Low-energy acoustic "shock-wave therapy" appears to be an effective treatment for heel pain due to chronic plantar fasciitis and may help patients avoid surgery.

The use of such therapy for musculoskeletal disorders is controversial, lead author and colleagues note. However, there have been some reports suggesting that it could be beneficial for patients with chronic plantar fasciitis.

Plantar fasciitis is heel pain that is usually worse first thing in the morning or after a period of inactivity; it is also often worse when walking bare foot. The pain is due to inflammation of the plantar fascia, a band of tissue that supports the bottom of the foot during walking.

As many as 6 million people may suffer from plantar fasciitis.

The investigators looked at 97 patients with chronic plantar fasciitis who were treated with one of two shock-wave regimens. All the patients had tried a number of different treatments with little success, including anti-inflammatory drugs, shock-absorbing shoe inserts, stretching exercises, night splints, casts, corticosteroid injections, physical therapy, icing, ultrasound and radiation therapy.

Patients in group I received three applications of 1,000 impulses of low-energy shock waves, while those in group II received three applications of 10 impulses. Because the shock waves are considered to be low-energy, anesthesia is unnecessary, although the treatment is unpleasant. The US Food and Drug Administration has approved a device that delivers high-energy acoustic shock waves for treating plantar fasciitis, but anesthesia is necessary for the treatment.

At 6 months, those in group I had better function and less pain than those in group II. Five years later, the differences were less pronounced, but outcomes were still better in group I.

The researchers say the difference is due to the fact that many patients in group II had, by that time, undergone surgery that led to major improvements.

At 5 years, fewer patients in group I (13%) had undergone surgery than patients in group II (58%).

Journal of Bone and Joint Surgery 2002;84-A:335-341

Dr. Mercola's Comments:

If you go to a surgeon with a problem there is a high likelihood they will offer a surgical or mechanical solution for the problem. While this shockwave therapy is certainly preferable to actually performing surgery on the heel bone to remove the "spur," there are better options. I actually suffered with this problem about fifteen years ago. My solution for it back then was to find a skilled podiatrist who could construct an good orthotic device which was molded to my foot and took most of the pressure off that I was applying during my many miles of running. However, I am now aware that there are even more elegant solutions that involve rebalancing the body’s structural system. My current favorite is NST. If you are a health care practitioner you will certainly want to consider attending our next NST training session to learn this important technique. If you suffer with this problem you can review the NST practitioner page to find someone who can help you with this technique.