Plantar fasciitis is an inflammation of the tissue supporting the arch of the foot. When non-surgical treatments fail, which is in about 10 percent of patients, they may need to undergo surgery that requires long recovery times.

German researchers have reported that patients suffering from this common and painful heel condition could benefit from new type of shock wave therapy and thus avoid surgery.

During this treatment, called radial extracorporeal shock wave therapy (ESWT), energy is delivered across a broader area of the foot while the standard ESWT delivers focused shock waves to the most tender point on the patient's foot. It requires no anesthesia, so long recovery times are avoided. This type of treatment is recommended for patients with therapy-resistant plantar painful heel syndrome and who are opted for the surgery.

Although ESWT is increasingly being used as an alternative to surgery for plantar fasciitis, clinical trials comparing it to placebo have yielded contradictory results.

To analyze the effectiveness of the new shock wave therapy, the researchers randomly assigned 245 patients with chronic plantar fasciitis to undergo three treatments 2 weeks apart with ESWT or a sham treatment with a device that did not transmit any shock waves.

Twelve weeks after, the patients who underwent the real treatment had a 72.1% reduction in their heel pain scores, while the reduction for the placebo group averaged 44.7%. One year after treatment, pain scores were 84.8 % lower than at the study's outset for the treatment group, while the placebo group's pain scores dropped by 43.2 %. Patients assigned to rESWT also showed significantly greater improvement in their quality of life and ability to function in daily life compared with those who received the sham treatment.

The researchers point out that the benefit of patients with painful heel by ESWT treatment may not be mirrored only through reduced pain but also through generally improved well being.