Extracorporeal Shockwave Therapy: Hope Or Hype?

Start Page: 46
Extracorporeal Shockwave Therapy: Hope Or Hype?
54
Author(s): 
By Lowell Scott Weil, Jr., DPM, MBA; By Patrick A. DeHeer, DPM, with Stephen M. Offutt, DPM, Gary A. Trent, DPM, and Michael J. Baker, DPM

Final Notes
So what is the bottom line with ESWT? If I had chronic, unresponsive heel pain and I chose ESWT, several conditions would have to be met prior to my consent to having the procedure. First, I would have had to undergone adequate conservative treatment for at least six months. Second, Baxter’s neuritis would have to have been ruled out. Third, I would have to accept the fact that no one knows how or why the procedure works and what the long-term success and recurrence rates are. Finally, I would have to have a clear understanding that this is not an entirely benign procedure without potential complications. My patients deserve the same consideration that I would warrant and so should yours.

Dr. DeHeer is a Fellow of the American College of Foot and Ankle Surgeons and is a Diplomate of the American Board of Podiatric Surgery. He is also the team podiatrist for the Indiana Pacers and the Indiana Fever.

Dr. Offutt is a second-year resident at Winona Memorial Hospital in Indianapolis, Ind. Dr. Baker works out of the Wound Care Center at the aforementioned institution and is also in private practice in Indianapolis, Ind. Dr. Trent is in private practice in Park Ridge, Ill.

References

1. Baxter DE, Thigpen CM. Heel pain-operative results. Foot and Ankle. 5: 16-25, 1984.

2. Boddeker IR, Schafer H, Haake M. Extracorporeal shockwave therapy (ESWT) in the treatment of plantar fasciitis - A Biomaterial Review. Clin Rhem. 20: 324-330, 2001.

3. Buchbinder R, Ptasznik R, Gordon J, Buchanaan J, Prabaharan V, Forbes A. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis. JAMA 288(11): 1364- 1372, 2002.

4. Chen HS, Chen,LM, Huang TW. Treatment of painful heel syndrome with shock waves. Clin Ortho Related Research. 387: 41-46, 2001.

5. Cosentino, R, Falsetti P, Manca S, De Stefano R, Frati E, Frediana B, Baldi F, Selvi E, Marcolongo R. Efficacy of extracorporeal shock wave treatment in Calcaneal enthesophytosis. Ann Rheum Dis. 60: 1064-1067, 2001.

6. Maier M, Steinborn M, Schmitz C, Stabler A, Kohler S, Pfahler M, Durr HR, Refior HJ. Extracorporeal shock wave application for chronic plantar fasciitis associated with heel spurs: prediction of outcome by magnetic resonance imaging. J Rheumatol. 27: 2455-2462, 2000.

7. Ogden JA, Alvarez R, Levitt R, Cross GL, Marlow M. Shock wave therapy for chronic proximal plantar fasciitis. Clin Ortho Related Research. 387: 47-57, 2001.

8. Ogden JA, Alvarez RG, Marlow M. Shockwave therapy for chronic proximal plantar fasciitis: a meta-analysis. Foot & Ankle. 23(4): 301-307, 2002.

9. Peterson KS: Study treads on “shock wave” heel therapy; Controversial report finds no evidence treatment cuts pain. USA Today, p. D8, Sept. 18, 2002.

10. Rajkurmar P, Schmitgen GF. Shock waves do more than just crush stones: extracorporeal shock wave therapy in plantar fasciitis. Int J Clin Pract 56(10): 735-737, 2002.

11. Rompe JD, Schoellner MD, Nafe B. Evaluation of low-energy extracorporeal shock-wave application for treatment of chronic plantar fasciitis. JBJS. 84A(3): 335-341, 2002.

12. Weil Jr. LS, Roukis TS, Weil Sr. 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. 41(3): 166-172, 2002.

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