SLR - July 2014 - Mohamed Saleh

Extracorporeal Shock wave Therapy of Gastroc-Soleus Trigger Points in Patients with Plantar Fasciitis: A Randomized, Placebo-Controlled Trial

Reference: Moghtaderi A, Khosrawi S, Dehghan F. Extracorporeal Shock Wave Therapy of Ggastroc-Soleus Trigger Points in Patients with Plantar Fasciitis: A Randomized, Placebo-Controlled Trial.  Adv Biomed Res. 2014 Mar 25; 3: 99.

Scientific Literature Review

Reviewed By: Mohamed A Saleh DPM
Residency Program
: Pinnacle Health Podiatric Residency Program

Podiatric Relevance: Heel pain secondary to plantar fasciitis is one of the most common problems that podiatric physicians treat. There are many different treatments for this common problem such as injections, taping, gait training, and stretching exercises. Extracoroporeal Shock Wave Therapy (ESWT) has been shown to be effective in treating plantar heel pain. However, there is relatively little known about ESWT and its effect on the gastro-soleus trigger point and its treatment of plantar fasciitis. The purpose of this study was to evaluate the effectiveness by comparing the utilization of ESWT of the gastroc-soleus trigger points and heel region with the ESWT of the heel region alone for the treatment of plantar fasciitis.

Methods: A placebo-controlled randomized trial between March 2012 and November 2012 was performed. The group consisted of 40 individuals who were previously diagnosed with plantar fasciitis, which had at least one gastroc-soleus trigger point concomitantly and did not respond to previous conservative measurements between the ages of 20 - 60. Patients that were excluded were people with a history of tumors, arthritis, had a previous injection within the last 12 weeks, or previous surgery on the heel. The 40 included patients were divided evenly between the experimental group, who received ESWT for the heel region and for the gastroc-soleus trigger points, and the control group who received ESWT only for the heel region. The Visual Analog score and the modified Roles and Maudsley score were used before the first session and eight weeks after the last session to assess for pain. Patients received treatments for three sessions every week for a period of eight weeks.

Results: The patients from both the control and case groups had similar VAS, Roles and Maudsley baseline pain scores prior to the beginning of treatment. Gender did not affect the baseline either. After eight weeks of treatment, both the control and case group had decreased pain in the plantar fascia. The results showed that the treatment significantly improved pain but was better in the experimental group.

Conclusions:  This study provides interesting and unique information with respect to evaluation and treatment of calf trigger points and their associated with chronic plantar fasciitis.

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