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How to Avoid Failure of Radial Pressure Waves and Focused Shock Waves Therapy in Plantar Heel Pain: Diagnostic, Technical, and Biomechanical Pitfalls

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Review Article | Vol 6 | Issue 1 |  January-June 2026 | page: 27-32 | Osvaldo Valle Toledo

DOI: https://doi.org/10.13107/jrs.2026.v06.i01.197

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2026; The Author(s).

Submitted Date: 05 Mar 2026, Review Date: 20 April 2026, Accepted Date: April 2026 & Published: 30 June 2026

Author: Osvaldo Valle Toledo [1]

[1] Department of Orthopedic Surgery, Ankle and Foot Team, MEDS Clinic, Santiago de Chile, Chile.

Address of Correspondence
Osvaldo Valle Toledo,

Department of Orthopedic Surgery, Ankle and Foot Team, MEDS Clinic, Santiago de Chile, Chile.

E-mail: osvaldo.valle@meds.cl

Abstract

Mechanical wave-based therapies are a widely used and effective treatment for chronic plantar fasciopathy (PF); however, some patients do not achieve satisfactory clinical outcomes. Treatment failure is not necessarily related to the intrinsic efficacy of the method but is more frequently associated with modifiable clinical factors. This narrative review aims to analyze the most common causes of failure, focusing on diagnostic errors, inappropriate timing of treatment, inadequate technical application, and failure to address biomechanical abnormalities. Misdiagnosis is a major cause of therapeutic failure, as plantar heel pain may originate from multiple conditions other than PF, including tarsal tunnel syndrome, Baxter’s nerve entrapment, heel fat pad syndrome, calcaneal stress fractures, bursitis, tumors, and systemic inflammatory diseases. Technical factors, such as inappropriate energy delivery, incorrect targeting, and the use of local anesthesia, may also negatively influence outcomes. Furthermore, uncorrected gastrocnemius contracture and altered foot biomechanics contribute to persistent overload of the plantar fascia. Finally, both radial pressure waves and focused shockwaves appear to be more effective in chronic than in acute PF. A better understanding of these factors may improve patient selection and optimize treatment outcomes.

Keywords: Heel pain, Radial pressure waves, Focused shock waves, Plantar fasciitis

