Institutional Review Board, Hospital for Special Surgery
May 20, 2021
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Steve B. Behrens, MD
Sean Matsuwaka, MD
Deirdre Rodericks, MD
Jennifer Cheng, PhD
Inflammation of the plantar fascia is known as plantar fasciitis. Extracorporeal shockwave therapy is a non-invasive treatment that recently has shown promise in treatment of plantar fasciitis. There are two types - radial and focused shockwave therapy. These treatments have different mechanisms, with focused therapy creating deeper-penetrating, higher-energy shockwaves, while radial therapy produces more superficial shockwaves that can treat a wider area of pathology. In this study we will treat patients with plantar fasciitis for longer than 3 months with current conservative standard of care: calf and plantar fascia stretching as well as use of gel heel cups for 1 month. Patients who have no relief will then be randomized to get radial or focused shockwave therapy. Shockwave treatments will be done at the maximal point of tenderness on their heels once a week for 4 weeks (total of 4 treatments). The patients in each of the 3 groups will then take surveys to assess VAS pain, functional outcomes, complications, and satisfaction at 1 month, 3 months, 6 months, and 1 year. The goal of this study is to compare the effectiveness of current conservative treatment vs radial shockwave therapy vs focused shockwave therapy in alleviating patients' pain. A total of 104 patients will be enrolled.
1. Ages 18+
2. Clinical diagnosis of chronic plantar fasciitis (>3 months) that has not responded to other treatments
3. Minimum VAS pain of 40/100 (4/10) => morning pain when taking first steps, pain after prolonged walking/standing
1. Cortisone injection within the past 3 months
2. Platelet-rich plasma injection within the past 6 months
3. History of previous foot-related injury
4. Previous foot surgery
5. Bilateral heel pain
6. Coagulopathies or use of anti-coagulants
7. Local and systemic neurologic or vascular insufficiencies
8. Rheumatologic disorders
9. Systemic inflammatory disorders
10. Active or chronic infection in the area
11. Lower extremity bone disorders (e.g., Paget's, osteomyelitis)
12. Calcaneal fractures
13. Nerve entrapment
14. Ruptures in tendon
15. Non-English speaking
Kristina Quirolgico, MD