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Updated: Jun 13, 2026
A Treatment Protocol for Achilles Tendinopathy with Extracorporeal Shockwave Therapy
Published on: August 2, 2024
Chronic plantar fasciitis treated with two sessions of radial extracorporeal shock wave therapy
Mahmoud I Ibrahim1, Robert A Donatelli, Christoph Schmitz
1Rocky Mountain University of Health Professions, Orthopeadic, Brooklyn, NY 11228, USA. msrt78@aol.com
Background:
Radial extracorporeal shock wave therapy (RSWT) has been previously demonstrated as an efficient treatment option for chronic plantar fasciitis (PF) when administered in three sessions. The present study tested the hypothesis that chronic PF can also be treated successfully with RSWT when only two treatment sessions are performed.
Materials And Methods:
A total of 50 patients with unilateral, chronic PF were randomly assigned to either RSWT (n = 25) or placebo treatment (n = 25). RSWT was applied in two sessions 1 week apart (2,000 impulses with energy flux density = 0.16 mJ/mm(2) per session). Placebo treatment was performed with a clasp on the heel. Endpoints were changes in the Visual Analog Scale (VAS) score and the modified Roles & Maudsley (RM) score from baseline to 4 weeks, 12 weeks and 24 weeks followup.
Results:
Mean VAS scores were reduced after RSWT from 8.5 +/- 0.3 (mean +/- SEM) at baseline to 0.6 +/- 1.5 at 4 weeks, 1.1 +/- 0.3 at 12 weeks and 0.5 +/- 0.1 at 24 weeks from baseline. Similar changes were found for mean RM scores from baseline after RSWT but were not observed after placebo treatment. Statistical analysis demonstrated that RSWT resulted in significantly reduced mean VAS scores and mean RM scores at all followup intervals compared to placebo treatment (each with p < 0.001). No serious adverse events of RSWT were observed.
Conclusion:
RSWT was successful in the treatment of chronic PF even when only two sessions with 2,000 impulses each were performed 1 week apart.