References

1. Nweke TC. Comprehensive review and evidence-based treatment framework for optimizing plantar fasciitis diagnosis and management. Cureus 2025;17:e88745.
2. Rhim HC, Kwon J, Park J, Borg-Stein J, Tenforde AS. A systematic review of systematic reviews on the epidemiology, evaluation, and treatment of plantar fasciitis. Life (Basel) 2021;11:1287.
3. Buchanan BK, Sina RE, Kushner D. Plantar fasciitis. In: StatPearls. Treasure Island: StatPearls Publishing; 2025.
4. Kobayashi R. Extracorporeal shock wave treatment and multimodal pain management for tarsal tunnel syndrome associated with plantar fasciitis. J Regen Sci 2024;4:31-4.
5. Schneider HP, Baca JM, Carpenter BB, Dayton PD, Fleischer AE, Sachs BD. American college of foot and ankle surgeons clinical consensus statement: Diagnosis and treatment of adult acquired infracalcaneal heel pain. J Foot Ankle Surg 2018;57:370-81.
6. Rompe JD, Cacchio A, Weil L Jr., Furia JP, Haist J, Reiners V, et al. Plantar fascia-specific stretching versus radial shock-wave therapy as initial treatment of plantar fasciopathy. J Bone Joint Surg Am 2010;92:2514-22.
7. Othman AM, Ragab EM. Endoscopic plantar fasciotomy versus extracorporeal shock wave therapy for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg 2010;130:1343-7.
8. Leão RG, Azuma MM, Ambrosio GH, Faloppa F, Takimoto ES, Tamaoki MJ. Effectiveness of shockwave therapy in the treatment of plantar fasciitis. Acta Ortop Bras 2020;28:7-11.
9. Yucel I, Ozturan KE, Demiraran Y, Degirmenci E, Kaynak G. Comparison of high-dose extracorporeal shockwave therapy and intralesional corticosteroid injection in the treatment of plantar fasciitis. J Am Podiatr Med Assoc 2010;100:105-10.
10. Moya D, Ramón S, Guiloff L, Terán P, Eid J, Serrano E. Malos resultados y complicaciones en el uso de ondas de choque focales y ondas de presión radial en patología musculoesquelética [Poor results and complications in the use of focused shockwaves and radial pressure waves in musculoskeletal pathology]. Rehabilitacion (Madr) 2022;56:64-73.
11. Kiel J, Kaiser K. Tarsal tunnel syndrome; 2024. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2026.
12. Hong CH, Lee HS, Lee WS, Kim HK, Won SH, Yeo ED, et al. Tarsal tunnel syndrome caused by posterior facet talocalcaneal coalition: A case report. Med (Baltimore) 2020;99:e20893.
13. Ferkel E, Davis WH, Ellington JK. Entrapment neuropathies of the foot and ankle. Clin Sports Med 2015;34:791-801.
14. Tedeschi R. Baxter’s nerve: The hidden culprit of chronic heel pain. Neurol Sci 2025;46:4685-9.
15. Recht MP, Groof P, Ilaslan H, Recht HS, Sferra J, Donley BG. Selective atrophy of the abductor Digiti Quinti: An MRI study. AJR Am J Roentgenol 2007;189:123-7.
16. Chimutengwende-Gordon M, O’Donnell P, Cullen N, Singh D. Oedema of the abductor digiti quinti muscle due to subacute denervation: Report of two cases. Foot Ankle Surg 2014;20:e3-6.
17. Chundru U, Liebeskind A, Seidelmann F, Fogel J, Franklin P, Beltran J. Plantar fasciitis and calcaneal spur formation are associated with abductor Digiti Minimi atrophy on MRI of the foot. Skeletal Radiol 2008;37:505-10.
18. Saad A, Kho J, Almeer G, Azzopardi C, Botchu R. Lesions of the heel fat pad. Br J Radiol 2021;94:20200648.
19. Dunn JE, Link CL, Felson DT, Crincoli MG, Keysor JJ, McKinlay JB. Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. Am J Epidemiol 2004;159:491-8.
20. Chang AH, Rasmussen SZ, Jensen AE, Sørensen T, Rathleff MS. What do we actually know about a common cause of plantar heel pain? A scoping review of heel fat pad syndrome. J Foot Ankle Res 2022;15:60.
21. Yi TI, Lee GE, Seo IS, Huh WS, Yoon TH, Kim BR. Clinical characteristics of the causes of plantar heel pain. Ann Rehabil Med 2011;35:507-13.
