention. Operative treatments, such as the fasciotomy, have shown promising results. The overarching issue with these types of treatments is, however, that they require long recovery times. For professional or semi-professional athletes, this period of immobilization can have serious repercussions, forcing them to seek alternative treatment modalities. Many in this situation have benefited from shockwave therapy, a modality that provides fast recovery times without the necessity of reduced weightbearing or immobilization.

To that end, radial shockwave therapy has proven to be especially useful. Radial shockwave therapy differs from regular shockwave treatments in that it allows for a broader application. Radial shockwaves are generated ballistically by accelerating a bullet to hit an applicator, which transforms the kinetic energy into radially expanding shock waves.

In a study published by the American Journal of Sports Medicine, radial shockwave therapy proved to be both safe and effective, particularly after only three rounds of consecutive treatment and when applied without anesthetic to the area of greatest pain. Given these findings, radial shockwave therapy can be strongly recommended for patients with therapy-resistant painful heel syndrome associated with plantar fasciitis. This represents an excellent alternative to surgery not only because anesthesia is not required, but also because long recovery times are avoided. It’s also worth noting that participants in this study were not required to refrain from their normal sports or activities during treatment. Radial shockwave therapy can be administered on an outpatient basis, meaning your patients can maintain their quality of life while you help them heal.

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