Assessment of the Efficacy of Extracorporeal Shockwave Therapy for Plantar Fasciitis with Magnetic Resonance Imaging Findings

J Am Podiatr Med Assoc. 2018 Mar;108(2):100-105. doi: 10.7547/15-106.


Background: Extracorporeal shockwave therapy (ESWT) has recently been used as a new treatment modality for plantar fasciitis. We aimed to determine the efficacy of ESWT by magnetic resonance imaging (MRI) findings.

Methods: Thirty patients with plantar fasciitis who had received no treatment for 6 months were included. Extracorporeal shockwave therapy was applied once a week for a total of three sessions (frequency of 12-15 Hz, 2-3 bars, and 2,500 pulses). All of the patients were assessed with the visual analog scale, a 6-point evaluation scale, the Foot and Ankle Outcome Score (FAOS), and MRI findings before and 3 months after ESWT. Visual analog scale scores were used in determining the pain level of patients in the morning, during activity, and at rest. Foot and ankle-related problems were evaluated with the FAOS.

Results: The duration of painless walking according to the 6-point rating scale, the FAOS, and pain showed significant improvements after ESWT ( P < .05). Significant decreases in MRI findings, including thickening of the plantar fascia, soft-tissue edema, and bone marrow edema, were observed after treatment ( P < .05).

Conclusions: Extracorporeal shockwave therapy is a safe and effective treatment that yields favorable results in improvement of pain and function for plantar fasciitis. An MRI is useful for determining response to ESWT for these patients.

MeSH terms

  • Adult
  • Extracorporeal Shockwave Therapy / methods*
  • Fasciitis, Plantar / diagnostic imaging
  • Fasciitis, Plantar / therapy*
  • Female
  • Foot / diagnostic imaging
  • Foot / pathology
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Pain / etiology
  • Pain Management / methods*
  • Treatment Outcome
  • Visual Analog Scale