22. Choo YJ, Park CH, Chang MC. Rearfoot disorders and conservative treatment: A narrative review. Ann Palliat Med 2020;9:3546-52.
23. Rajivan R, Hind J, Shrestha S, Ashwood N. Delayed diagnosis of calcaneal stress fracture: A case report. Cureus 2025;17:e83161.
24. Yan L, Zong J, Chu J, Wang W, Li M, Wang X, et al. Primary tumours of the calcaneus. Oncol Lett 2018;15:8901-14.
25. Koumakis E, Gossec L, Elhai M, Burki V, Durnez A, Fabreguet I, et al. Heel pain in spondyloarthritis: Results of a cross-sectional study of 275 patients. Clin Exp Rheumatol 2012;30:487-91.
26. Mardani-Kivi M, Karimi Mobarakeh M, Hassanzadeh Z, Mirbolook A, Asadi K, Ettehad H, et al. Treatment outcomes of corticosteroid injection and extracorporeal shock wave therapy as two primary therapeutic methods for acute plantar fasciitis: A prospective randomized clinical trial. J Foot Ankle Surg 2015;54:1047-52.
27. Helbig K, Herbert C, Schostok T, Brown M, Thiele R. Correlations between the duration of pain and the success of shock wave therapy. Clin Orthop 2001;387:68-71.
28. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am 2018;100:251-63.
29. Wang YC, Chen SJ, Huang PJ, Huang HT, Cheng YM, Shih CL. Efficacy of different energy levels used in focused and radial extracorporeal shockwave therapy in the treatment of plantar fasciitis: A meta-analysis of randomized placebo-controlled trials. J Clin Med 2019;8:1497.
30. Andrés Toribio AM, González Rebollo AM, Tristán-Vega A, Garrosa M. Influencia de la densidad de energía de ondas de choque focalizadas en el tratamiento de la fascitis plantar. [Influence of energy density on the effectiveness of the treatment of plantar fasciitis with focused extracorporeal shock waves]. Invest Clín 2022;63:32-46.
31. Ines L, Rihab M, Sana B, Saoussen L, Mariem G, Sinene F, et al. The effectiveness of radial extracorporeal shock wave therapy (rESWT) in plantar fasciitis: A 12 months randomised controlled trial in a Tunisian rehabilitation department. BMC Musculoskelet Disord 2025;26:938.
32. Wheeler PC, Dudson C, Calver R. Radial extracorporeal shockwave therapy (rESWT) is not superior to “minimal-dose” rESWT for patients with chronic plantar fasciopathy; A double-blinded randomised controlled trial. Foot Ankle Surg 2022;28:1356-65.
33. Szajkowski S, Pasek J, Cieślar G. Dose escalation can enhance the therapeutic potential of radial extracorporeal shock-wave therapy in the treatment of plantar fasciitis in runners. Medicina (Kaunas) 2024;60:766.
34. Jenkins S, Bordes SJ. Posterior tibial artery. In: Bordes SJ Jr., Iwanaga J, Loukas M, Tubbs RS, editors. The Clinical Anatomy of the Vascular System. Cham: Springer; 2025.
35. Rompe JD, Meurer A, Nafe B, Hofmann A, Gerdesmeyer L. 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. J Ortho Res 2005;23:931-41.
36. Yucel I, Ozturan KE, Demiraran Y, Degirmenci E, Kaynak G. Comparison of high-dose extracorporeal shockwave therapy and intralesional corticosteroid injection in the treatment of plantar fasciitis. J Am Podiatr Med Assoc 2010;100:105-10.
37. Amis J. The gastrocnemius: A new paradigm for the human foot and ankle. Foot Ankle Clin 2014;19:637-47.
38. Solan MC, Carne A, Davies MS. Gastrocnemius shortening and heel pain. Foot Ankle Clin 2014;19:719-38.
39. Monteagudo M, De Albornoz PM, Gutierrez B, Tabuenca J, Álvarez I. Plantar fasciopathy: A current concepts review. EFORT Open Rev 2018;3:485-93.
40. Burton I. Combined extracorporeal shockwave therapy and exercise for the treatment of tendinopathy: A narrative review. Sports Med Health Sci 2021;4:8-17.
41. Kobayashi R. Extracorporeal shock wave treatment and multimodal pain management for tarsal tunnel syndrome associated with plantar fasciitis. J Regen Sci 2024;4:31-4.

