Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low-energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis.

Rompe, JD; Meurer, A; Nafe, B; Hofmann, A; Gerdesmeyer, L

doi:10.1016/j.orthres.2004.09.003

2005

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Title:: Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low-energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis.
Document type:: Clinical Trial; Journal Article; Randomized Controlled Trial
Author(s):: Rompe, JD; Meurer, A; Nafe, B; Hofmann, A; Gerdesmeyer, L
Abstract:: BACKGROUND: It remains unclear whether application of local anesthesia (LA) interferes with clinical efficacy of extracorporeal shock wave therapy (ESWT) for chronic plantar fasciitis. Aims: To evaluate the effect of local anesthesia on the clinical outcome after repetitive low-energy ESWT for chronic plantar fasciitis. METHODS: Eighty-six patients with chronic plantar fasciitis were randomly assigned to receive either low-energy ESWT without LA, given weekly for three weeks (Group I, n=45; 3 x 2000 pulses, total energy flux density per shock 0.09 mJ/mm2) or identical ESWT with LA (Group II, n=41). Primary outcome measure was: Reduction of pain from baseline to month 3 post-treatment in a pain numeric rating scale [0-10 points] during first steps in the morning, evaluated by an independent blinded observer. Calculations were based on intention-to-treat. RESULTS: No difference was found between the groups at baseline. At 3 months, the average pain score was 2.2+/-2.0 points for patients of Group I, and 4.1+/-1.5 points for patients of Group II. The mean between-group difference was 1.9 points (95% CI: [1.1-2.7 points]; P<.001). Significantly more patients of Group I achieved 50% reduction of pain compared to Group II (67% vs 29%, P<.001). CONCLUSION: ESWT as applied should be done without LA in patients suffering from chronic heel pain. LA applied prior treatment reduced the efficiency of low-energy ESWT.
Journal title abbreviation:: J Orthop Res
Year:: 2005
Journal volume:: 23
Journal issue:: 4
Pages contribution:: 931-41
Language:: eng
Fulltext / DOI:: doi:10.1016/j.orthres.2004.09.003
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/16023010
Print-ISSN:: 0736-0266
TUM Institution:: Klinik und Poliklinik für Orthopädie und Sportorthopädie
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Orthopädie und Sportorthopädie (Prof. von Eisenhart-Rothe)2005