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Extracorporeal shock wave treatment in plantar fasciitis with an associated neuropathic component. How to optimize the result?

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Case Report | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 21-23 | Lauro Schledorn de Camargo , Ricardo Kobayashi
DOI: 10.13107/jrs.2022.v02.i02.59

Author: Lauro Schledorn de Camargo [1], Ricardo Kobayashi [2]

[1] Orthopedic Surgeon at LC Clinic, Jundiai-SP Brazil, Brazil,
[2] Pain Center, Department of Neurology, University of São Paulo, Brazil.

Address of Correspondence
Dr. Lauro Schledorn de Camargo, MD,
Orthopedic Surgeon at LC Clinic, Jundiai-SP Brazil, Brazil.
E-mail: laurosch@hotmail.com

Abstract

Introduction: Current evidence supports the use of radial pressure wave and focused extracorporeal shock wave treatment (ESWT) for the treatment of chronic plantar fasciitis that does not improve with conservative treatment. Studies show that a quarter of plantar fasciitis may have an associated neuropathic component and the literature shows that neuropathic pain causes more intense pain and greater functional disability. However, there is a lack of literature on the results of ESWT in tendinopathies associated with the neuropathic pattern.
Case report: We report a case of plantar fasciitis with central sensitization and associated neuropathic component. At first, pregabalin 75mg twice a day was used, which improved the neuropathic pattern. After that, 3 sessions were performed with piezoelectric ESWT with energy of 0.12 mJ/mm2, 2000 impulses at a frequency of 8 Hz, once a week for three weeks. The patient was followed up for 3 months and had complete improvement of symptoms without functional limitation for activities of daily living.
Conclusion: This case report serves to draw attention to the importance of evaluating and treating the neuropathic pattern associated with tendinopathies in order to optimize the therapeutic result. However, randomized clinical trials are lacking to determine the real difference in results between using ESWT in nociceptive pain or in mixed pain with an associated neuropathic component.

Keywords: Chronic pain, plantar fasciitis, mixed pain, neuropathic pain, shockwaves.

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How to Cite this article: Camargo Lsd, Kobayashi R |Extracorporeal shock wave treatment in plantar fasciitis with an associated neuropathic component. How to optimize the result?. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 21-23.

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Plantar Fasciopathy, General Concepts, Shock Wave Treatment and Other Additional Therapeutic Considerations

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 39-43 | Osvaldo Valle Toledo. DOI: 10.13107/jrs.2021.v01.i01.021

Author: Osvaldo Valle Toledo [1]

[1] Department of Orthopedics and Traumatology, Ankle Foot Subspecialist, Ankle-Foot Team, MEDS Clinic, Santiago de Chile.

 

Address of Correspondence
Dr. Osvaldo Valle Toledo, MD,
Department of Orthopedics and Traumatology, Ankle Foot Subspecialist, Ankle-Foot Team, MEDS Clinic, Santiago de Chile.
E-mail: osvaldovalletoledo@yahoo.es

Abstract

Plantar fasciopathy is the most common cause of heel pain. It is a primarily degenerative and mechanical overuse pathology. The plantar fascia fulfills important biomechanical functions in the foot, being its “windlass” mechanism, the most important function in this regard, allowing the foot to act as a single and efficient motor unit during gait. Its clinical and imaging diagnosis is fully defined, being Baxter’s nerve entrapment neuropathy, its most significant differential diagnosis. The elongation exercises constitute the basic treatment, being the extracorporeal shock wave therapy of significant utility, amplified in its effects by the association with the referred therapeutic exercises.

Keywords: Plantar fasciitis, shock waves, fasciopathy.

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How to Cite this article: Toledo OV | Plantar Fasciopathy, General Concepts, Shock Wave Treatment and Other Additional Therapeutic Consideration. | Journal of Regenerative Science | Dec 2021; 1(1): 39-43.

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