 

How to Cite this article: Toledo OV How to Avoid Failure | of Radial Pressure Waves and Focused Shock Waves Therapy in Plantar Heel Pain: Diagnostic, Technical, and Biomechanical Pitfalls | Journal of Regenerative Science | Jan-Jun 2026; 6(1): 27-32.

 

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Exploratory Analysis of Pain and Function Improvement after Radial Pressure Wave Therapy in Plantar Fasciitis

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Original Article | Vol 5 | Issue 1 |  January-June 2025 | page: 08-13 | Armando Tonatiuh Ávila García, Ana Lilia Villagrana Rodríguez, Cinthia Citlalli Domínguez Navarrete, Karen Chacón Morales, Marco Antonio González López

DOI: https://doi.org/10.13107/jrs.2025.v05.i01.159

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted Date: 07 Mar 2025, Review Date: 30 Apr 2025, Accepted Date: 10 May 2025 & Published: 30 Jun 2025

Author: Armando Tonatiuh Ávila García [1], Ana Lilia Villagrana Rodríguez [1], Cinthia Citlalli Domínguez Navarrete [1], Karen Chacón Morales [1], Marco Antonio González López [1]

[1] Department of Physical Medicine and Rehabilitation, Hospital Civil de Guadalajara Fray Antonio Alcalde, Jalisco, México, 44280

Address of Correspondence
Dr. Armando Tonatiuh Ávila García,
Department of Physical Medicine and Rehabilitation, Hospital Civil de Guadalajara Fray Antonio Alcalde, Coronel Calderón 777, Guadalajara, Jalisco, México, 44280
E-mail: atavila@hcg.gob.mx

