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A Shocking Treatment for Heel Pain

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April 11, 2002 -- Researchers have found that applying low-energy shock waves to the bottom of the foot can make a real difference for people suffering from a common cause of heel pain -- called plantar fasciitis.

The plantar fascia is a sheet of tissue running along the bottom of the foot. Lots of exercise or walking, excess weight, flat feet, and high arches can all cause the area to become inflamed -- a painful condition called plantar fasciitis that doesn't always respond to treatment.

Jan D. Rompe, MD, and colleagues gave three weekly, low-energy shock wave treatments to 100 people with plantar fasciitis who'd gained no pain relief from stretching exercises, shock-absorbing insoles, night splints, anti-inflammatory drugs, steroid injections, physical therapy, or walking casts.

The researchers are in the department of orthopaedics at Johannes Gutenburg University of Medicine in Mainz, Germany. Their research is published in the March issue of The Journal of Bone and Joint Surgery.

The 50 people in group 1 received 1,000 impulses and the 50 in group 2 received 10 impulses of low-energy shock waves per treatment. There were no side effects, and none of the patients quit the treatment, although most of them found the shock wave process unpleasant.

Six months after the treatment, group 1 patients reported feeling significantly better than did group 2 patients. By five years after treatment, both groups reported similar levels of pain relief and satisfaction. However, 58% of patients in group 2 had undergone surgery compared with only 13% in group 1.

"Three treatments with 1,000 impulses of low-energy shock waves appear to be an effective therapy for plantar fasciitis and may help the patient to avoid surgery for recalcitrant heel pain," the researchers write. "In contrast, three applications of 10 impulses did not improve symptoms substantially."

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