Annotated Bibliography
Results of Extracorporeal Shockwave Therapy Peer Reviewed Research

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Articles addressing Success of High Energy ESWT
Summary: High-energy shockwave therapy is effective, and is more effective when compared to Low energy shockwave therapy. Substantial improvement in the symptoms occurred between 6-12 weeks after treatment and the improvement continued beyond 24 weeks. Mobility is immediate, and no side effects were reported.

Malay, D. Scot, et al. "Extracorporeal Shockwave Tehrapy Versus Placebo for the Treatment of Chronic Proximal Plantar Fasciitis: Results of a Randomized, Placebo-Controlled, Double Blinded, Multicenter Intervention Trial." The Journal of Foot & Ankle Surgery Volume 45 Number 4, July/August 2006, 196-210.
Study Type: Randomized, placebo controlled, double blinded, multicenter (OrthoSpec)
Results: 3 months success defined as > 50% improvement with a VAS score < 4cm. ESWT: 43%. Placebo: 20%. Sufficiently high energy levels > level 4 for the device tested [or > .21 mJ/mm2 (17-18 kV)] is required to have a therapeutic response.

Kudo, P, et al. "Randomized, placebo-controlled, double-blind clinical trial evaluating the treatment of plantar fasciitis with an extracoporeal shockwave therapy (ESWT) device: a North American confirmatory study.” J Orthop Res 2006 Feb;24(2):11-23.
Study Type: RCT double-blind, placebo controlled (Dornier Epos Ultra)
Results: 3 months success defined as >60% improvement on VAS. ESWT: 47%. Placebo: 23%

Hyer, C. "Evaluation of UltraSound-Guided Extracorporeal Shockwave Therapy (EST) in the treatment of Chronic Plantar Fasciitis." The Journal of Foot and Ankle Surgery. Volume 44, Number 2, March/April 2005: 137-43.
Study Type: Prospective
Results: 83% improved a statistically significant mean of 56% from baseline with a single treatment.

Norris, D "Effectiveness of Extracorporeal Shock Wave Technology in 353 Patients with Chronic Plantar Fasciitis." JAPMA Volume 95, Number 6, 2005: 517-25.
Study Type: Retrospective 353 patient post-treatment survey
Results: 76% of post-treatment surveyed patients experienced a 43% decline in pain and 66% of patients experienced a 44% increase in mobility after a single treatment.

Chen, Han-Shiang, et al. "Treatment of Painful Heel Syndrome with Shock Waves." Clinical Orthopaedics and Related Research. June 2001. No. 387, 41-46.
Study Type: Prospective Clinical Study
Results: 6 week Success: 39% (complaint free and significantly better). 12 week Success: 73% (complaint free and significantly better). 27 week Success: 87% (complaint free and significantly better). Substantial improvement in the symptoms occurred between 6-12 weeks after treatment and the improvement continued beyond 24 weeks.

Theodore, George, et al. "Extracorporeal Shock Wave Therapy for the Treatment of Plantar Fasciitis." Foot and Ankle International. May 2004. Vol. 25, No. 5, 290-297.
Study Type: Multi-center, randomized, placebo-controlled, prospective, double blind
Results: 3 month Success: 62%. 12 month Success: 94%. ESWT has several advantages over surgery: 1) Noninvasive technology without the obvious complications associated with surgery. 2) Relatively limited recovery time during which the patient may return to employment and normal activities the day following treatment. 3) Success rates comparable to surgery and even to other conventional therapies for plantar fasciitis

Gerdesmeyer, L, et al. "Extracorporeal Shock Wave Therapy for the Treatment of Chronic Calcifying Tendonitis of the Rotator Cuff." JAMA, November 19, 2003, vol 290, No. 19, 2573-2580.
Study Type: Double Blind Randomized Placebo Controlled Study
Results: 12 month Success: 94% High Energy. 45% Low Energy. 22% Placebo.
Both high-energy and low energy ESWT appeared to provide a beneficial effect on shoulder function, as well as on self-rated pain and diminished size of calcifications, compared with placebo. Furthermore, high-energy ESWT appeared to be superior to low energy ESWT.

Ko, Jih-Yang, et al. "Treatment of Lateral Epicondylitis of the Elbow with Shock Waves." Clinical Orthopaedics and Related Research, June 2001 No 387, 60-67.
Study Type: Prospective Clinical Study
Results: 6 week Success: 37% (excellent or good). 12 week Success: 58% (excellent or good). 24 week Success: 73% (excellent or good).
Substantial improvement in the symptoms occurred between 6-12 weeks after treatment and the improvement continued beyond 24 weeks.

Strash, W, Perez, R. "Extracorporeal Shockwave Therapy for Chronic Proximal Plantar Fasciitis." Clinics in Podiatric Medicine and Surgery, 19 (2002) 467-476.
Study Type: Retrospective Study
Results: High Energy 12 month Success: 80-90%


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