Abstract
Background: Plantar fasciitis (PF) is a common cause of heel pain, impairing functionality and quality of life. Radial pressure wave therapy (RPWT) is a well-known non-invasive option to treat PF, but evidence on factors influencing outcomes is limited.
Objectives: The objectives of the study are to explore associations between baseline patient characteristics and clinical outcomes and to evaluate the impact of RPWT on pain and functionality in PF patients.
Materials and Methods: This exploratory, pilot study included 19 PF patients treated with three RPWT sessions. Pain intensity (numerical pain rating scale [NPRS]) and functionality (World Health Organization Disability Assessment Schedule 2.0 [WHODAS 2.0]) were assessed pre- and post-treatment. Retrospective data on age, body mass index (BMI), and PF chronicity were analyzed. Statistical tests included Wilcoxon signed rank for outcome comparisons and Spearman’s correlation for associations.
Results: NPRS scores decreased significantly from 6.89 ± 1.88 to 4.42 ± 2.36 (P = 0.001), while WHODAS 2.0 scores improved from 47.60 ± 21.85 to 21.34 ± 20.30 (P = 0.001). Baseline NPRS scores showed a moderate, positive correlation with post-treatment NPRS scores (ρ = 0.561, P = 0.01). No significant correlations were found between post-treatment outcomes and BMI, age, or PF chronicity.
Conclusion: RPWT significantly reduced pain and improved functionality in PF patients, with baseline pain levels emerging as a factor associated with outcomes. These preliminary findings support RPWT as a promising treatment and highlight the need for larger, controlled studies to validate and expand these results.
Keywords: Pain intensity, Plantar fasciitis, Radial pressure wave therapy, Rehabilitation outcomes, Therapeutic effectiveness, Treatment predictors

References:

1. Rhim HC, Kwon J, Park J, Borg-Stein J, Tenforde AS. A systematic review of systematic reviews on the epidemiology, evaluation, and treatment of plantar fasciitis. Life (Basel) 2021;11:1287.
2. Sezaki Y, Ikeda N, Toyoshima S, Aoki A, Fukaya T, Yokoi Y, et al. Analgesic effect and efficacy rate of radial extracorporeal shock wave therapy for plantar fasciitis: A retrospective study. J Phys Ther Sci 2024;36:537-541. Erratum in: J Phys Ther Sci 2024;36:684.
3. Elía Martínez JM, Schmitt J, Tenías Burillo JM, Valero Inigo JC, Sánchez Ponce G, Peñalver Barrios L, García Fenollosa M, et al. Comparación de la terapia de ondas de choque extracorpóreas focales y presión radiales en la fascitis plantar [Comparison between extracorporeal shockwave therapy and radial pressure wave therapy in plantar fasciitis]. Rehabilitacion (Madr) 2020;54:11-8.
4. Salvioli S, Guidi M, Marcotulli G. The effectiveness of conservative, non-pharmacological treatment, of plantar heel pain: A systematic review with meta-analysis. Foot (Edinb) 2017;33:57-67.
5. Hedrick MR. The plantar aponeurosis. Foot Ankle Int 1996;17:646-9.
6. Simplicio CL, Purita J, Murrell W, Santos GS, Dos Santos RG, Lana JF. Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine. J Clin Orthop Trauma 2020;11 Suppl 3:S309-18.
7. Zare Bidoki M, Vafaeei Nasab MR, Khatibi Aghda A. Comparison of high-intensity laser therapy with extracorporeal shock wave therapy in the treatment of patients with plantar fasciitis: A double-blind randomized clinical trial. Iran J Med Sci 2024;49:147-55.
8. Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res 2012;7:11.
9. Auersperg V, Trieb K. Extracorporeal shock wave therapy: An update. EFORT Open Rev 2020;5:584-92.
10. De la Corte-Rodríguez H, Román-Belmonte JM, Rodríguez-Damiani BA, Vázquez-Sasot A, Rodríguez-Merchán EC. Extracorporeal shock wave therapy for the treatment of musculoskeletal pain: A narrative review. Healthcare (Basel) 2023;11:2830.
11. Speed C. A systematic review of shockwave therapies in soft tissue conditions: Focusing on the evidence. Br J Sports Med 2014;48:1538-42.
12. Lee JY, Yoon K, Yi Y, Park CH, Lee JS, Seo KH, et al. Long-term outcome and factors affecting prognosis of extracorporeal shockwave therapy for chronic refractory achilles tendinopathy. Ann Rehabil Med 2017;41:42-50.
13. Guimarães JS, Arcanjo FL, Leporace G, Metsavaht LF, Conceição CS, Moreno MV, et al. Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis. Clin Rehabil 2023;37:727-46.
14. Charles R, Fang L, Zhu R, Wang J. The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: A systematic review and meta-analysis. Front Immunol 2023;14:1193835.
15. Schuitema D, Greve C, Postema K, Dekker R, Hijmans JM. Effectiveness of mechanical treatment for plantar fasciitis: A systematic review. J Sport Rehabil 2019;29:657-74.
16. Melese H, Alamer A, Getie K, Nigussie F, Ayhualem S. Extracorporeal shock wave therapy on pain and foot functions in subjects with chronic plantar fasciitis: Systematic review of randomized controlled trials. Disabil Rehabil 2022;44:5007-14.
17. Notarnicola A, Maccagnano G, Tafuri S, Fiore A, Margiotta C, Pesce V, et al. Prognostic factors of extracorporeal shock wave therapy for tendinopathies. Musculoskelet Surg 2016;100:53-61.
18. Li H, Xiong Y, Zhou W, Liu Y, Liu J, Xue H, et al. Shock-wave therapy improved outcome with plantar fasciitis: A meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg 2019;139:1763-70.
19. Vahdatpour B, Sajadieh S, Bateni V, Karami M, Sajjadieh H. Extracorporeal shock wave therapy in patients with plantar fasciitis. A randomized, placebo-controlled trial with ultrasonographic and subjective outcome assessments. J Res Med Sci 2012;17:834-8.
20. Lai TW, Ma HL, Lee MS, Chen PM, Ku MC. Ultrasonography and clinical outcome comparison of extracorporeal shock wave therapy and corticosteroid injections for chronic plantar fasciitis: A randomized controlled trial. J Musculoskelet Neuronal Interact 2018;18:47-54.
21. Ulusoy A, Cerrahoglu L, Orguc S. Magnetic resonance imaging and clinical outcomes of laser therapy, ultrasound therapy, and extracorporeal shock wave therapy for treatment of plantar fasciitis: A randomized controlled trial. J Foot Ankle Surg 2017;56:762-7.
22. Tung WS, Daher M, Covarrubias O, Herber A, Gianakos AL. Extracorporeal shock wave therapy shows comparative results with other modalities for the management of plantar fasciitis: A systematic review and meta-analysis. Foot Ankle Surg 2024;31:90.
23. Yusof TN, Seow D, Vig KS. Extracorporeal shockwave therapy for foot and ankle disorders: A systematic review and meta-analysis. J Am Podiatr Med Assoc 2022;112:18-91.

