High-Intensity Laser Therapy Versus Extracorporeal Shockwave Therapy for Plantar Fasciitis: A Systematic Review and...

Area of Science:

• Musculoskeletal Disorders
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Plantar fasciitis is a common cause of heel pain and reduced mobility.
• Both high-intensity laser therapy (HILT) and extracorporeal shockwave therapy (ESWT) are used for plantar fasciitis treatment.
• Direct comparative evidence on the efficacy of HILT versus ESWT for plantar fasciitis is limited.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials (RCTs) comparing HILT and ESWT for plantar fasciitis.
• To evaluate the comparative effects of HILT and ESWT on pain intensity and foot function.

Main Methods:

• Searched major databases (PubMed, Cochrane, EMBASE, Scopus) for relevant RCTs up to July 2025.
• Extracted data and assessed study quality using the PEDro scale; evaluated evidence certainty with GRADE.
• Performed meta-analysis using standardized mean differences (SMDs) and random-effects models, assessing heterogeneity with the I² test.

Main Results:

• Five RCTs involving 236 participants were included.
• No significant differences in pain reduction (VAS) were found between HILT and ESWT at any follow-up.
• ESWT showed a significant short-term advantage in foot function (FFI) after sensitivity analysis and a medium-term advantage, though effect sizes were small.

Conclusions:

• Current evidence suggests no significant difference in pain relief between HILT and ESWT for plantar fasciitis.
• ESWT may provide a slight functional improvement over HILT in the short to medium term.
• Further high-quality RCTs with standardized protocols are necessary to confirm comparative efficacy due to limited data and heterogeneity.