Annotated Bibliography
Results of Extracorporeal Shockwave Therapy Peer Reviewed Research

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Articles addressing Predictive Success of ESWT based upon duration of condition
Summary: Traditional conservative methods of treating plantar fasciitis (e.g. Orthotics, physical therapy, modification of shoes, NSAIDS, steroid injections etc) should be prescribed first. Following failure of conservative methods and continued duration of symptoms, indicating a chronic condition versus an acute condition, ESWT appears to have greater success.

Alvarez RG, Ogden JA, Jaakkola J, Cross GL. "Symptom Duration of Plantar Fasciitis and the Effectiveness of Orthotripsy." Foot & Ankle International. 24(12): 916-921, 2003.
Study Type: Randomized prospective study with Cross over
Results: Randomized prospective study with cross over demonstrated that the longevity of symptoms of chronic proximal plantar fasciopathy had a minimal effect on the likelihood of a positive response to high-dose shock wave therapy. Even patients who had had symptoms for 15 plus years could have complete symptom relief.

Helbig, K., et al. "Correlations Between the Duration of pain and the Success of Shock Wave Therapy." Clinical Orthopaedics and Related Research, June 2001, No.387, 68-71.
Study Type: Retrospective Study
Results: Shock wave treatment is more successful for the chronic condition than for the more recent acute complaint.


ESWT Literature Review Article
Summary: Shock wave therapy is safe and effective. Shock wave therapy should be considered before invasive surgery.

Younger, Alastair. "Shock Wave Therapy for Treatment of Foot and Ankle Conditions." Techniques in Foot and Ankle Surgery; 5(1): 60-65, 2006.
Study Type: Review
Conclusion: Outcome studies in general have supported a positive outcome. Shock wave therapy should be offered as a second line of treatment to patients with plantar fasciitis, possibly before steroid injection, as the complication rates may be lower and the therapeutic effect higher. Shock wave therapy may have better outcomes than surgery for plantar fasciitis.

Ogden, John A., et al. "Shockwave Therapy for Chronic Proximal Plantar Fasciitis: A Meta Analysis." Foot & Ankle International; Vol. 23, No. 4/ April 2002.
Study Type: Meta Analysis
Conclusion: Directed application of shockwaves to the enthesis of the plantar fascia at the inferior calcaneus is a safe and effective non-surgical method for treating chronic, recalcitrant heel pain syndrome that has been refractory to other commonly used non-operative therapies. The results suggest that this therapeutic procedure should be considered before any surgical intervention, and may be preferable prior to cortisone injection, which has a recognized risk of rupture of the plantar fascia and a frequent recurrence of symptoms.

Sems, A, Dimeff, R, and Iannotti, J. "Extracorporeal Shockwave Therapy in the Treatment of Chronic Tendonopathies." JAAOS; 14(4): 195-204.
Study Type: Review
Conclusion: There is sufficient information to conclude that shockwave therapy is an appropriate treatment, in the right circumstances, for calcific tendonosis and plantar fasciitis that have failed non-surgical management.

Chung, B, Wiley, J. Preston. "Extracorporeal Shockwave Therapy, A Review." Sports Medicine; 32(13): 851-865.
Study Type: Review article of 48 published articles, reviewing shoulder, elbow and heel applications.
Conclusion: There is an increasing body of literature that suggests that ESWT can be an effective therapy for patients who have had repeated conservative treatment failures ESWT is effective. No reports of significant adverse effects. Highest strength of evidence coming from randomized controlled studies.


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