How to Cite this article: Ávila García AT, Rodríguez ALV, Navarrete CCD, Morales KC, López MAG | Exploratory analysis of pain and function improvement after radial pressure wave therapy in plantar fasciitis. | Journal of Regenerative Science | Jan-Jun 2025; 5(1): 08-13.

 

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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.

References:

1. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The Role of Extracorporeal Shockwave Treatment in Musculoskeletal Disorders. J Bone Joint Surg Am. 2018 Feb 7 ; 100 (3):251-263. doi:10.2106/JBJS.17.00661.
2. Schneider HP, Baca JM, Carpenter BB, Dayton PD, Fleischer AE, Sachs BD. American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain. J Foot Ankle Surg. 2018 Mar-Apr;57(2):370-381. doi: 10.1053/j.jfas.2017.10.018.
3. Wheeler PC. Neuropathic pain may be common in chronic lower limb tendinopathy: a prospective cohort study. Br J Pain. 2017 Feb;11(1):16-22. doi: 10.1177/2049463716680560.
4. Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, Cunin G, Fermanian J, Ginies P, Grun-Overdyking A, Jafari-Schluep H, Lantéri-Minet M, Laurent B, Mick G, Serrie A, Valade D, Vicaut E. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (Dn4). Pain. 2005 Mar;114(1-2):29-36. doi: 10.1016/j.pain.2004.12.010.
5. Santos JG, Brito JO, de Andrade DC, Kaziyama VM, Ferreira KA, Souza I, Teixeira MJ, Bouhassira D, Baptista AF. Translation to Portuguese and validation of the Douleur Neuropathique 4 questionnaire. J Pain. 2010 May;11(5):484-90. doi: 10.1016/j.jpain.2009.09.014.
6. Maki M, Ikoma K, Kido M, Hara Y, Sawada K, Ohashi S, Kubo T. Magnetic resonance imaging findings of chronic plantar fasciitis before and after extracorporeal shock wave therapy. Foot (Edinb). 2017 Dec;33:25-28. doi: 10.1016/j.foot.2017.10.002.
7. Wheeler PC. Up to a quarter of patients with certain chronic recalcitrant tendinopathies may have central sensitisation: a prospective cohort of more than 300 patients. Br J Pain. 2019 Aug;13(3):137-144. doi: 10.1177/2049463718800352.
8. Colloca L, Ludman T, Bouhassira D, Baron R, Dickenson AH, Yarnitsky D, Freeman R, Truini A, Attal N, Finnerup NB, Eccleston C, Kalso E, Bennett DL, Dworkin RH, Raja SN. Neuropathic pain. Nat Rev Dis Primers. 2017 Feb 16;3:17002. doi: 10.1038/nrdp.2017.2.
9. Attal N, Cruccu G, Baron R, Haanpää M, Hansson P, Jensen TS, Nurmikko T. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010 Sep;17(9):1113-e88. doi: 10.1111/j.1468-1331.2010.02999.x.
10. Finnerup NB, Attal N, Haroutounian S, McNicol E, Baron R, Dworkin RH, Gilron I, Haanpää M, Hansson P, Jensen TS, Kamerman PR, Lund K, Moore A, Raja SN, Rice AS, Rowbotham M, Sena E, Siddall P, Smith BH, Wallace M. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015 Feb;14(2):162-73. doi: 10.1016/S1474-4422(14)70251-0.
11. Gerdesmeyer L, Frey C, Vester J, Maier M, Weil L Jr, Weil L Sr, Russlies M, Stienstra J, Scurran B, Fedder K, Diehl P, Lohrer H, Henne M, Gollwitzer H. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med. 2008 Nov;36(11):2100-9. doi: 10.1177/0363546508324176.
12. Gollwitzer H, Saxena A, DiDomenico LA, Galli L, Bouché RT, Caminear DS, Fullem B, Vester JC, Horn C, Banke IJ, Burgkart R, Gerdesmeyer L. Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am. 2015 May 6;97(9):701-8. doi: 10.2106/JBJS.M.01331.
13. Morrissey D, Cotchett M, Said J’Bari A, Prior T, Griffiths IB, Rathleff MS, Gulle H, Vicenzino B, Barton CJ. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. Br J Sports Med. 2021 Oct;55(19):1106-1118. doi: 10.1136/bjsports-2019-101970.

 

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.

References:

1. Rodríguez. Qué es la Fascia Plantar? 2015. Available from: https://lafisioterapia.net/que-es-la-fascia-plantar [Last accessed on 2021 Dec 12].
2. Buchanan BK, Kushner D. Plantar Fasciitis. Treasure Island, FL: StatPearls Publishing; 2021.
3. Monteagudo M, de Albornoz PM, Gutierrez B, Tabuenca J, Álvarez I. Plantar fasciopathy: A current concepts review. EFORT Open Rev 2018;3:485-93.
4. Pasapula C, Kiliyanpilakkil B, Khan DZ, Di Marco Barros R, Kim S, Ali AM, et al. Plantar fasciitis: Talonavicular instability/spring ligament failure as the driving force behind its histological pathogenesis. Foot (Edinb) 2021;46:101703.
5. Harutaichun P, Boonyong S, Pensri P. Differences in lower-extremity kinematics between the male military personnel with and without plantar fasciitis. Phys Ther Sport 2021;50:130-7.
6. Kirkpatrick J, Yassaie O, Mirjalili SA. The plantar calcaneal spur: A review of anatomy, histology, etiology and key associations. J Anat 2017;230:743-51.
7. Li J, Muehleman C. Anatomic relationship of heel spur to surrounding soft tissues: Greater variability than previously reported. Clin Anat 2007;20:950-5.
8. Díaz-Llopis IV. Despejando dudas sobre la fascitis plantar. XXIX Congreso de la Sociedad Valenciana de Medicina Física y Rehabilitación. Slides Presentation. Available from: https://svmefr.com/wp-content/uploads/2020/03/ISMAEL-DIAZ.pdf [Last accessed on 2021 Dec 12].
9. Forman WM, Green MA. The role of intrinsic musculature in the formation of inferior calcaneal exostoses. Clin Podiatr Med Surg 1990;7:217-23.
10. Acosta TB, Pérez YM, Tápanes SH, Cordero JE, Lottie AG, Aliaga B, et al. Bibliographic review. Rev Iberoamericana Fisiot Kinesiol 2008;11:26-31.

11. Finkenstaedt T, Siriwanarangsun P, Statum S, Biswas R, Anderson KE, Bae WC, et al. The calcaneal crescent in patients with and without plantar fasciitis: An ankle MRI study. AJR Am J Roentgenol 2018;211:1075-82.
12. Arnold MJ, Moody AL. Common running injuries: Evaluation and management. Am Fam Physician 2018;97:510-6.
13. Cotchett M, Lennecke A, Medica VG, Whittaker GA, Bonanno DR. The association between pain catastrophising and kinesiophobia with pain and function in people with plantar heel pain. Foot (Edinb) 2017;32:8-14.
14. Tschopp M, Brunner F. Diseases and overuse injuries of the lower extremities in long distance runners. Z Rheumatol 2017;76:443-50.
15. Baur D, Schwabl C, Kremser C, Taljanovic MS, Widmann G, Sconfienza LM, et al. Shear wave elastography of the plantar fascia: Comparison between patients with plantar fasciitis and healthy control subjects. J Clin Med 2021;10:2351.
16. Schillizzi G, Alviti F, D’Ercole C, Elia D, Agostini F, Mangone M, et al. Evaluation of plantar fasciopathy shear wave elastography: A comparison between patients and healthy subjects. J Ultrasound 2021;24:417-22..
17. Yucel I, Ozturan KE, Demiraran Y, Degirmenci E, Kaynak G. Comparison of high-dose extracorporeal shockwave therapy and intralesional corticosteroid injection in the treatment of plantar fasciitis. J Am Podiatr Med Assoc 2010;100:105-10.
18. Puttaswamaiah R, Chandran P. Degenerative plantar fasciitis: A review of current concepts. Foot 2007;17:3-9.
19. Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: A randomized controlled trial. JAMA 2002;288:1364-72.
20. Aqil A, Siddiqui MR, Solan M, Redfern DJ, Gulati V, Cobb JP. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Clin Orthop Relat Res 2013;471:3645-52..

21. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am 2018;100:251-63.
22. Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Medicine (Baltimore) 2017;96:e6621.
23. Chang KV, Chen SY, Chen WS, Tu YK, Chien KL. Comparative effectiveness of focused shock wave therapy of different intensity levels and radial shock wave therapy for treating plantar fasciitis: A systematic review and network meta-analysis. Arch Phys Med Rehabil 2012;93:1259-68.
24. Greve JM, Grecco MV, Santos-Silva PR. Comparison of radial shockwaves and conventional physiotherapy for treating plantar fasciitis. Clinics (Sao Paulo) 2009;64:97-103.
25. Rompe JD, Meurer A, Nafe B, Hofmann A, Gerdesmeyer L. 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. J Orthop Res 2005;23:931-41.
26. Haddad S, Yavari P, Mozafari S, Farzinnia S, Mohammadsharifi G. Platelet-rich plasma or extracorporeal shockwave therapy for plantar fasciitis. Int J Burns Trauma 2021;11:1-8.
27. Llurda-Almuzara L, Labata-Lezaun N, Meca-Rivera T, Navarro-Santana MJ, Cleland JA, Fernández-de-Las-Peñas C, et al. Is dry needling effective for the management of plantar heel pain or plantar fasciitis? An updated systematic review and meta-analysis. Pain Med 2021;22:1630-41.
28. DiGiovanni BF, Nawoczenski DA, Lintal ME, Moore EA, Murray JC, Wilding GE, et al. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. J Bone Joint Surg Am 2003;85:1270-7.
29. Avilés SG. Efectividad de las Ondas de Choque en la Fascitis Plantar. Revisión Sistemática. España: Alcalá la Real; 2017.
30. Schuitema D, Greve C, Postema K, Dekker R, Hijmans JM. Effectiveness of mechanical treatment for plantar fasciitis: A systematic review. J Sport Rehabil 2019;29:657-74.

31. Weil LS Jr., Roukis TS, Weil LS, Borrelli AH. Extracorporeal shock wave therapy for the treatment of chronic plantar fasciitis: Indications, protocol, intermediate results, and a comparison of results to fasciotomy. J Foot Ankle Surg 2002;41:166-72.
32. Maier M, Steinborn M, Schmitz C, Stäbler A, Köhler S, Pfahler M, et al. Extracorporeal shock wave application for chronic plantar fasciitis associated with heel spurs: Prediction of outcome by magnetic resonance imaging. J Rheumatol 2000;27:2455-62.

 

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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